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An 8-year-old child falls from a 15-foot retaining wall and is found unconscious by emergency personnel. Which of the following is the most appropriate form of cervical stabilization in the acute setting?
Utilize adult spine board with modification of a one inch sandbag under the patient's head
Maintaining in-line cervical stabilization with the external auditory meatus posterior to the shoulders
Maintaining in-line cervical stabilization with the external auditory meatus anterior to the shoulders
Halo immobilization with 8 to 12 low insertion torque pins
Maintaining in-line cervical stabilization with the external auditory meatus in-line with the shoulders
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Cervical spine injuries should be immobilized in a postion of relative extension in both children and adults. Applying cervical traction with the external auditory meatus in-line with the shoulders can serve as a guideline.
Herzenberg et al. found that because of relatively large head size in children, an adult backboard can force a childs' cervical spine into a position of flexion. This might have catastrophic results and lead to spinal cord injury. Therefore, they recommend that pediatric backboards, or modified adult backboards, should be used in pediatric cervical injuries.
Herzenberg JE, Hensinger RN, Dedrick DK, Phillips WA
J Bone Joint Surg Am. 1989 Jan;71(1):15-22. PMID: 2912996 (Link to Abstract)
Herzenberg, JBJS 1989
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