Risks of MRI and Cervical Collar in Comatose Trauma Patients
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)
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