Characteristics of Children With CSI Whose ED Provider Did Not Report One of the Risk Factors From the PECARN Model
| Age . | Mechanism of Injury on Chart Review . | Chief Complaint on Chart Review . | Examination Findings on Chart Review . | PECARN Risk Factors on Chart Review . | Diagnosis . | Treatment . |
|---|---|---|---|---|---|---|
| 5.7 y | Fall from second story (10 ft) | Back pain | Diffuse thoracic spine tenderness | None | C7 burst fracture; T2–T4 compression fractures | Brace |
| 15.3 y | ATV crash | Arrived from OSH with concern for CSI | None | Neck pain | C1 lateral mass contusion and bilateral C1–C2 alar ligament injury | Unknowna |
| 6.1 yb | Fall (10 ft) | Loss of consciousness; axial load | Signs of substantial head injury other than altered mental status | Neck pain | C1–C2 epidural hemorrhage; no fracture or ligamentous disruption | None |
| 7 wk | Fall from bed reported, suspected NAT | Loss of consciousness | Repeat episodes of unresponsiveness and limp tone | Altered mental status | C1–C4 subdural hemorrhage; no fracture or ligamentous disruption | None |
| 6 mo | NAT | Arrived from OSH with concern for substantial head injury | Irritable; signs of substantial head injury; palpable skull fracture | Altered mental status | C7–T2 compression deformities with associated C7–T1 ligamentous injury | None |
| 8.3 y | MVC >55 MPH | Arrived by EMS with concern for substantial head injury | GCS 14 at scene; persistent somnolence and confusion; tenderness to neck palpation; sixth nerve palsy | Altered mental status; focal neurologic deficit | C2 ventral subdural hematoma | None |
| 3.8 y | Fall from bench hitting head on a table | Transferred with concern for CSI; complained of neck pain and holding neck | Occipital laceration; tenderness to palpation of the posterior midline neck | Neck pain | C1 posterior synchondrosis fracture | Rigid cervical collar |
| Age . | Mechanism of Injury on Chart Review . | Chief Complaint on Chart Review . | Examination Findings on Chart Review . | PECARN Risk Factors on Chart Review . | Diagnosis . | Treatment . |
|---|---|---|---|---|---|---|
| 5.7 y | Fall from second story (10 ft) | Back pain | Diffuse thoracic spine tenderness | None | C7 burst fracture; T2–T4 compression fractures | Brace |
| 15.3 y | ATV crash | Arrived from OSH with concern for CSI | None | Neck pain | C1 lateral mass contusion and bilateral C1–C2 alar ligament injury | Unknowna |
| 6.1 yb | Fall (10 ft) | Loss of consciousness; axial load | Signs of substantial head injury other than altered mental status | Neck pain | C1–C2 epidural hemorrhage; no fracture or ligamentous disruption | None |
| 7 wk | Fall from bed reported, suspected NAT | Loss of consciousness | Repeat episodes of unresponsiveness and limp tone | Altered mental status | C1–C4 subdural hemorrhage; no fracture or ligamentous disruption | None |
| 6 mo | NAT | Arrived from OSH with concern for substantial head injury | Irritable; signs of substantial head injury; palpable skull fracture | Altered mental status | C7–T2 compression deformities with associated C7–T1 ligamentous injury | None |
| 8.3 y | MVC >55 MPH | Arrived by EMS with concern for substantial head injury | GCS 14 at scene; persistent somnolence and confusion; tenderness to neck palpation; sixth nerve palsy | Altered mental status; focal neurologic deficit | C2 ventral subdural hematoma | None |
| 3.8 y | Fall from bench hitting head on a table | Transferred with concern for CSI; complained of neck pain and holding neck | Occipital laceration; tenderness to palpation of the posterior midline neck | Neck pain | C1 posterior synchondrosis fracture | Rigid cervical collar |
ATV, all-terrain vehicle; GCS, Glasgow Coma Scale; MPH, miles per hour; NAT, non-accidental trauma; OSH, outside hospital.
Medical record review lacks information regarding treatment rendered.
Subject not missed by de novo model due to axial load biomechanics noted by ED provider.