Kids vs. Adults: C-spine Immobilization Jerome Pediatric Products & The Broselow-Luten Color Coding System

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

Cervical Spine System for Kids

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

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). Pick a picture.

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

Collar Sizing: Simple Sizing based on: Age  Broselow-Luten color code 0 – 6 mos 6 mos – 2 yrs Simple Sizing based on:  Broselow-Luten color code Age 2 – 6 yrs Poster and front face photo. 6 – 12 yrs

Pediatric Collar Design Kids vs. Adults P1 Collar (Ages 0-2 yrs.) P2 Collar (Ages 2-6 yrs.) P3 Collar (Ages 6-12 yrs.) Adult (Ages > 12 yrs.)

Kids vs. Adults Relative Head Size Change in Relative Body Proportions from Fetus to Adult (from Robbins et al: Growth, Yale University Press, New Haven, 1928.)

Adult / Child Differences:

Chin Height: Negative Chin Height

Kids vs. Adults Neck Length P1 Collar (Ages 0-2 yrs.) P2 Collar (Ages 2-6 yrs.) P3 Collar (Ages 6-12 yrs.) Adult (Ages > 12 yrs.)

Back of Head to Back: Negative Ratio

Occipital Angle: 30 ° 45 ° 60 ° 75 ° 90 °

Kids vs. Adults Occipital Angle P1 Collar (Ages 0-2 yrs.) P2 Collar (Ages 2-6 yrs.) P3 Collar (Ages 6-12 yrs.) Adult (Ages > 12 yrs.)

Kids vs. Adults Flexibility / Range of Motion

Kids vs. Adults Airway & Spinal Alignment

Kids vs. Adults Airway & Spinal Alignment

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

AirWay PAD KID = PAD

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

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

AirWay PAD

AirWay PAD

AirWay PAD

AirWay PAD

AirWay PAD Guidelines: Ear in line with shoulder Pad height should match occipital offset of collar

AirWay PAD

AirWay PAD pad.exe

Papoose®

Infant Spinal Cord Injury: How do we immobilize? How do we establish proper airway alignment?

PROPER AIRWAY ALIGNMENT Papoose Marriage of two important ideas: IMMOBILIZATION and PROPER AIRWAY ALIGNMENT

AirWay and Anatomy:

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

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.

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