Kids vs' Adults: Cspine Immobilization

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Kids vs. AdultsC-spine Immobilization

• Jerome Pediatric Products The Broselow-Luten
  Color Coding System

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Broselow-Luten System

• Patented pediatric measuring and dosage system
• Originally developed by James Broselow, MD
  (Hickory, NC) and Bob Luten, MD (Jacksonville,
  FL)
• Assigns each child 1 of 9 color codes
• Based upon length or weight
• Better Patient Care
• Eliminates dosage calculation errors
• Simplifies treatment
• Widely recognized by EMS and ED personnel

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Cervical Spine System for Kids
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NecLoc Kids, Miami Jr. AirWay PAD

• Uniquely designed pediatric spinal immobilization
  and positioning devices for maintaining kids
  necks in proper anatomical c-spine airway
  alignment

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Jerome Pediatric Collars

• Patented "Airway Back" design.
• Flared occiput uniquely maintains airway and
  c-spine alignment.
• Addresses anatomical growth transition from birth
  to adolescence (0 12 years).

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Jerome Pediatric Collars

• Miami Jr.
• Hospital
• Long term use
• 4 sizes P0, P1, P2, P3
• Color coded labeling

• NecLoc Kids
• Pre-hospital
• Short term use
• 3 sizes P1, P2, P3
• Color coded labeling

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Collar Sizing

• Simple Sizing based on
• Broselow-Luten color code
• Age

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Pediatric Collar DesignKids vs. Adults
P1 Collar (Ages 0-2 yrs.)
P2 Collar (Ages 2-6 yrs.)
P3 Collar (Ages 6-12 yrs.)
Adult (Ages gt 12 yrs.)
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Kids vs. AdultsRelative Head Size
Change in Relative Body Proportions from Fetus to
Adult (from Robbins et al Growth, Yale
University Press, New Haven, 1928.)
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Adult / Child Differences
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Chin Height
Negative Chin Height
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Kids vs. AdultsNeck Length
P1 Collar (Ages 0-2 yrs.)
P2 Collar (Ages 2-6 yrs.)
P3 Collar (Ages 6-12 yrs.)
Adult (Ages gt 12 yrs.)
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Back of Head to Back
Negative Ratio
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Occipital Angle
90
75
60
45
30
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Kids vs. AdultsOccipital Angle
P1 Collar (Ages 0-2 yrs.)
P2 Collar (Ages 2-6 yrs.)
P3 Collar (Ages 6-12 yrs.)
Adult (Ages gt 12 yrs.)
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Kids vs. AdultsFlexibility / Range of Motion
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Kids vs. AdultsAirway Spinal Alignment
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Kids vs. AdultsAirway Spinal Alignment
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AirWay PAD

• Pediatric supine Alignment and positioning Device
  
• Achieves neutral c-spine alignment
• Opens airway
• For Kids 0-12 years
• Full-size Broselow Scale
• Indicates appropriate Jerome collar size

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AirWay PAD

• KID PAD
• KID PAD
• KID PAD

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AirWay PAD MR Testing
11 yo No collar, No Pad
11 yo w/ AirWay PAD
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AirWay PAD

• Simple as 1, 2, 3, 4!
• Open Pad
• Measure Child
• Choose Color
• Fold Pad

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AirWay PAD
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AirWay PAD
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AirWay PAD
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AirWay PAD
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AirWay PAD

• Guidelines
• Ear in line with shoulder
• Pad height should match occipital offset of collar

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AirWay PAD
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AirWay PAD

• pad.exe

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Papoose
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Infant Spinal Cord Injury

• How do we immobilize?
• How do we establish proper airway alignment?

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Papoose

• Marriage of two important ideas

IMMOBILIZATION and PROPER AIRWAY ALIGNMENT
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AirWay and Anatomy
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AirWay PAD MR Testing
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Papoose

• Immobilizes the youngest of our pediatric
  population Broselow Gray (0 3 months).
• CTLSO Allows for immobilization of C-Spine and
  T-Spine injuries.
• Occipital shape prevents plagiocephaly /
  brachiocephaly.

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Papoose

• Allows for continued intimacy between caregiver
  and child.
• Permits convenient diaper changing with minimal
  disruption in immobilization.
• Temporary immobilization for IV placement,
  diagnostic imaging, suturing, etc.
• Extrication Transport