Cervical collar effect on pulmonary volumes in patients with trauma

ABSTRACT Objective: to evaluate the clinical-epidemiological characteristics, treatment, and evolution of patients with occipital condyle fracture (OCF) at one of the largest referral trauma centers in Latin America. Methods: this was a retrospective observational study of OCF identified from trauma cases admitted between December 2011 and December 2019 by the neurosurgery team at a Type 3 trauma center. Results: a total of twenty-eight occipital condyle fractures were identified in twenty-six patients. The incidence was less than 0.2% per year and more common in male patients (4:1 ratio) involved in traffic accidents. The mean age was 42.08 years. Anderson and Montesano type II and Tuli type 1 were the most frequent (67.9% and 89.3%, respectively) and no case presented C0-C1-C2 instability. All patients were treated with a cervical collar for 3 to 6 months. About 65% of the patients exhibited good progression (Glasgow Outcome Scale equal to 4), and the severity of traumatic brain injury was the main determinant for negative outcomes. Conclusion: the findings of this study are in accordance with available literature data. The use of external stabilization with a cervical collar is reinforced for the treatment of stable lesions, even when these are bilateral. Assessment of the patients’ follow-up results in the studied sample may contribute with useful information for the treatment of occipital condyle fractures.

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Maximum Movement and Cumulative Movement (Travel) to Inform our Understanding of Secondary Spinal Cord Injury and its Application to Collar use in Self-extrication

10.21203/rs.3.rs-1074763/v1 ◽

2021 ◽

Author(s):

Tim Nutbeam ◽

Rob Fenwick ◽

Barbara May ◽

Willem Stassen ◽

Jason Smith ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Healthy Volunteers ◽

Motor Vehicle ◽

Cervical Collar ◽

Spinal Movement ◽

Cord Injury ◽

Total Movement ◽

The Mean ◽

Secondary Spinal Cord Injury

Abstract Background:Motor vehicle collisions remain a common cause of spinal cord injury. Biomechanical studies of spinal movement often lack “real world” context and applicability. Additional data may enhance our understanding of the potential for secondary spinal cord injury. We propose the metric ‘travel’ (total movement) and suggest that our understanding of movement related risk of injury could be improved if travel was routinely reported. We report maximal movement and travel for collar application in vehicle and subsequent self-extrication.Methods:Biomechanical data on application of cervical collar with the volunteer sat in a vehicle were collected using Inertial Measurement Units on 6 healthy volunteers. Maximal movement and travel are reported. These data and a re-analysis of previously published work is used to demonstrate the utility of travel and maximal movement in the context of self-extrication.Results:Data from a total of 60 in-vehicle collar applications across three female and three male volunteers was successfully collected for analysis. The mean age across participants was 50.3 years (range 28–68) and the BMI was 27.7 (range 21.5–34.6). The mean maximal anterior-posterior movement associated with collar application was 2.3mm with a total AP travel of 4.9mm. Travel (total movement) for in-car application of collar and self-extrication was 9.5mm compared to 9.4mm travel for self-extrication without a collar. Conclusion:We have demonstrated the application of ‘travel’ in the context of self-extrication. Total travel is similar across self-extricating healthy volunteers with and without a collar.We suggest that where possible ‘travel’ is collected and reported in future biomechanical studies in this and related areas of research. It remains appropriate to apply a cervical collar to self-extricating casualties when the clinical target is that of movement minimisation.

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Acquiring and Maintaining Competence in the Application of Extrication Cervical Collars by a Group of First Responders

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00006373 ◽

2008 ◽

Vol 23 (6) ◽

pp. 530-536 ◽

Cited By ~ 3

Author(s):

Colin J. Ireland ◽

Kathryn M. Zeitz ◽

Franklin H.G. Bridgewater

Keyword(s):

Skill Acquisition ◽

Training Session ◽

First Responders ◽

First Aid ◽

Cervical Collar ◽

Prehospital Setting ◽

Skill Retention ◽

Spinal Immobilization ◽

Hands On ◽

Practical Session

AbstractIntroduction:Research on skill acquisition and retention in the prehospital setting has focused primarily on resuscitation and defibrillation. Investigation into other first aid skills is required in order to validate practices and support training regimes. No studies have investigated competency using an extrication cervical collar for cervical spine immobilization.Objective:This study was conducted to confirm that a group of first responders could acquire and maintain competency in the application of an extrication cervical collar over a 12-month period.Methods:Participants attended a standardized training session that addressed the theory of application of an extrication cervical collar followed by hands-on practice. The training was presented by the same instructor and covered the nine key elements necessary in order to be deemed competent in extraction cervical collar application. Following the practical session, the competency of the participants was assessed. Participants were requested not to practice the skill during the 12-month period. Following the 12-month period, their skills were re-assessed by the same assessor.Results:Of the 64 subjects who participated in the study, 100% were competent after the initial first assessment. Forty-one participants (64%) were available for the second assessment (12 months later); of these, 25 (61%) maintained competence.Conclusions:Although the sample size was small, this research demonstrates that first responders are able to acquire competence in applying an extrication cervical collar. However, skill retention in the absence of usage or re-training is poor. Larger studies should be conducted to validate these results. In addition, there is a need for research on the clinical practice and outcomes associated with spinal immobilization in the prehospital setting.

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