In healthy volunteers the Miami-J® cervical collar causes swallow dysfunction. This may increase the risk of aspiration; of particular potential consequence in older people with neck injury

Hudson, Murray A.J.; Ehsanullah, Jasmine; Lee, Annabelle; Macpherson, Nicola; Ogilvie, A L; Shrestha, Alvin; Tsang, Kevin; Morgan, Cerys; Peck, George; Koizia, Louis; Fertleman, Michael

doi:10.1016/j.inat.2023.101788

Interdisciplinary Neurosurgery

2023

DOI: 10.1016/j.inat.2023.101788

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In healthy volunteers the Miami-J® cervical collar causes swallow dysfunction. This may increase the risk of aspiration; of particular potential consequence in older people with neck injury

Murray A.J. Hudson

Jasmine Ehsanullah

Annabelle Lee

et al.

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2024

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Change from semi‐rigid to soft collars for prehospital management of trauma patients: An observational study

Mitra,

Bernard,

Yankoff

et al. 2024

JACEP Open

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ObjectivesProtection of the cervical spine is recommended following multisystem injury. In 2021, Ambulance Victoria changed clinical practice guidelines to apply soft collars instead of semi‐rigid collars for suspected cervical spine injury. The aim of this study was to describe associated changes in imaging practices and diagnoses of pressure sores, hospital acquired pneumonia, and spinal cord injury.MethodsA retrospective pre‐ and postintervention study was conducted including all consecutive patients that presented to an adult major trauma center in Melbourne, Australia with a cervical collar placed by emergency medical services over two 3‐month periods.ResultsThere were 1762 patients included. A computed tomography (CT) of the cervical spine was performed in 795 (88.4%) patients in the semi‐rigid collar period and 810 (93.8%) in the soft collar period (p = 0.001). Soft collars were associated with higher rates of clearance of the cervical spine in the emergency department (ED) (odds ratio [OR] 4.14; 95% confidence interval [CI]: 3.36–5.09). There were no differences in diagnosis of pressure sores (0.11% vs. 0.23%, p = 0.97) or hospital acquired pneumonia (2.0% vs. 2.7%; p = 0.44) or cervical spinal cord injury (0.45% vs. 0.81%; p = 0.50).ConclusionsFollowing a change from prehospital semi‐rigid collars to soft collars, more patients were investigated with a CT scan and more frequent clearance of the cervical spine occurred in the ED. There were no differences in the rates of spinal cord injuries, pressure sores or hospital acquired pneumonia, but the study was underpowered to detect significant differences. The practice of soft collars for prehospital care of patients with suspected neck injury requires ongoing surveillance.

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Change from semi‐rigid to soft collars for prehospital management of trauma patients: An observational study

Mitra,

Bernard,

Yankoff

et al. 2024

JACEP Open

View full text Add to dashboard Cite

show abstract

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In healthy volunteers the Miami-J® cervical collar causes swallow dysfunction. This may increase the risk of aspiration; of particular potential consequence in older people with neck injury

Cited by 1 publication

References 18 publications

Change from semi‐rigid to soft collars for prehospital management of trauma patients: An observational study

Change from semi‐rigid to soft collars for prehospital management of trauma patients: An observational study

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