PECARN C-Spine Rule

Cervical spine injuries are serious but uncommon (<1%) in childrens. NEXSUS and Canadian C-Spine Rule have good sensitivity in adults but they are not well validated in childrens. 

Pediatric Emergency Care Applied Research Network (PECARN) did a multientric prospective observational study of 22,430 childrens with blunt trauma to develop a robust pediatric Cervical Spine Injury (CSI) prediction rule that can be incorporated into an algorithm to guide radiographic screening of children for CSI in ED. 

Study derived a validated CSI prediction rule with >92% sensitivity. Study found that GCS of 3-8, AVPU Score : Unresponsive, Abnormal airway, breathing or circulation findings and focal neurologic deficits were assosciated with high CSI risk. Study found that GCS of 9-14, AVPU score : V or P , substanial head injury, torso injury , midline tenderness is associated with CSI. 

Study also found that CT and plain radiography use would have been decreased from 17.2% to 6.9% and 39.7% to 34.2% respectively.