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Conclusion
Throughout the medical and surgical literature, it is apparent that the use of evidence-based protocols or checklists are extremely important because they have been shown to decrease hospital costs, reduce the length of hospital stays, and reduce morbidity and mortality. We have demonstrated in this study that written cervical spine clearance protocols exist in 57% of level 1 trauma centers in the United States, and only 60% of the participating centers have protocols that incorporate the most recent evidence-based recommendations provided by the 2009 EAST guidelines. The strength of this study is that the response rate was 87%, suggesting that results obtained herein accurately represent the current existence of cervical spine clearance guidelines in level 1 trauma centers in the United States. A limitation of our study is that analyzing written protocols may not accurately reflect current clinical practice at each individual institution. However, written protocols serve as a roadmap to which physicians can turn for up-to-date information on the topic. Thus, it is important to develop and implement standardized protocols for the clearance of the cervical spine with the goal to prevent undiagnosed cervical injuries and the potential for significant neurological sequelae. Thus, future studies should be performed to identify current clinical practice of cervical spine clearance at all trauma centers throughout the United States and ultimately to determine whether cervical spine clearance protocols improve clinical outcomes. Additionally, new polices should be developed to encourage utilization of these standardized protocols in all trauma centers in the United States.
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