Prehospital Emergency Care, Vol. 16, No. 4, Pages 513-518 

The purpose of this study was to describe potential adverse effects associated with spinal immobilisation following trauma among children seen at St. Louis Children’s Hospital.  Children were eligible if they underwent spinal immobilisation prior to physician evaluation or if they met the American College of Surgeons (ACS) guidelines for spinal immobilisation but were not immobilised. The children who were immobilised were compared with those who were not immobilised for self-reported pain, use of radiography to evaluate the cervical spine, ED length of stay, and ED disposition.

One hundred seventy-three spine-immobilised children and 112 children who met ACS criteria but were not immobilised were enrolled. There were differences between the two study groups, which included age, mechanism of injury, and proportion transported by emergency medical services. However, the comparison groups had comparable Pediatric Trauma Scores (PTSs) and Glasgow Coma Scale scores (GCSs). Immobilised children had a higher median pain score (3 versus 2) and were more likely to undergo cervical radiography (56.6% versus 13.4%) and be admitted to the hospital (41.6% versus 14.3%).

The authors concluded that despite presenting with comparable PTSs and GCSs, children who underwent spinal immobilisation following trauma had a higher degree of self-reported pain, and were much more likely to undergo radiographic cervical spine clearance and be admitted to the hospital than those who were not immobilised, however, future studies are required to determine whether these differences are related to spinal immobilisation or differences in the mechanisms of injury, injury patterns, or other variables.

http://informahealthcare.com/doi/abs/10.3109/10903127.2012.689925