Impact of rigid cervical collars on the vital signs and cervical vasculature: Should we be on the alert for anything?

Abstract

ObjectiveIn this study, it was aimed to reveal the effect of RCC application on vital signs and physiology of the neck vascular structures. MethodsThe study was designed as a prospective interventional study on 11 volunteers. The factors that would affect the hemodynamics of the volunteers were standardized before the measurements. The vital signs before and after RCC were measured and under the guidance of ultrasonography (USG), internal jugular vein cross-sectional area (CSA), diameter of the common carotid artery (CCAD), peak systolic velocity (PSV). end-diastolic velocity (EDV), time-averaged maximum velocity (TAMAX), Pulsatility Index, Resistivity Index, time averaged mean velocity (TAMEAN), Volume Flow (FV) measurements were made and compared with each other. ResultsAmong 11 volunteers, the study included 5 women (45.5%). 10 min of RCC application was associated with a reduction of the heart rate by 7.9 bpm (95% CI 4.84–10.98) (pre-collar 74.73 + −8.84, post-collar 66.82 + −9.05, p < 0.001). A corresponding 7.18 mmHg (95% CI 2.11–12.25) decrease in systolic blood pressure (pre-collar mean 115.82 mmHg + −12.55, post-collar mean 108.64 mmHg + −11.46, p = 0.01) and 108.55 mL/min reduction of mean common carotid artery blood volume (95% CI 22.28–194.82) (pre-collar 590.14 mL/min + −194.63, post-collar 481.59 mL/min + −279.36, p = 0.019) were noted. Internal jugular vein CSA has decreased for 0.17 cm2 (95% CI 0.05–0.29) (pre-collar CSA 0.53 + −0.29, post-collar CSA 0.36 + −0.17, p = 0.012). ConclusionIn healthy volunteers, RCC application lasting for ten minutes may reduce systolic blood pressure and heart rate, while decreasing blood volume in both the common carotid artery and the internal jugular vein. It has also been noted that the collapse is larger in the internal jugular vein than in the common carotid artery following the pressure applied by RCC.