Prehospital clinical clearance of the cervical spine: a prospective study
Physician clinical clearance of the cervical spine after blunt trauma is practiced in many trauma centers. Prehospital clinical clearance of the cervical spine (c-spine) performed by emergency medical services (EMS) personnel can decrease cost, improve patient comfort, decrease complications, and de...
Gespeichert in:
| Veröffentlicht in: | The American surgeon 2013-11, Vol.79 (11), p.1213-1217 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1217 |
|---|---|
| container_issue | 11 |
| container_start_page | 1213 |
| container_title | The American surgeon |
| container_volume | 79 |
| creator | Gonzalez, Richard P Cummings, Glenn R Baker, Jeremy A Frotan, Amin M Simmons, Jon D Brevard, Sydney B Michon, Elizabeth Harlan, Shanna M Meyers, Douglas C Rodning, Charles B |
| description | Physician clinical clearance of the cervical spine after blunt trauma is practiced in many trauma centers. Prehospital clinical clearance of the cervical spine (c-spine) performed by emergency medical services (EMS) personnel can decrease cost, improve patient comfort, decrease complications, and decrease prehospital time. The purpose of this study was to assess whether EMS personnel can effectively clinically clear the c-spine of injury in the prehospital setting. All paramedics from a single urban fire department were trained in clinical clearance of the c-spine. During the 14-month period from January 2008 through March 2009, clinical examination of the c-spine was performed by paramedics on blunt trauma patients in the prehospital setting. Paramedics immobilized the c-spine and delivered the patients to the University of South Alabama Medical Center. After trauma center arrival, paramedics documented their clinical examination of the c-spine in a computerized data collection form. Paramedic clinical findings were compared with trauma surgeon clinical examination findings and computed tomographic findings of the c-spine. All patients had prehospital Glasgow Coma Score 14 or greater. Patients were not excluded for distracting injuries. One hundred ninety-three blunt trauma patients were entered. Sixty-five (34%) c-spines were clinically cleared by EMS. There were no known missed injuries in this patient group. Eight (6%) patients who were not clinically cleared by EMS were diagnosed with c-spine injury. Trauma surgeons clinically cleared 135 (70%) of the patients with no known missed injury. EMS personnel in the prehospital setting may reliably and effectively perform clinical clearance of the c-spine. Further prospective study for prehospital c-spine clinical clearance is warranted. |
| doi_str_mv | 10.1177/000313481307901128 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1447107133</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1447107133</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-b8701861371fbf821d0d1850c8b8afec90385bee1ed936e9b9ff55328edf28533</originalsourceid><addsrcrecordid>eNplkE9PwzAMxSMEYmPwBTigSly4FOKkaVJuaOLPpElwgHOVpo7WqWtH0k7at1-6DQ5wsi3_3pP9CLkGeg8g5QOllANPFHAqMwrA1AkZgxAizhTjp2Q8APFAjMiF98swJqmAczJiCaSCpXRMZh8OF61fV52uI1NXTWX2DWqnG4NRa6NugZFBt9lvAtngY6SjtQsqNF21wch3fbm9JGdW1x6vjnVCvl6eP6dv8fz9dTZ9mseGS9HFhZIUVApcgi2sYlDSEpSgRhVKWzQZ5UoUiIBlxlPMisxaIThTWFqmBOcTcnfwDRd89-i7fFV5g3WtG2x7n0OSSKAS-IDe_kGXbe-acF2gUkYpg70hO1AmvOQd2nztqpV22xxoPgSd_w86iG6O1n2xwvJX8pMs3wEoHHbL</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1462002153</pqid></control><display><type>article</type><title>Prehospital clinical clearance of the cervical spine: a prospective study</title><source>MEDLINE</source><source>SAGE Journals Online</source><creator>Gonzalez, Richard P ; Cummings, Glenn R ; Baker, Jeremy A ; Frotan, Amin M ; Simmons, Jon D ; Brevard, Sydney B ; Michon, Elizabeth ; Harlan, Shanna M ; Meyers, Douglas C ; Rodning, Charles B</creator><creatorcontrib>Gonzalez, Richard P ; Cummings, Glenn R ; Baker, Jeremy A ; Frotan, Amin M ; Simmons, Jon D ; Brevard, Sydney B ; Michon, Elizabeth ; Harlan, Shanna M ; Meyers, Douglas C ; Rodning, Charles B</creatorcontrib><description>Physician clinical clearance of the cervical spine after blunt trauma is practiced in many trauma centers. Prehospital clinical clearance of the cervical spine (c-spine) performed by emergency medical services (EMS) personnel can decrease cost, improve patient comfort, decrease complications, and decrease prehospital time. The purpose of this study was to assess whether EMS personnel can effectively clinically clear the c-spine of injury in the prehospital setting. All paramedics from a single urban fire department were trained in clinical clearance of the c-spine. During the 14-month period from January 2008 through March 2009, clinical examination of the c-spine was performed by paramedics on blunt trauma patients in the prehospital setting. Paramedics immobilized the c-spine and delivered the patients to the University of South Alabama Medical Center. After trauma center arrival, paramedics documented their clinical examination of the c-spine in a computerized data collection form. Paramedic clinical findings were compared with trauma surgeon clinical examination findings and computed tomographic findings of the c-spine. All patients had prehospital Glasgow Coma Score 14 or greater. Patients were not excluded for distracting injuries. One hundred ninety-three blunt trauma patients were entered. Sixty-five (34%) c-spines were clinically cleared by EMS. There were no known missed injuries in this patient group. Eight (6%) patients who were not clinically cleared by EMS were diagnosed with c-spine injury. Trauma surgeons clinically cleared 135 (70%) of the patients with no known missed injury. EMS personnel in the prehospital setting may reliably and effectively perform clinical clearance of the c-spine. Further prospective study for prehospital c-spine clinical clearance is warranted.</description><identifier>ISSN: 0003-1348</identifier><identifier>EISSN: 1555-9823</identifier><identifier>DOI: 10.1177/000313481307901128</identifier><identifier>PMID: 24165260</identifier><language>eng</language><publisher>United States: SAGE PUBLICATIONS, INC</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Agreements ; Algorithms ; Cervical Vertebrae - injuries ; Clinical Competence ; Decision Trees ; Emergency Medical Services ; Emergency services ; Female ; Fire stations ; Fires ; Glasgow Coma Scale ; Hospitals ; Humans ; Male ; Middle Aged ; Morbidity ; Mortality ; Pain ; Paramedics ; Physical Examination ; Prospective Studies ; Reproducibility of Results ; Spinal Injuries - diagnosis ; Spinal Injuries - etiology ; Trauma ; Trauma centers ; Wounds, Nonpenetrating - complications ; Wounds, Nonpenetrating - diagnosis ; Young Adult</subject><ispartof>The American surgeon, 2013-11, Vol.79 (11), p.1213-1217</ispartof><rights>Copyright Southeastern Surgical Congress Nov 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-b8701861371fbf821d0d1850c8b8afec90385bee1ed936e9b9ff55328edf28533</citedby><cites>FETCH-LOGICAL-c375t-b8701861371fbf821d0d1850c8b8afec90385bee1ed936e9b9ff55328edf28533</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24165260$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gonzalez, Richard P</creatorcontrib><creatorcontrib>Cummings, Glenn R</creatorcontrib><creatorcontrib>Baker, Jeremy A</creatorcontrib><creatorcontrib>Frotan, Amin M</creatorcontrib><creatorcontrib>Simmons, Jon D</creatorcontrib><creatorcontrib>Brevard, Sydney B</creatorcontrib><creatorcontrib>Michon, Elizabeth</creatorcontrib><creatorcontrib>Harlan, Shanna M</creatorcontrib><creatorcontrib>Meyers, Douglas C</creatorcontrib><creatorcontrib>Rodning, Charles B</creatorcontrib><title>Prehospital clinical clearance of the cervical spine: a prospective study</title><title>The American surgeon</title><addtitle>Am Surg</addtitle><description>Physician clinical clearance of the cervical spine after blunt trauma is practiced in many trauma centers. Prehospital clinical clearance of the cervical spine (c-spine) performed by emergency medical services (EMS) personnel can decrease cost, improve patient comfort, decrease complications, and decrease prehospital time. The purpose of this study was to assess whether EMS personnel can effectively clinically clear the c-spine of injury in the prehospital setting. All paramedics from a single urban fire department were trained in clinical clearance of the c-spine. During the 14-month period from January 2008 through March 2009, clinical examination of the c-spine was performed by paramedics on blunt trauma patients in the prehospital setting. Paramedics immobilized the c-spine and delivered the patients to the University of South Alabama Medical Center. After trauma center arrival, paramedics documented their clinical examination of the c-spine in a computerized data collection form. Paramedic clinical findings were compared with trauma surgeon clinical examination findings and computed tomographic findings of the c-spine. All patients had prehospital Glasgow Coma Score 14 or greater. Patients were not excluded for distracting injuries. One hundred ninety-three blunt trauma patients were entered. Sixty-five (34%) c-spines were clinically cleared by EMS. There were no known missed injuries in this patient group. Eight (6%) patients who were not clinically cleared by EMS were diagnosed with c-spine injury. Trauma surgeons clinically cleared 135 (70%) of the patients with no known missed injury. EMS personnel in the prehospital setting may reliably and effectively perform clinical clearance of the c-spine. Further prospective study for prehospital c-spine clinical clearance is warranted.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Agreements</subject><subject>Algorithms</subject><subject>Cervical Vertebrae - injuries</subject><subject>Clinical Competence</subject><subject>Decision Trees</subject><subject>Emergency Medical Services</subject><subject>Emergency services</subject><subject>Female</subject><subject>Fire stations</subject><subject>Fires</subject><subject>Glasgow Coma Scale</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Pain</subject><subject>Paramedics</subject><subject>Physical Examination</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>Spinal Injuries - diagnosis</subject><subject>Spinal Injuries - etiology</subject><subject>Trauma</subject><subject>Trauma centers</subject><subject>Wounds, Nonpenetrating - complications</subject><subject>Wounds, Nonpenetrating - diagnosis</subject><subject>Young Adult</subject><issn>0003-1348</issn><issn>1555-9823</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNplkE9PwzAMxSMEYmPwBTigSly4FOKkaVJuaOLPpElwgHOVpo7WqWtH0k7at1-6DQ5wsi3_3pP9CLkGeg8g5QOllANPFHAqMwrA1AkZgxAizhTjp2Q8APFAjMiF98swJqmAczJiCaSCpXRMZh8OF61fV52uI1NXTWX2DWqnG4NRa6NugZFBt9lvAtngY6SjtQsqNF21wch3fbm9JGdW1x6vjnVCvl6eP6dv8fz9dTZ9mseGS9HFhZIUVApcgi2sYlDSEpSgRhVKWzQZ5UoUiIBlxlPMisxaIThTWFqmBOcTcnfwDRd89-i7fFV5g3WtG2x7n0OSSKAS-IDe_kGXbe-acF2gUkYpg70hO1AmvOQd2nztqpV22xxoPgSd_w86iG6O1n2xwvJX8pMs3wEoHHbL</recordid><startdate>201311</startdate><enddate>201311</enddate><creator>Gonzalez, Richard P</creator><creator>Cummings, Glenn R</creator><creator>Baker, Jeremy A</creator><creator>Frotan, Amin M</creator><creator>Simmons, Jon D</creator><creator>Brevard, Sydney B</creator><creator>Michon, Elizabeth</creator><creator>Harlan, Shanna M</creator><creator>Meyers, Douglas C</creator><creator>Rodning, Charles B</creator><general>SAGE PUBLICATIONS, INC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>201311</creationdate><title>Prehospital clinical clearance of the cervical spine: a prospective study</title><author>Gonzalez, Richard P ; Cummings, Glenn R ; Baker, Jeremy A ; Frotan, Amin M ; Simmons, Jon D ; Brevard, Sydney B ; Michon, Elizabeth ; Harlan, Shanna M ; Meyers, Douglas C ; Rodning, Charles B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-b8701861371fbf821d0d1850c8b8afec90385bee1ed936e9b9ff55328edf28533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Agreements</topic><topic>Algorithms</topic><topic>Cervical Vertebrae - injuries</topic><topic>Clinical Competence</topic><topic>Decision Trees</topic><topic>Emergency Medical Services</topic><topic>Emergency services</topic><topic>Female</topic><topic>Fire stations</topic><topic>Fires</topic><topic>Glasgow Coma Scale</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Pain</topic><topic>Paramedics</topic><topic>Physical Examination</topic><topic>Prospective Studies</topic><topic>Reproducibility of Results</topic><topic>Spinal Injuries - diagnosis</topic><topic>Spinal Injuries - etiology</topic><topic>Trauma</topic><topic>Trauma centers</topic><topic>Wounds, Nonpenetrating - complications</topic><topic>Wounds, Nonpenetrating - diagnosis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gonzalez, Richard P</creatorcontrib><creatorcontrib>Cummings, Glenn R</creatorcontrib><creatorcontrib>Baker, Jeremy A</creatorcontrib><creatorcontrib>Frotan, Amin M</creatorcontrib><creatorcontrib>Simmons, Jon D</creatorcontrib><creatorcontrib>Brevard, Sydney B</creatorcontrib><creatorcontrib>Michon, Elizabeth</creatorcontrib><creatorcontrib>Harlan, Shanna M</creatorcontrib><creatorcontrib>Meyers, Douglas C</creatorcontrib><creatorcontrib>Rodning, Charles B</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Research Library</collection><collection>ProQuest Science Journals</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>The American surgeon</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gonzalez, Richard P</au><au>Cummings, Glenn R</au><au>Baker, Jeremy A</au><au>Frotan, Amin M</au><au>Simmons, Jon D</au><au>Brevard, Sydney B</au><au>Michon, Elizabeth</au><au>Harlan, Shanna M</au><au>Meyers, Douglas C</au><au>Rodning, Charles B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prehospital clinical clearance of the cervical spine: a prospective study</atitle><jtitle>The American surgeon</jtitle><addtitle>Am Surg</addtitle><date>2013-11</date><risdate>2013</risdate><volume>79</volume><issue>11</issue><spage>1213</spage><epage>1217</epage><pages>1213-1217</pages><issn>0003-1348</issn><eissn>1555-9823</eissn><abstract>Physician clinical clearance of the cervical spine after blunt trauma is practiced in many trauma centers. Prehospital clinical clearance of the cervical spine (c-spine) performed by emergency medical services (EMS) personnel can decrease cost, improve patient comfort, decrease complications, and decrease prehospital time. The purpose of this study was to assess whether EMS personnel can effectively clinically clear the c-spine of injury in the prehospital setting. All paramedics from a single urban fire department were trained in clinical clearance of the c-spine. During the 14-month period from January 2008 through March 2009, clinical examination of the c-spine was performed by paramedics on blunt trauma patients in the prehospital setting. Paramedics immobilized the c-spine and delivered the patients to the University of South Alabama Medical Center. After trauma center arrival, paramedics documented their clinical examination of the c-spine in a computerized data collection form. Paramedic clinical findings were compared with trauma surgeon clinical examination findings and computed tomographic findings of the c-spine. All patients had prehospital Glasgow Coma Score 14 or greater. Patients were not excluded for distracting injuries. One hundred ninety-three blunt trauma patients were entered. Sixty-five (34%) c-spines were clinically cleared by EMS. There were no known missed injuries in this patient group. Eight (6%) patients who were not clinically cleared by EMS were diagnosed with c-spine injury. Trauma surgeons clinically cleared 135 (70%) of the patients with no known missed injury. EMS personnel in the prehospital setting may reliably and effectively perform clinical clearance of the c-spine. Further prospective study for prehospital c-spine clinical clearance is warranted.</abstract><cop>United States</cop><pub>SAGE PUBLICATIONS, INC</pub><pmid>24165260</pmid><doi>10.1177/000313481307901128</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0003-1348 |
| ispartof | The American surgeon, 2013-11, Vol.79 (11), p.1213-1217 |
| issn | 0003-1348 1555-9823 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1447107133 |
| source | MEDLINE; SAGE Journals Online |
| subjects | Adolescent Adult Aged Aged, 80 and over Agreements Algorithms Cervical Vertebrae - injuries Clinical Competence Decision Trees Emergency Medical Services Emergency services Female Fire stations Fires Glasgow Coma Scale Hospitals Humans Male Middle Aged Morbidity Mortality Pain Paramedics Physical Examination Prospective Studies Reproducibility of Results Spinal Injuries - diagnosis Spinal Injuries - etiology Trauma Trauma centers Wounds, Nonpenetrating - complications Wounds, Nonpenetrating - diagnosis Young Adult |
| title | Prehospital clinical clearance of the cervical spine: a prospective study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-25T02%3A12%3A36IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prehospital%20clinical%20clearance%20of%20the%20cervical%20spine:%20a%20prospective%20study&rft.jtitle=The%20American%20surgeon&rft.au=Gonzalez,%20Richard%20P&rft.date=2013-11&rft.volume=79&rft.issue=11&rft.spage=1213&rft.epage=1217&rft.pages=1213-1217&rft.issn=0003-1348&rft.eissn=1555-9823&rft_id=info:doi/10.1177/000313481307901128&rft_dat=%3Cproquest_cross%3E1447107133%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1462002153&rft_id=info:pmid/24165260&rfr_iscdi=true |