cliot (version 1.0.0)

pecarn_c_spine_rule: PECARN Pediatric Cervical Spine Injury Risk Score

Description

Applies the PECARN decision rule to identify children at very low risk of clinically important cervical spine injury (CSI) after blunt trauma. The rule stratifies patients into High Risk (requiring CT), Intermediate Risk (requiring plain films or observation), and Low Risk (no imaging needed).

Usage

pecarn_c_spine_rule(gcs_score, altered_mental_status, focal_neurologic_deficit,
                    neck_pain, torticollis, substantial_torso_injury,
                    predisposing_condition, high_risk_mechanism)

Value

A list containing:

Risk_Level

Classification (High Risk, Intermediate Risk, Low Risk).

Recommendation

Imaging guidance based on the risk level.

Arguments

gcs_score

Numeric. Glasgow Coma Scale score (3-15). (GCS < 15 is a high-risk factor).

altered_mental_status

Numeric (0 or 1). Presence of altered mental status (agitation, somnolence, repetitive questioning, or slow response to verbal questioning). (1 = Yes).

focal_neurologic_deficit

Numeric (0 or 1). Presence of focal neurologic deficit. (1 = Yes).

neck_pain

Numeric (0 or 1). Patient complains of neck pain. (1 = Yes).

torticollis

Numeric (0 or 1). Presence of torticollis (wry neck/stiff neck). (1 = Yes).

substantial_torso_injury

Numeric (0 or 1). Presence of substantial torso injury (e.g., seatbelt sign, chest/abdominal tenderness, or deformities). (1 = Yes).

predisposing_condition

Numeric (0 or 1). Presence of conditions predisposing to CSI (e.g., Trisomy 21, collagen vascular disease, prior cervical spine surgery/abnormality). (1 = Yes).

high_risk_mechanism

Numeric (0 or 1). High-risk mechanism of injury (e.g., diving, MVC, fall > 10ft/3m, axial load). (1 = Yes).

References

Leonard JC, Kuppermann N, Olsen C, et al. Factors associated with cervical spine injury in children after blunt trauma. Ann Emerg Med. 2011;58(2):145-155. doi:10.1016/j.annemergmed.2010.08.038

Examples

# Example 1: High Risk (GCS 14)
pecarn_c_spine_rule(14, 0, 0, 0, 0, 0, 0, 1)

# Example 2: Intermediate Risk (Neck Pain only)
pecarn_c_spine_rule(15, 0, 0, 1, 0, 0, 0, 0)

# Example 3: Low Risk (No factors)
pecarn_c_spine_rule(15, 0, 0, 0, 0, 0, 0, 0)