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Abstract
Spinal immobilization and the application of a rigid collar to protect the neck forms
an integral part of care of the injured. The very nature of collar design predisposes
to vascular obstruction of blood draining from the brain and theoretically may raise
intracranial pressure (ICP). We analysed this effect prospectively in a series of
injured patients using the Stifneck rigid collar, the most popular collar used in
the UK. Comparison of the ICP before, during and after collar application showed a
significant rise (P < 0.001), a mean rise in ICP of 4.5 mmHg, with a standard deviation of 4.1 mmHg.
Insignificant changes in mean arterial pressure suggested that this effect is a response
to distortion of venous drainage rather than cutaneous stimulation alone. Since head-injured
patients with lowered level of consciousness form a key group who require cervical
spinal immobilization it is essential that secondary insults producing raised ICP
are minimized. Alternative forms of cervical spinal immobilization should be considered
if collars impede venous drainage through the neck.
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References
- Advanced Trauma Life Support Manual. ACS, 1991 3rd Ed.
- Prehospital Trauma Life Support Manual. XXX. NAEMT, 1994 3rd Ed.
- Advanced Paediatric Life Support Manual. 1993;
- Efficacy of cervical spine immobilisation methods.J Trauma. 1983; 23: 461
- Comparison of the effectiveness of different cervical immobilisation collars.Ann Emerg Med. 1986; 15: 50
- A radiographic comparison of prehospital cervical immobilisation methods.Ann Emerg Med. 1987; 16: 1127
- Emergency cervical-spine immobilisation.Ann Emerg Med. 1992; 21: 1185
- A comparison of methods of cervical immobilisation used in patient extrication and transport.J Trauma. 1985; 25: 649
- Comparison of two new immobilisation collars.Ann Emerg Med. 1992; 21: 1189
- Rigid cervical collars and intracranial pressure.Intensive Care Med. 1991; 17: 504
- Skin necrosis caused by a semi rigid cervical collar in a ventilated patient with multiple injuries.Injury. 1994; 25: 323
- Complication of hard cervical collars in multiply injured trauma patients.Aust NZ J Surg. 1994; 64: 139
- Effects of the cervical collar on cerebrospinal fluid pressure.Anaesthesia. 1994; 49: 437
- Cervical collars: a potential risk to the head injured patient.Injury. 1993; 24: 454
- Effect of external cervical spine immobilisation on intracranial pressure.Aktuel Traumatol. 1993; 23: 350
- Delayed diagnosis of cervical spine injuries.J Trauma. 1991; 31: 1622
- A practical radiographic comparison of short board technique and Kendrick extrication device.Ann Emerg Med. 1989; 18: 943
- Effect of spinal immobilisation devices on pulmonary function in the healthy non-smoking man.Ann Emerg Med. 1988; 17: 915
Article info
Publication history
Accepted:
May 8,
1996
Identification
Copyright
© 1996 Published by Elsevier Inc.