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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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Article info
Publication history
Accepted:
May 8,
1996
Identification
Copyright
© 1996 Published by Elsevier Inc.
