A Study To Compare The Usefulness Of Double Soft Cervical Collar Versus Hard Cervical Collar (Philadelphia Collar) For Neck Immobilization

摘要

Objective: This is a study to compare the usefulness of double soft cervical collar versus the hard cervical collar for neck immobilization.Hypothesis: With the usage of the double cervical soft collar, the degree of immobilization can be achieved similar to that of a hard cervical collar.Methods and materials:The study was conducted using healthy volunteers from emergency medicine training residents recruited for the study on a voluntary basis.All the participants wore all the four types of cervical collars one after another and scored their experience with each collar in the data sheet. The four types of cervical collars were worn by the participants as follows:i. Hard cervical collar was worn normally.ii. Single soft cervical collar was worn in a traditional manner with the sticky portion to the back of the neck.iii. Single soft cervical collar was worn in reverse manner with the sticky portion to the front of the neck.iv. Double cervical collar worn with the first soft cervical collar in the traditional manner with the sticky portion to the back and on top of it, the second soft cervical collar in the reverse manner with the sticky portion to the front of the neck.The participants were asked to score in the score sheet depending upon their subjective feelings with regards to tightness and inability to move the neck for all the 4 forms of cervical collars.Results:The total number of subjects (residents and attending) was 18. They were asked to circle the scores for two subjective feelings in all the 4 varieties of cervical collars.The two subjective feelings were-- tightness and easy movement of the neck. In each of them there are 4 different scores as below.A. Tightness around the neck :Score 1: No tightnessScore2: Slightly tightScore 3: Almost tightScore 4: Very tight.B. Movement of the neck upon wearing different cervical collars:Score 1: Movement of the neck freely.Score 2: Movement of the neck with slight difficulty.Score 3: Movement of the neck with great difficultyScore 4: No movement of the neck.The scores were as follows:For hard collar: All 18 participants gave a score of 4 for Tightness; and for Movement of neck a score of 3.For single soft cervical collar (worn in both traditional & reverse manners): All gave a score of 2 for Tightness and for Movement.For double soft cervical collar: For Tightness around neck- 18/18 gave a score of 4. For Movement of the neck- 1/18 gave a score of 2 and 17/18 gave a score of 3.Interestingly no participant gave a score of 4 for Movement, with any of the 4 collars. It means they can still move the neck, even with a hard cervical collar.Statistics:We compared all the scores for different cervical collars for both Tightness around the neck and for Movement of the neck, after wearing collars. Pearson Chi-square two tailed p-value is <0.0001.Conclusions:According to our study, both the hard and double cervical collars were superior to the usage of single cervical collar. The usage of the double cervical collar is as effective as hard cervical collar. Surprisingly, our study has shown that participants even with the hard cervical collar can move the neck. In real traumatic situations, our study indicates requirement of additional reinforcements to the hard cervical collar, such as sand bags etc. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable{mso-style-name:"Table Normal";mso-tstyle-rowband-size:0;mso-tstyle-colband-size:0;mso-style-noshow:yes;mso-style-priority:99;mso-style-parent:"";mso-padding-alt:0in 5.4pt 0in 5.4pt;mso-para-margin-top:0in;mso-para-margin-right:0in;mso-para-margin-bottom:8.0pt;mso-para-margin-left:0in;line-height:107%;mso-pagination:widow-orphan;font-size:11.0pt;font-family:"Calibri","sans-serif";mso-ascii-font-family:Calibri;mso-ascii-theme-font:minor-latin;mso-hansi-font-family:Calibri;mso-hansi-theme-font:minor-latin;} Background A rigid cervical collar has been traditionally used for traumatic cervical spine injuries