open access

Vol 3, No 1 (2018)
ORIGINAL ARTICLE
Published online: 2018-06-12
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ASSESSMENT OF THE CERVICAL COLLAR APPLICATION IMPACT ON THE CONDITIONS OF INTUBATION AND THE FEELINGS OF PATIENTS — PILOT STUDY

Michal Ladny, Jacek Smereka, Lukasz Szarpak, Jerzy Robert Ladny
DOI: 10.5603/DEMJ.2018.0001
·
Disaster Emerg Med J 2018;3(1):1-4.

open access

Vol 3, No 1 (2018)
ORIGINAL ARTICLE
Published online: 2018-06-12

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.

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Keywords

cervical collar, prehospital, emergency medicine, endotracheal intubation

About this article
Title

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

Vol 3, No 1 (2018)

Pages

1-4

Published online

2018-06-12

DOI

10.5603/DEMJ.2018.0001

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

References (12)
  1. Rahmani F, Pouraghaei M, Moharamzadeh P, et al. Effect of Neck Collar Fixation on Ventilation in Multiple Trauma Patients. Trauma Mon. 2016; 21(4): e21866.
  2. Peck GE, Shipway DJ, Tsang K, et al. Cervical spine immobilisation in the elderly: a literature review. Br J Neurosurg. 2018 [Epub ahead of print]: 1–5.
  3. Barati K, Arazpour M, Vameghi R, et al. The Effect of Soft and Rigid Cervical Collars on Head and Neck Immobilization in Healthy Subjects. Asian Spine J. 2017; 11(3): 390–395.
  4. Kreinest M, Goller S, Rauch G, et al. [Parameters influencing the preclinical application of cervical collars]. Unfallchirurg. 2017; 120(8): 675–682.
  5. Pryce R, McDonald N. Prehospital Spinal Immobilization: Effect of Effort on Kinematics of Voluntary Head-neck Motion Assessed using Accelerometry. Prehosp Disaster Med. 2016; 31(1): 36–42.
  6. Gawlowski P, Smereka J, Madziala M, et al. Comparison of the ETView Single Lumen and Macintosh laryngoscopes for endotracheal intubation in an airway manikin with immobilized cervical spine by novice paramedics: A randomized crossover manikin trial. Medicine (Baltimore). 2017; 96(16): e5873.
  7. Benger J, Blackham J. Why do we put cervical collars on conscious trauma patients? Scand J Trauma Resusc Emerg Med. 2009; 17: 44.
  8. Bledsoe B, Carrison D. Why EMS Should Limit the Use of Rigid Cervical Collars. Journal of Emergency Medical Services. 2015; Jan 26.
  9. Goutcher CM, Lochhead V. Reduction in mouth opening with semi-rigid cervical collars. Br J Anaesth. 2005; 95(3): 344–348.
  10. Madziala M, Smereka J, Dabrowski M, et al. A comparison of McGrath MAC® and standard direct laryngoscopy in simulated immobilized cervical spine pediatric intubation: a manikin study. Eur J Pediatr. 2017; 176(6): 779–786.
  11. Madziala M. Endotracheal intubation during manual inline cervical stabilization performed by nurses. Am J Emerg Med. 2016; 34(12): 2456–2457.
  12. Gawlowski P, Smereka J, Madziala M, et al. Comparison of the Macintosh laryngoscope and blind intubation via the iGEL for Intubation With C-spine immobilization: A Randomized, crossover, manikin trial. Am J Emerg Med. 2017; 35(3): 484–487.

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