|
Craig et al., 1991 [25]
|
UK
|
Case review:
|
Intracranial pressure and collar use
|
Collar use was associated with impaired venous drainage and as such relates to an increase in ICP
|
Only two patients
|
|
2 patients
|
|
Lemyze et al., 2011 [28]
|
France
|
Case review:
|
Level of consciousness
|
Collar use post hanging may exacerbate cerebral oedema due to compression of neck veins
|
Only one patient
|
|
1 patient
|
|
Dunham et al., 2008 [32]
|
USA
|
Literature Review
|
Risks with MRI and collar use
|
Collar use is associated with a rise in ICP, and secondary brain injury; early collar removal advocated
|
Evidence supports the theory but no substantial proof
|
|
Ho et al., 2002 [7]
|
China
|
Literature Review
|
Intracranial pressure and collar use
|
Collars appear to act like a tourniquet around the neck, potentially exacerbating a head injury and increasing ICP
|
Evidence supports the theory but no substantial proof
|
|
Dunham et al., 2011 [8]
|
USA
|
Simulation study
|
Collar use and outcome
|
Early collar removal is advocated for unstable/high risk and stable patients with spinal injuries
|
Simulation study only; no real proof for claims
|
|
Davies et al., 1996 [6]
|
UK
|
Study:
|
ICP before and after collar application
|
Stifneck collar may cause a rise in intracranial pressure.
|
Supports hypothesis for collars affecting ICP but exact mechanism for rise in ICP was not determined
|
|
19 patients
|
|
Hunt et al., 2001 [29]
|
UK
|
Study:
|
ICP before and after collar application
|
Collars are associated with a rise in intracranial pressure, potentially worse if the ICP is higher to start with
|
Supports hypothesis for collars affecting ICP but exact mechanism for rise in ICP was not determined
|
|
30 patients
|
|
Kolb et al., 1999 [24]
|
USA
|
Study:
|
Cerebrospinal fluid pressure before and after collar application
|
Cerebrospinal fluid pressure increased after collar application, but no clear associated with BMI
|
Collars were placed when the patient was inclined to the side rather than supine; exact mechanism for rise in ICP was not determined
|
|
20 patients
|
|
Kuhnigk et al., 1993 [30]
|
Germany
|
Study:
|
Intracranial pressure and collar use
|
Found no correlation between collar use and increased intracranial pressure
|
Baseline ICP readings were higher than in other reports and as such may have had an impact on the results
|
|
18 patients
|
|
Mobbs et al., 2002 [9]
|
Australia
|
Study:
|
ICP before and after collar application
|
Intracranial pressure was higher following the application of a collar
|
Supports hypothesis for collars affecting ICP but exact mechanism for rise in ICP was not determined
|
|
10 patients
|
|
Stone et al., 2010 [31]
|
USA
|
Study:
|
Jugular vein dimensions before and after collar application
|
Collar application associated with alteration to jugular vein diameter indicative of venous obstruction
|
Supports hypothesis for collars affecting ICP but no mechanism was determined as actual ICP was not measured
|
|
42 volunteers
|
|
Porter et al., 1999 [27]
|
UK
|
Study:
|
ICP before and after collar application
|
All patients showed a rise in ICP following collar application
|
Supports hypothesis for collars affecting ICP but no mechanism was determined
|
|
9 patients
|
|
Ferguson et al., 1993 [10]
|
UK
|
Study:
|
Tissue Interface Pressure around neck area
|
Normal jugular venous pressure when supine was 2-7 mmHg, concluded pressures exerted on the neck over this will cause a ‘back pressure’
|
Supposition rather than fact with the relationship of collar use to increased ICP
|
|
5 patients
|
|
Raphael et al., 1994 [26]
|
UK
|
Study:
|
Cerebrospinal fluid pressure before and after collar application
|
7/9 experienced raised cerebrospinal fluid pressure following collar application
|
Supports hypothesis for collars affecting ICP but no mechanism was determined
|
|
9 patients
|
