Nypaver M, Treloar D
Division of Pediatric Emergency Medicine, Henry Ford Hospital, Detroit, Michigan.
Ann Emerg Med. 1994 Feb;23(2):208-11. doi: 10.1016/s0196-0644(94)70032-x.
To determine the height of back elevation required to place the cervical spine of children less than 8 years old in neutral position and whether agreement on the height required for neutral position could be reached by two independent observers.
Prospective.
Pediatric emergency department and outpatient clinics.
Convenience sample of children less than 8 years old.
Independent placement of children in neutral position by two observers using standard sized padding with or without shims to raise the back off a backboard.
All children required elevation of the back for correct neutral position (mean height, 25.4 +/- 6.7 mm; range, 5 to 41 mm). Children less than 4 years old required more elevation than those > or = 4 years old (27 +/- 7.2 vs 22 +/- 4.2 mm, P < .05). Independent observer measurements were similar (mean, 25 +/- 8.0 vs 25.7 +/- 6.8 mm; interobserver kappa = .56).
Children less than 8 years old require back elevation to achieve neutral position while lying supine on a backboard. Also, independent observers can agree on what constitutes neutral position in most children.
确定将8岁以下儿童颈椎置于中立位所需的背部抬高高度，以及两名独立观察者能否就中立位所需高度达成一致。
前瞻性研究。
儿科急诊科和门诊。
8岁以下儿童的便利样本。
两名观察者使用标准尺寸的衬垫，有或没有垫片来抬高背板上的背部，将儿童独立置于中立位。
所有儿童均需要抬高背部以达到正确的中立位（平均高度，25.4±6.7毫米；范围，5至41毫米）。4岁以下儿童比4岁及以上儿童需要更多的抬高（27±7.2对22±4.2毫米，P<.05）。独立观察者的测量结果相似（平均，25±8.0对25.7±6.8毫米；观察者间kappa系数=.56）。
8岁以下儿童在背板上仰卧时需要抬高背部以达到中立位。此外，独立观察者在大多数儿童中能够就中立位的构成达成一致。
