• Evaluation of clinical efficacy and safety of cervical trauma collars: differences in immobilization, effect on jugular venous pressure and patient comfort

    by Alan Batt. Last modified: 17/06/14

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    Karason S, Reynisson K, Sigvaldason K, Sigurdsson GH. Evaluation of clinical efficacy and safety of cervical trauma collars: differences in immobilization, effect on jugular venous pressure and patient comfort. Scand J Trauma Resusc Emerg Med. 2014 Jun 6;22(1):37. PMID: 24906207.

    openaccess

    Abstract

    Background

    Concern has been raised that cervical collars may increase intracranial pressure in traumatic brain injury. The purpose of this study was to compare four types of cervical collars regarding efficacy of immobilizing the neck, effect on jugular venous pressure (JVP), as a surrogate for possible effect on intracranial pressure, and patient comfort in healthy volunteers.

    Methods

    The characteristics of four widely used cervical collars (Laerdal Stifneck(R) (SN), Vista(R) (VI), Miami J Advanced(R) (MJ), Philadelphia(R) (PH)) were studied in ten volunteers. Neck movement was measured with goniometry, JVP was measured directly through an endovascular catheter and participants graded the collars according to comfort on a scale 1-5.

    Results

    The mean age of participants was 27 +/- 5 yr and BMI 26 +/- 5. The mean neck movement (53 +/- 9[degree sign]) decreased significantly with all the collars (p < 0.001) from 18 +/- 7[degree sign] to 25 +/- 9[degree sign] (SN < MJ < PH < VI). There was a significant increase in mean JVP (9.4 +/- 1.4 mmHg) with three of the collars, but not with SN, from 10.5 +/- 2.1 mmHg to 16.3 +/- 3.3 mmHg (SN < MJ < VI < PH). The grade of comfort between collars varied from 4.2 +/- 0.8 to 2.2 +/- 0.8 (VI > MJ > SN > PH).

    Conclusion

    Stifneck and Miami J collars offered the most efficient immobilization of the neck with the least effect on JVP. Vista and Miami J were the most comfortable ones. The methodology used in this study may offer a new approach to evaluate clinical efficacy and safety of neck collars and aid their continued development.

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    Alan Batt

    Alan Batt

    Paramedic, educator, researcher
    Alan is a critical care paramedic, paramedic educator and prehospital researcher, currently working around the world as an educator and researcher. He has previously worked and studied across Europe, North America and the Middle East. He holds a Graduate Certificate in Intensive Care Paramedic Studies, and an MSc in Critical Care. His main interests are in care of the elderly, end-of-life care, patient safety, professionalism (including role and identity), and paramedic education.

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