Adorable baby girl sleeping in co-sleeper crib attached to parents' bed. Little child having a day nap in cot. Sleep training concept. Infant kid in sunny nursery
A 3-year-old boy is struck by a car moving at high speed and presents to the emergency department with neck pain. If there is suspicion that he has sustained an atlanto-occipital dislocation, which of the following methods is preferred to immobilize his neck?
Apply the smallest adult-sized C-spine collar available
The preferred immobilization is sandbags/blocks around the head to immobilize the neck. An adult C-spine collar would likely distract the neck, worsening a presumed atlanto-occipital dislocation.
Apply gentle manual traction along the axis of the C-spine
The preferred immobilization is sandbags/blocks around the head to immobilize the neck. Applying in-line traction would distract the neck, worsening a presumed atlanto-occipital dislocation.
Place the child on an adult spine board
The preferred immobilization is sandbags/blocks around the head to immobilize the neck. An adult spine board will often cause neck flexion since the child’s head is relatively larger compared with the child’s body.
Apply sandbags/blocks to sides of head and tape them in place
The preferred immobilization is sandbags/blocks around the head to immobilize the neck, with a cutout in the transport board to prevent excessive neck flexion for a child.
