Cervical collars: a potential risk to the head-injured patient

Ferguson, James; Mardel, S; Beattie, Tom F.; Wytch, R.

doi:10.1016/0020-1383(93)90148-y

Cited by 21 publications

(17 citation statements)

References 4 publications

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“…Intracranial venous drainage may be hindered by an increase in internal jugular pressure due to the collar's direct compression of the jugular veins or by some other mechanism. Ferguson et al 6 recorded mean interface pressures ranging from 0.3 to 9.1 mm Hg directly underneath cervical collars, and the values varied depending on the collar that was used. Kuhnigk et al 4 also found variations in the change in ICP depending on the collar used.…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Rigid Cervical Collars on Internal Jugular Vein Dimensions

Stone

Tubridy

Curran

2010

Academic Emergency Medicine

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Objectives: Prior research has demonstrated that rigid cervical collars cause an increase in intracranial pressure (ICP). The mechanism for this effect is unclear and one proposed mechanism involves obstruction of venous outflow in the neck. Ultrasound (US) allows assessment of internal jugular vein dimensions and may yield information regarding the mechanism for the increase in ICP seen with rigid collar application.Methods: Forty-two healthy volunteers underwent US examination of the internal jugular vein before and after cervical collar application. Internal jugular vein cross-sectional areas were compared with and without the cervical collar in place. Results:The cross-sectional area of the internal jugular vein increased significantly (p < 0.0001) after application of the cervical collar. The mean percentage increase in cross-sectional area was 37% (95% confidence interval [CI] = 20% to 53%).Conclusions: Internal jugular vein cross-sectional area increases after application of a rigid cervical collar. This supports the hypothesis that venous obstruction in the neck may contribute to the increase in ICP seen after rigid collar application.

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Section: Discussionmentioning

confidence: 99%

“…1,2 Recent studies have suggested a potential detrimental effect of cervical collars on patients with severe head injury by demonstrating that cervical collars can elevate intracranial pressure (ICP). [3][4][5][6][7][8] Increased ICP decreases cerebral perfusion and exacerbates ischemia, thus increasing the likelihood of secondary brain injury.…”

mentioning

confidence: 99%

The Effect of Rigid Cervical Collars on Internal Jugular Vein Dimensions

Stone

Tubridy

Curran

2010

Academic Emergency Medicine

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“…However, cervical collars have been found to result in increased intracranial pressure due to obstruction in venous outflow in acute head injured patients. 10,25 In the absence of evidence to suggest otherwise, and given the significant indentation caused by the cervical collar in this case, one possible theory is that venous outflow may have been obstructed by the collar to the extent that thrombus formation occurred in our young patient.…”

Section: Discussionmentioning

confidence: 80%

Unilateral internal jugular venous thrombosis in a young trauma patient

et al. 2009

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“…They decided that the risk of increasing ICP in a head injured patient was low [20] . A number of studies have detected a tourniquet effect of rigid cervical collar on neck veins, with an influence on intracranial pressure [21] , [22] .This has been supported by research postulating that ICP increases when a cervical collar is applied, and then gradually decreases on removal [23] .…”

Section: Table (2): Mean Psv Edv and Ld Of The Right And Left Vertementioning

confidence: 92%