Background: Pediatric cervical spine clearance guidelines should reduce computed tomography (CT) usage in combined pediatric and adult trauma centers biased by adult CT clearance.
Methods: Cervical spine clearance under age 15 years was compared 12 months before (128 patients) and after (105 patients) guideline implementation, emphasizing National Emergency X-Radiography Utilization Study (NEXUS) criteria when appropriate.
Results: CT scans in patients clearable by NEXUS criteria decreased 23% (p = 0.01) and decreased by 16% in cases where radiography other than CT was indicated by guidelines (p = 0.01).
Conclusion: Guideline implementation can have an immediate effect in decreasing pediatric cervical spine CT usage and should improve across time.
Level of evidence: Care management study, level IV.