Range-of-Motion Restriction and Craniofacial Tissue-Interface Pressure From Four Cervical Collars

Tescher, Ann N.; Rindflesch, Aaron; Youdas, James W.; Jacobson, Therese; Downer, Lisa L.; Miers, Anne G.; Basford, Jeffrey R.; Cullinane, Daniel C.; Stevens, Susanna R.; Pankratz, V. Shane; Decker, Paul A.

doi:10.1097/ta.0b013e3180487d0f

Cited by 49 publications

(30 citation statements)

References 16 publications

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“…In those individuals, the collar or Vista Ò TS would serve as effective alternatives. Skin breakdown and pressure ulcers [32,33] due to prolonged usage have been documented in some patients particularly at the main contact points at the mandible, occiput, ears, shoulders, and clavicles. Prior studies have demonstrated that these complications may be reduced or eliminated with appropriate choice of newer, improved orthotics, an appropriate skin care regimen and monitoring, and proper fitting and application of the orthoses [34][35][36].…”

Section: Discussionmentioning

confidence: 99%

Effects of orthoses on three-dimensional load–displacement properties of the cervical spine

Ivancic

2012

Eur Spine J

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Purpose Our objectives were to develop a skull-neckthorax model capable of quantifying spinal motions in an intact human cadaver neck with and without cervical orthoses, determine the effect of orthoses on three-dimensional load-displacement properties of all cervical spinal levels, and compare and contrast our results with previously reported in vivo data. Methods Load input flexibility tests were performed to evaluate two cervical collars (Vista Ò collar and Vista ÒMultipost collar) and two cervicothoracic orthoses (CTOs: Vista Ò TS and Vista Ò TS4) using the skull-neck-thorax model with 10 intact whole cervical spine specimens. The physiologic range of motion (RoM) limit was the peak obtained from flexibility tests with no orthosis. Pair-wise repeated measures, analysis of variance (p \ 0.05), and Bonferroni post hoc tests determined significant differences in average peak RoM at each spinal level among the experimental conditions. Results Significant reductions below physiologic limits were observed due to all orthoses in: three-dimensional head/T1 RoMs, all sagittal intervertebral RoMs, and lateral bending at C4/5 through C7/T1. Both CTOs significantly reduced C6/7 sagittal RoM as compared to both collars. Intervertebral RoMs with the orthoses could not be differentiated from physiologic limits at the upper cervical spine in lateral bending and throughout the entire cervical spine in axial rotation, with the exception of C1/2.Conclusions Our results indicate that cervical orthoses effectively immobilized the entire cervical spine in flexion/ extension and the lower cervical spine in lateral bending. The CTOs improved immobilization of the lower cervical spine in flexion/extension as compared to the collars. The orthoses were least effective at restricting lateral bending of the upper spinal levels and axial rotation of all spinal levels, except C1/2. Understanding immobilization provided by orthoses will assist clinicians in selecting the most appropriate brace based upon patient-specific immobilization requirements.

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Section: Discussionmentioning

confidence: 99%

Effects of orthoses on three-dimensional load–displacement properties of the cervical spine

Ivancic

2012

Eur Spine J

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“…When the train-of-four response was zero at the ulnar nerve, the neck was immobilised with an appropriately sized semirigid Philadelphia Patriot Ò cervical collar (Philadelphia Cervical Collar Co., Thorofare, NJ, USA), according to the manufacturer's instructions [18]. The head was taped to the trolley ( Fig.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the GlideScope^® for tracheal intubation in patients with cervical spine immobilisation by a semi‐rigid collar

Bathory¹,

Frascarolo²,

Kern

et al. 2009

Anaesthesia

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SummaryApplication of cervical collars may reduce cervical spine movements but render tracheal intubation with a standard laryngoscope difficult if not impossible. We hypothesised that despite the presence of a Philadelphia Patriot® cervical collar and with the patient’s head taped to the trolley, tracheal intubation would be possible in 50 adult patients using the GlideScope® and its dedicated stylet. Laryngoscopy was attempted using a Macintosh laryngoscope with a size 4 blade, and the modified Cormack–Lehane grade was scored. Subsequently, laryngoscopy with the GlideScope was graded and followed by tracheal intubation. All patients’ tracheas were successfully intubated with the GlideScope. The median (IQR) intubation time was 50 s (43–61 s). The modified Cormack–Lehane grade was 3 or 4 at direct laryngoscopy. It was significantly reduced with the GlideScope (p < 0.0001), reaching grade 2a in most patients. Tracheal intubation in patients wearing a semi‐rigid collar and having their head taped to the trolley is possible with the help of the GlideScope.

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“…For the same outcome, we also identified very-low-quality evidence (downgraded for indirectness) from 13 nonrandomized studies [140][141][142][143][144][145][146][147][148][149][150][151][152] Seven additional studies [153][154][155][156][157][158][159] were not included in the final analysis because they were missing data (mean and/or SD of intervention and control group not reported).…”

Section: (Semi)rigid Collar (I) Compared With No Collar (C)mentioning

confidence: 99%

Part 9: First Aid

Em¹,

Da²,

Buck³

et al. 2015

Circulation

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and curriculum development, and a specialist in first aid evidence evaluation methodology and guideline development.The task force convened in June 2013 to review the topics and questions that were evaluated in 2005 and 2010, past research questions formulated in the PICO style (population, intervention, comparator, outcomes) that were never completed, and the new questions that had been submitted since 2010 to the task force, and a priority list created. Topics were reviewed for areas of controversy, known additional new science, and subject matter not previously evaluated. Task force members created a priority list for review, and the top 10 priority-ranked PICO questions were assigned. After the successful commencement of the workflow, the task force co-chairs added a further 12 PICO questions, including 5 new questions, 1 derived question, and 6 that had been previously reviewed. Selected PICO questions that had been previously reviewed were, in some cases, reworded to facilitate literature searches, and outcomes were decided upon by group consensus.Evidence reviewers were recruited through a call for volunteers distributed by ILCOR to stakeholder organizations around the world. More than 30 individual reviewers were assigned to topics, usually by preference or expertise, but avoiding any direct conflicts of interest. In general, 2 evidence reviewers were assigned to each PICO, supervised by a member of the task force designated as the task force question owner. Evidence reviewers included physicians with diverse specialties including emergency medicine, EMS, wilderness medicine, critical care, cardiology, occupational medicine, toxicology, anesthesia, pediatric emergency medicine, public health, and epidemiology, as well as paramedics, nurse practitioners and first aid education specialists with experience in guideline and curriculum development, and professional evidence evaluation and methodology experts. The Evidence Evaluation ProcessFor the 2015 international evidence evaluation process, the AHA developed a new Web-based information and documentation platform, the Systematic Evidence Evaluation and Review System (SEERS), to support the ILCOR systematic reviews and to capture the data in reusable formats. This Webbased system facilitated structured reviews in a consistent format that would support the ultimate development of science summaries and evidence-based treatment recommendations.Each task force performed a detailed systematic review based on the recommendations of the Institute of Medicine of the National Academies, 1 using the methodological approach proposed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group.2 After identifying and prioritizing the PICO questions to be addressed, 3 and with the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evalu...

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Range-of-Motion Restriction and Craniofacial Tissue-Interface Pressure From Four Cervical Collars

Abstract: Miami J and Philadelphia collars restricted CROM to the greatest extent. Miami J and Miami J/Occian back had the lowest levels of mandibular and occipital pressure; these collars may markedly reduce the risk of occipital pressure ulcers without compromising immobilization.

Cited by 49 publications

References 16 publications

Effects of orthoses on three-dimensional load–displacement properties of the cervical spine

Effects of orthoses on three-dimensional load–displacement properties of the cervical spine

Evaluation of the GlideScope^® for tracheal intubation in patients with cervical spine immobilisation by a semi‐rigid collar

Part 9: First Aid

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Range-of-Motion Restriction and Craniofacial Tissue-Interface Pressure From Four Cervical Collars

Abstract: Miami J and Philadelphia collars restricted CROM to the greatest extent. Miami J and Miami J/Occian back had the lowest levels of mandibular and occipital pressure; these collars may markedly reduce the risk of occipital pressure ulcers without compromising immobilization.

Cited by 49 publications

References 16 publications

Effects of orthoses on three-dimensional load–displacement properties of the cervical spine

Effects of orthoses on three-dimensional load–displacement properties of the cervical spine

Evaluation of the GlideScope® for tracheal intubation in patients with cervical spine immobilisation by a semi‐rigid collar

Part 9: First Aid

Contact Info

Product

Resources

About

Evaluation of the GlideScope^® for tracheal intubation in patients with cervical spine immobilisation by a semi‐rigid collar