Risks associated with magnetic resonance imaging and cervical collar in comatose, blunt trauma patients with negative comprehensive cervical spine computed tomography and no apparent spinal deficit
2008

Risks of MRI and Cervical Collar in Comatose Trauma Patients

Sample size: 2216 publication 10 minutes Evidence: moderate

Author Information

Author(s): Dunham C Michael, Brocker Brian P, Collier B David, Gemmel David J

Primary Institution: St. Elizabeth Health Center

Hypothesis

What are the risks associated with magnetic resonance imaging and cervical collar use in comatose blunt trauma patients with negative cervical spine CT scans?

Conclusion

Secondary brain injury from cervical collar or MRI is more likely than cervical spine instability in comatose blunt trauma patients.

Supporting Evidence

  • 350 per 1,000 comatose unstable patients are functional survivors.
  • 2.5% risk for cervical spine instability in patients with negative CT scans.
  • Prolonged cervical collar use increases ICU complications by 26.2%.
  • 72.1% risk of increased intracranial pressure during MRI scanning.

Takeaway

When patients are in a coma from trauma, using a cervical collar or getting an MRI can be risky, and it might be better to remove the collar without an MRI if scans show no injuries.

Methodology

A literature review was conducted to assess risks associated with cervical collar use and MRI in comatose blunt trauma patients.

Potential Biases

There may be a bias in reporting missed cases of cervical spine instability leading to neurologic deficits.

Limitations

The study may not accurately represent the risk of cervical spine instability due to potential biases in the literature.

Participant Demographics

Comatose blunt trauma patients with Glasgow Coma Scale scores of 3 to 8.

Statistical Information

P-Value

p<0.05

Confidence Interval

95% CI = 35.8% to 70.5%

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/cc6957

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