Background: Concern has been raised that cervical collars may increase intracranial pressure in traumatic brain\ninjury. The purpose of this study was to compare four types of cervical collars regarding efficacy of immobilizing\nthe neck, effect on jugular venous pressure (JVP), as a surrogate for possible effect on intracranial pressure, and\npatient comfort in healthy volunteers.\nMethods: The characteristics of four widely used cervical collars (Laerdal StifneckÃ?® (SN), VistaÃ?® (VI), Miami J\nAdvancedÃ?® (MJ), PhiladelphiaÃ?® (PH)) were studied in ten volunteers. Neck movement was measured with\ngoniometry, JVP was measured directly through an endovascular catheter and participants graded the collars\naccording to comfort on a scale 1ââ?¬â??5.\nResults: The mean age of participants was 27 Ã?± 5 yr and BMI 26 Ã?± 5. The mean neck movement (53 Ã?± 9Ã?°) decreased\nsignificantly with all the collars (p < 0.001) from 18 Ã?± 7Ã?° to 25 Ã?± 9Ã?° (SN < MJ < PH < VI). There was a significant increase in\nmean JVP (9.4 Ã?± 1.4 mmHg) with three of the collars, but not with SN, from 10.5 Ã?± 2.1 mmHg to 16.3 Ã?± 3.3 mmHg\n(SN < MJ < VI < PH). The grade of comfort between collars varied from 4.2 Ã?± 0.8 to 2.2 Ã?± 0.8 (VI >MJ > SN > PH).\nConclusion: Stifneck and Miami J collars offered the most efficient immobilization of the neck with the least effect on\nJVP. Vista and Miami J were the most comfortable ones. The methodology used in this study may offer a new\napproach to evaluate clinical efficacy and safety of neck collars and aid their continued development.
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