The Association between Cervical Collar and Intracranial Pressure Measured by the Optic Nerve Sheath Diameter in Trauma Patients Refered to the Emergency Department

Objective: The aim of the present study was to determine the effect of the application or prolonged use of a Cervical Collar (CC) on intracranial pressure (ICP) through the changes in optic nerve sheath diameter (ONSD). Materials and methods: This prospective study was performed on 94 adult trauma patients who were referred to the emergency department between November, 15, 2017 and November, 15, 2018. Patients with any co-morbidities were excluded. The following factors were evaluated; age, gender, the mechanism of the trauma, the period between the trauma and admission, presence of any cranial and cervical trauma, symptoms and signs of head trauma, brain tomography (BT) findings, vital parameters, and ONSD values of the patients measured 3 times every 20 minutes. Results: The average age of the patients admitted to the emergency department due to trauma included 51 (54.3%) males and was 42.0 ± 16.1 years. ONSD was 4.8 ± 0.9 mm at admission, 5.0 ± 0.9 mm at the 20th minute of the admission, and was 4.4 ± 0.9 mm at the 20th minute after removal of the CC. The changes in ONSD diameter during the follow-up was statistically significant (p < 0.05). Conclusions: CC increases the ICP and ONSD regardless of the type of trauma types. Unnecessary CC applications should be avoided and the collar should be removed immediately after the presence of cervical trauma has been eliminated.

Cervical collar, Intracranial pressure, Optic nerve sheath diameter, Trauma

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