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Cervical collars and intracranial pressure
  1. Muhammad Ahmad,
  2. John Butler
  1. Department of Emergency Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK
  1. Correspondence to: Kevin Mackway-Jones, Consultant (kevin.mackway-jones{at}man.ac.uk)

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Report by Muhammad Ahmad; Specialist RegistrarChecked by John Butler Specialist Registrar

Clinical scenario

A 26 year old man was brought to the emergency department by the paramedics after a road traffic accident. He was immobilised on a long spinal board and a correctly fitted collar was applied to his neck. The patient was unconscious. You wonder whether the cervical collar raises intracranial pressure in head injury patients

Three part question

In [patients with a head injury requiring cervical spine immobilisation] does [a correctly fitted cervical collar] increase [intracranial pressure]?

Search strategy

Medline 1966–07/2001 using the OVID interface. [({exp neck OR exp neck injuries OR exp cervical vertebrae OR cervical.mp} AND {exp braces OR brace$.mp OR collar$.mp}) OR cervical collar$.mp) AND {exp intracranial pressure OR intracranial pressure$.mp OR ICP.mp}]

Search outcome

Altogether seven papers were found of which four were relevant to the three part question. These four papers are shown in table 6.

Table 6

Comments

These studies have shown that a semi-rigid cervical collar, causes a variable rise in intracranial pressure in most patients.

Clinical bottom line

Correctly fitted cervical collars increase intracranial pressure.

Report by Muhammad Ahmad; Specialist RegistrarChecked by John Butler Specialist Registrar

References

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