CERVICAL COLLARS - A POTENTIAL RISK TO THE HEAD-INJURED PATIENT

Interface pressures beneath six types of collar in volunteers were mea sured Under certain types of collar mean interface pressures of more t han 10 mmHg were obtained, with several individual readings around 30 mmHg. By causing jugular venous obstruction a similar rise in intracra nial pressure may be produced inadvertently. The mechanisms of action for this are discussed. Those collars with the least tendency to produ ce jugular venous obstruction were of the moulded variety which extend support to the occiput, mandible and shoulder girdle. The authors the refore recommend this type of cervical splintage device where injury o f the cervical spine is suspected. This paper emphasizes the potential danger to head-injured patients when the other devices are applied to o tightly, producing a 'venous tourniquet' effect.