EditorialRoutine application of cervical collars – What is the evidence?
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Cited by (24)
Spine trauma management issues: C-spine
2022, Neural Repair and Regeneration after Spinal Cord Injury and Spine TraumaUtilization of computerized tomography and magnetic resonance imaging for diagnosis of traumatic C-Spine injuries at a level 1 trauma center: A retrospective Cohort analysis
2021, Annals of Medicine and SurgeryCitation Excerpt :However, it is worth noting that although patients who had C-collar placement were found to have higher raw mortality rates than patients with no C-collar placement, it is possible that patients with a C-collar placed inherently possessed a higher mortality rate due to the nature of their injuries rather than deleterious effects of C-collar placement itself. For every 50–100 patients in whom a C-collar is placed, one patient is likely to have suffered from a significant spinal injury [34]. In comparing CT and MRI in the detection of C-spine injuries, it was found that CT was able to rule out nearly all cervical vertebrae fractures with a negative predictive value of 98.3–99.9%, outperforming MRI in the detection of C1 vertebral fracture.
Effects of 20-degree spinal immobilization on respiratory functions in otherwise healthy volunteers with android-type obesity
2020, American Journal of Emergency MedicineCitation Excerpt :Mortality and morbidity rates are high among multi-trauma patients, and several international guidelines routinely recommend spinal immobilization with long backboard (LBB) and semi-rigid cervical collar (CC) for such patients [1,2]. However, the existing spinal immobilization literature reports little supporting evidence for this approach [3-5], and previous studies have reported side effects of spinal immobilization that include pain, changes in vital signs, reduced pulmonary functions, skin ulcers, and increased intracranial pressure [6-11]. To address these side effects, some studies (including our own two recent studies) have evaluated the effect of spinal immobilization performed at 20° instead of the traditional 0° [12-14].
The effects of spinal immobilization at 20° on intracranial pressure
2019, American Journal of Emergency MedicineCitation Excerpt :The reason for this recommendation is that spinal cord injury is one of the main causes of both mortality and morbidity in trauma patients [3]. However, in spite of this general recommendation, there is little evidence of the routine use of spinal immobilization [4,5]. In fact, several side effects of spinal immobilization, including pain, changes in vital signs, decreased pulmonary functions, skin ulcers, and increased intracranial pressure have been reported by various studies [6-11].
A prospective evaluation of cervical spine immobilisation in low-risk trauma patients at a tertiary Emergency Department
2019, Australasian Emergency CareCitation Excerpt :Universal application of CSI precautions has been the mainstay of trauma team education for four decades [2]. While CSI is often seen as an essential part of trauma care, there is no high quality evidence that CSI is effective in preventing secondary spinal injury [3–5]. Additionally, the Australian Resuscitation Council no longer recommends routine use of semi-rigid collars because there is increasing recognition that extended periods of immobilisation are associated with harm [6,7].
Effects of spinal immobilization at a 20° angle on cerebral oxygen saturations measured by INVOS™
2018, American Journal of Emergency MedicineCitation Excerpt :The recent dissenting opinions against the routine spinal immobilization of all trauma patients are based on the harmful and painful side effects of this practice. Besides, evidence for the benefits of routine spinal immobilization is quite limited [3,6]. Some authors argue that immobilization with a hard cervical collar has the potential to cause an increase in intracranial pressure, and some warn that skin lesions can occur due to the hard cervical collar and backboard [7,8].