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ASSESSMENT OF THE CERVICAL COLLAR APPLICATION IMPACT ON THE CONDITIONS OF INTUBATION AND THE FEELINGS OF PATIENTS — PILOT STUDY
Affiliations- Department of Trauma-Orthopedic Surgery, Solec Hospital, Warsaw, Poland
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
- Department of Emergency Medicine, Medical University of Warsaw, Lindleya 4 Str., 02-005 Warsaw, Poland
- Department of Emergency Medicine and Disaster, Medical University Bialystok, Bialystok, Poland
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Abstract
INTRODUCTION: Securing the stability of the cervical spine is one of the basic procedures performed by medical personnel in trauma patients. Unfortunately, standard cervical collars limit the effectiveness of some procedures, including endotracheal intubation, as well as affect the pain sensations of the injured person. The aim of the study was to compare the influence of two different types of cervical collars on the technical conditions of endotracheal intubation and the patient’s sense of comfort.
METHOD: The study was designed as a randomised, cross-over research and included 32 healthy paramedics, who had a cervical collar installed for 20 minutes in a randomised way. During the examination, the patient’s comfort and pain resulting from the pressure on mastoid processes were evaluated.
RESULTS: Prior to the study, the mouth opening in the examined group was 51 ± 12 mm. After the set-up of the Patriot collar, the mouth opening amounted to 37 ± 10 mm, while in the NECKLITE collar group amounted to 49 ± 13 mm (p < 0.001). The use of a cervical collar reduced the degree of mouth opening by 27% when using a standard cervical collar, and less than 4% when using a NECKLITE collar. The pressure on the mastoid processes assessed on a 10-point scale varied between the cervical collars and amounted to 7 ± 2 points for Patriot and 1 ± 1 points for NECKLITE collar (p < 0.001). The pain sensations associated with the cervical collar were also varied and amounted to 6 ± 3 points for Patriot collar vs. 1 ± 1 points for NECKLITE collar (p < 0.001). Ninety- -seven per cent of study participants declared, that they preferred the NECKLITE collar comparing to the Patriot cervical collar.
CONCLUSIONS: A standard cervical collar causes an increase in pain due to the pressure on the mastoid processes and a sense of discomfort for the patient. The NECKLITE collar thanks to the possibility of better fit to the patient’s neck, does not cause any pain, and using this collar it is possible to perform endotracheal intubation without the need to unfasten it.
Abstract
INTRODUCTION: Securing the stability of the cervical spine is one of the basic procedures performed by medical personnel in trauma patients. Unfortunately, standard cervical collars limit the effectiveness of some procedures, including endotracheal intubation, as well as affect the pain sensations of the injured person. The aim of the study was to compare the influence of two different types of cervical collars on the technical conditions of endotracheal intubation and the patient’s sense of comfort.
METHOD: The study was designed as a randomised, cross-over research and included 32 healthy paramedics, who had a cervical collar installed for 20 minutes in a randomised way. During the examination, the patient’s comfort and pain resulting from the pressure on mastoid processes were evaluated.
RESULTS: Prior to the study, the mouth opening in the examined group was 51 ± 12 mm. After the set-up of the Patriot collar, the mouth opening amounted to 37 ± 10 mm, while in the NECKLITE collar group amounted to 49 ± 13 mm (p < 0.001). The use of a cervical collar reduced the degree of mouth opening by 27% when using a standard cervical collar, and less than 4% when using a NECKLITE collar. The pressure on the mastoid processes assessed on a 10-point scale varied between the cervical collars and amounted to 7 ± 2 points for Patriot and 1 ± 1 points for NECKLITE collar (p < 0.001). The pain sensations associated with the cervical collar were also varied and amounted to 6 ± 3 points for Patriot collar vs. 1 ± 1 points for NECKLITE collar (p < 0.001). Ninety- -seven per cent of study participants declared, that they preferred the NECKLITE collar comparing to the Patriot cervical collar.
CONCLUSIONS: A standard cervical collar causes an increase in pain due to the pressure on the mastoid processes and a sense of discomfort for the patient. The NECKLITE collar thanks to the possibility of better fit to the patient’s neck, does not cause any pain, and using this collar it is possible to perform endotracheal intubation without the need to unfasten it.
Keywords
cervical collar, prehospital, emergency medicine, endotracheal intubation
About this articleTitle
ASSESSMENT OF THE CERVICAL COLLAR APPLICATION IMPACT ON THE CONDITIONS OF INTUBATION AND THE FEELINGS OF PATIENTS — PILOT STUDY
Journal
Disaster and Emergency Medicine Journal
Issue
Pages
1-4
Published online
2018-06-12
Page views
2549
Article views/downloads
1082
DOI
Bibliographic record
Disaster Emerg Med J 2018;3(1):1-4.
Keywords
cervical collar
prehospital
emergency medicine
endotracheal intubation
Authors
Michal Ladny
Jacek Smereka
Lukasz Szarpak
Jerzy Robert Ladny
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