![]() ![]() ![]() The 316 patients kept in a cervical collar for intoxication had no missed CSIs but were kept immobilized for a mean (SD) of 12 (19) hours. Among 567 normal CT scans, 4 (0.7%) had central cord syndrome found on initial physical examination, and 1 (0.2%) had a symptomatic unstable ligament injury that was misread as normal on CT scan but was abnormal on magnetic resonance imaging. There were 65 abnormal CT scans (10.3%) in the intoxicated group. Half (316 ) were admitted with cervical spine immobilization, and 38 (12%) of these were solely owing to the presence of intoxication. Intoxication was identified in 632 of 1429 of patients tested (44.2% 425 by serum alcohol levels and 350 by urine drug screens). Vehicular (734 ) and falls (579 ) were the most common mechanisms for hospitalization. Results Of 1668 patients, 1103 (66.1%) were male, with a mean (SD) age of 49 (20) years and a mean (SD) Injury Severity Score of 10 (9). The hypotheses formed prior to data collection were that cervical CT scans are sensitive and specific enough to diagnose CSIs that require stabilization and that normal CT scans are sufficient to clear CSIs in intoxicated patients. Main Outcomes and Measures Clinically relevant CSIs requiring cervical stabilization. Physical examination and CT scan findings were evaluated for cervical spine injuries (CSI) and the incidence of missed injuries. Intoxication was determined by serum alcohol levels and urine drug screens. Objective To analyze cervical spine clearance practices and the utility of CT scans of the cervical spine in intoxicated patients with blunt trauma.ĭesign, Setting, and Participants We performed a prospective observational study of 1668 patients with blunt trauma aged 18 years and older who underwent cervical spine CT scans from March 2014 to March 2015 at an American College of Surgeons–verified Level I trauma center. Modern computed tomography (CT) technology may obviate this and allow for immediate clearance. Importance Current trauma guidelines dictate that the cervical spine should not be cleared in intoxicated patients, resulting in prolonged immobilization or additional imaging. ![]() Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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