Placement of a cervical collar increases the optic nerve sheath diameter in healthy adults

Zwank, Michael D.; Pasquarella, Joseph R.; Wewerka, Sandi S.; Anderson, Jeffrey P.; Greupner, Jessica T.; Motalib, Sakib

doi:10.1016/j.ajem.2017.08.051

Cited by 15 publications

(15 citation statements)

References 24 publications

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“…Wooster et al reported that ONSD started to increase within 5 minutes after CC application and such an increase continued until the 20th minute of application [15]. In this study, a significantly positive correlation was found between the duration of hospital admission and ONSD.…”

Section: Discussionsupporting

confidence: 66%

“…Increased ICP results in tissue damage by impairing cerebral perfusion. Therefore, the early identification of ICP is essential to prevent further brain damage [13][14][15]. ONSD may be easily evaluated through ultrasonography, and has a strong correlation with ICP [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the early identification of ICP is essential to prevent further brain damage [13][14][15]. ONSD may be easily evaluated through ultrasonography, and has a strong correlation with ICP [15][16][17]. Ohle et al reported in their meta-analysis that ONSD has higher negative and positive predictive value rates to demonstrate ICP, with a sensitivity and specifity rates of 95.6% and 92.3%, respectively [16].…”

Section: Discussionmentioning

confidence: 99%

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The Association between Cervical Collar and Intracranial Pressure Measured by the Optic Nerve Sheath Diameter in Trauma Patients Refered to the Emergency Department

Çolak¹,

Çelik²

2020

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Objective:The aim of the present study was to determine the effect of the application or prolonged use of a Cervical Collar (CC) on intracranial pressure (ICP) through the changes in optic nerve sheath diameter (ONSD). Materials and methods: This prospective study was performed on 94 adult trauma patients who were referred to the emergency department between November, 15, 2017 and November, 15, 2018. Patients with any co-morbidities were excluded. The following factors were evaluated; age, gender, the mechanism of the trauma, the period between the trauma and admission, presence of any cranial and cervical trauma, symptoms and signs of head trauma, brain tomography (BT) findings, vital parameters, and ONSD values of the patients measured 3 times every 20 minutes. Results: The average age of the patients admitted to the emergency department due to trauma included 51 (54.3%) males and was 42.0 ± 16.1 years.ONSD was 4.8 ± 0.9 mm at admission, 5.0 ± 0.9 mm at the 20th minute of the admission, and was 4.4 ± 0.9 mm at the 20th minute after removal of the CC. The changes in ONSD diameter during the follow-up was statistically significant (p < 0.05). Conclusions: CC increases the ICP and ONSD regardless of the type of trauma types. Unnecessary CC applications should be avoided and the collar should be removed immediately after the presence of cervical trauma has been eliminated.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Association between Cervical Collar and Intracranial Pressure Measured by the Optic Nerve Sheath Diameter in Trauma Patients Refered to the Emergency Department

Çolak¹,

Çelik²

2020

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“…Methods to immobilise the c-spine may include manual in-line stabilisation, SAM splints, or cervical collars [41]. Cervical collars must be applied correctly [42], with special attention to maintaining venous return [23,[43][44][45][46][47]. Spinal injury is covered under Disability.…”

Section: Grade 2cmentioning

confidence: 99%

Multiple trauma management in mountain environments - a scoping review

Sumann¹,

Moens

Brink

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background Multiple trauma in mountain environments may be associated with increased morbidity and mortality compared to urban environments. Objective To provide evidence based guidance to assist rescuers in multiple trauma management in mountain environments. Eligibility criteria All articles published on or before September 30th 2019, in all languages, were included. Articles were searched with predefined search terms. Sources of evidence PubMed, Cochrane Database of Systematic Reviews and hand searching of relevant studies from the reference list of included articles. Charting methods Evidence was searched according to clinically relevant topics and PICO questions. Results Two-hundred forty-seven articles met the inclusion criteria. Recommendations were developed and graded according to the evidence-grading system of the American College of Chest Physicians. The manuscript was initially written and discussed by the coauthors. Then it was presented to ICAR MedCom in draft and again in final form for discussion and internal peer review. Finally, in a face-to-face discussion within ICAR MedCom consensus was reached on October 11th 2019, at the ICAR fall meeting in Zakopane, Poland. Conclusions Multiple trauma management in mountain environments can be demanding. Safety of the rescuers and the victim has priority. A crABCDE approach, with haemorrhage control first, is central, followed by basic first aid, splinting, immobilisation, analgesia, and insulation. Time for on-site medical treatment must be balanced against the need for rapid transfer to a trauma centre and should be as short as possible. Reduced on-scene times may be achieved with helicopter rescue. Advanced diagnostics (e.g. ultrasound) may be used and treatment continued during transport.

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“…Thus, we additionally sought to validate the results of these studies in an independent data. [2627]…”

Section: Introductionmentioning

confidence: 99%

The influence of cervical collar immobilization on optic nerve sheath diameter

Yard

Richman

Leeson

et al. 2019

J Emerg Trauma Shock

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Background: Prior research has revealed that cervical collars elevate intracranial pressure (ICP) in patients with traumatic brain injury. Two recent small studies evaluated the change in optic sheath nerve diameter (ONSD) measured by ultrasound as a proxy for ICP following cervical collar placement in healthy volunteers. Objective: We sought to validate the finding that ONSD measured by ultrasound increases after cervical collar placement within an independent data set. Methods: This was a prospective, crossover study involving volunteers. Participants were randomized to either have the ONSD measured first without a cervical collar or initially with a cervical collar. Two sonographers performed independent ONSD diameter measurements. Continuous data were analyzed by matched-paired t -tests. Alpha was set at 0.05. The primary outcome parameter was the overall mean difference between ONSD measurements with the cervical collar on and off. Multiple linear regression was performed to examine the relationship between variables and the primary outcome parameter. Results: There were 30 participants enrolled in the study. Overall mean ONSD for participants without the collar was 0.365 ± 0.071 cm and with the collar was 0.392 ± 0.081 cm. The mean change in ONSD for participants with and without the collar was 0.026 ± 0.064 cm (95% confidence interval of difference: 0.015–0.038; P < 0.001). Multiple regression analysis did not identify any variables associated with the variation in ONSD observed for collar versus noncollar. Conclusions: We confirmed that ONSD does vary by a measurable amount with placement of a rigid cervical collar on healthy volunteers when assessed by ultrasound.

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Placement of a cervical collar increases the optic nerve sheath diameter in healthy adults

Cited by 15 publications

References 24 publications

The Association between Cervical Collar and Intracranial Pressure Measured by the Optic Nerve Sheath Diameter in Trauma Patients Refered to the Emergency Department

The Association between Cervical Collar and Intracranial Pressure Measured by the Optic Nerve Sheath Diameter in Trauma Patients Refered to the Emergency Department

Multiple trauma management in mountain environments - a scoping review

The influence of cervical collar immobilization on optic nerve sheath diameter

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