The latest JRCALC guidelines (as an appendix written with the Faculty of
Pre-Hospital Care of the Royal College of Surgeons of Edinburgh) make
reference to this:
Though there have been studies (see refs below) demonstrating a rise in
intracranial pressure associated with the prolonged wearing of collars
this complication was not deemed to be relevant in pre-hospital care in
the circumstances where collars would normally be used. Though a well
fitting collar has no effect on the patient's tidal volume, there is
some evidence that an ill fitting collar may be associated with airway
obstruction. For both these reasons and especially in cases of a severe
head injury (or a GCS of < 8), a collar applied at the scene should be
removed as soon as feasible, for example once the patient has been
immobilised on a spinal board.
Refs:
Raphael JH, Chotai R. Effects of the cervical collar on cerebrospinal
fluid pressure. Anaesthesia 1994;49:437-
Craig GR, Neilsen MS. Rigid cervical collars and intracranial pressure.
Intensive Care Med 1991;17: 504-5
Hope this helps
Mark Parsons - State Registered Paramedic
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]]On Behalf Of fred
Sent: 24 August 2002 12:06
To: [log in to unmask]
Subject: semi regid collars
Just looking for an old article saying that once a casualty is strapped
down on a spine board. The collar severs no purpose other than a visual
reminder, but it still increases the intracranial pressure. The article
went on to question whether the collar should be removed at this stage.
Has anyone seen or has this article??
If so could you please forward any details on it.
many thanks in advance
Fred
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