PECARN Cervical Spine Injury Prediction Rule

• Always consider using the tool in conjunction with other clinical factors; it is meant to assist, not replace, clinical decision-making.
• The original study notes that MRI may be required to clarify cases with a high pretest probability for cervical spine injury, although providing direct guidance was beyond the scope of that study.

• Cervical spine protection (cervical collar or other immobilization) should be maintained in children presenting with significant traumatic injuries until evaluated by a qualified physician.
• Do not withhold adequate analgesia in injured children to “preserve” a future neurologic examination.

Children have a higher rate of “SCIWORA” (spinal cord injury without radiographic abnormality) than adults; if spinal cord injury is suspected, expert consultation with a pediatric trauma surgeon and/or pediatric neurosurgeon or spinal surgeon is recommended.