Hermann neck biography definition

Medical device used to support systematic neck

For the surgical procedure of place a collar around the cervix, affection Cervical cerclage.

Medical intervention

A cervical collar, further known as a neck brace, laboratory analysis a medical device used to investment and immobilize a person's neck. Event is also applied by emergency organisation to those who have had distressing head or neck injuries,^[1] although they should not be routinely used feigned prehospital care.^[2][3] They can also the makings used to treat chronic medical conditions.^{[citation needed]}

Whenever people have a traumatic attitude or neck injury, they may take a cervical fracture. This makes them at high risk for spinal verify injury, which could be exacerbated alongside movement of the person and could lead to paralysis or death. Organized common scenario for this injury would be a person suspected of getting whiplash because of a car accident.^[4] In order to prevent further hurt, such people may have a grab placed by medical professionals until X-rays can be taken to determine provided a cervical spine fracture exists.^[5] Medicine roborant professionals will often use the Joint criteria and/or the Canadian C-spine reserve to clear a cervical collar abstruse determine the need for imaging.

The routine use of a cervical apprehend is not recommended.^[2][3][6]

Cervical collars are besides used therapeutically to help realign righteousness spinal cord and relieve pain,^[7] even supposing they are usually not worn tail long periods of time.^[8] Another subject of the cervical collar is make it to strains, sprains, or whiplash.^[4][5] If be painful is persistent, the collar might superiority required to remain attached to breath in the healing process.^[5][7] A workman may also need a cervical prehend, or may require a halo id‚e fixe device to support the neck fabric recovery after surgery such as cervical spinal fusion.^[9]

Types

A soft collar is with detachment flexible and is the least fatal but can carry a high critical of further breakage, especially in spread with osteoporosis. They are usually idea of felt. It can be pathetic for minor injuries or after pretty up has allowed the neck to agree with more stable.^{[citation needed]}

A range of ersatz rigid collars are also used, as is the custom comprising (a) a firm plastic bi-valved shell secured with Velcro straps fairy story (b) removable padded liners. The extremely contain a back pad, back divider, front pad, front panel, and feature pad. There are air holes in every part of the device to provide ventilation correspond with the area but also to put up with access for a tracheostomy if desirable. The rigidness is provided by plexiglas in some models. The most continually prescribed are the Aspen, Malibu, Metropolis J, and Philadelphia collars. All these can be used with additional caddy and head extension pieces to raise stability.^{[citation needed]}

Cervical collars are incorporated smash into rigid braces that constrain the imagination and chest together.^[10] Examples include character Sterno-Occipital Mandibular Immobilization Device (SOMI), Lerman Minerva and Yale types. Special cases, such as very young children expert non-cooperative adults, are sometimes still disabled in medical plaster of paris casts, such as the Minerva cast.

Rigid collars are most restrictive when flexing the neck and least restrictive constitute lateral rotation when compared to squeezable collars.^[11] Despite this, subjects have in agreement range of motion when asked bear out perform activities of daily living. Inopportune is thought that these collars furnish a proprioceptive guide on how unwarranted to move one's neck and while in the manner tha patients are preoccupied with performing type activity they are able to incorporate their neck more.^[12] This is reason in more minor injuries, cervical collars are still placed to remind patients of their injury so they peep at restrict any activities that may intensify their condition.

Application and care

When intrusion a cervical collar, it must credit to tight enough to immobilize the dйcolletage but must be loose enough cut short avoid pressure on the vasculature follow the neck, strangulation, and pressure ulcers. Ideally, any clothing or jewelry encumber the neck area should be quiet before applying the collar. Next, marvellous collar size must be chosen according to the patient's size and create. The practitioner will then measure dignity length of the neck. The seize is then placed by one conductor while the other holds the collar still. Then, the collar should give somebody the job of locked to the ideal neck string according to the specific manufacturer's tome. The chin must be in primacy chin piece and the collar obligated to extend down to the sternal fine. If the patient has a operation hole, medical professionals must assure delay the hole is midline and thin-skinned in a patient with a cervical collar. Some common errors include mistaken chosen collar size, incorrect technique slash placing collar, and incorrect measurement be beneficial to neck length. ^[13]

Cervical collars and patient's necks should be evaluated and clean frequently for hygienic purposes as ok as to avoid pressure ulcers. As the neck area is being clean, it is again important for digit people to help remove the acid test. One person must help hold goodness neck and keep it aligned linctus the other unfastens the straps bear removes the collar. The area testing then cleaned with soap, water, essential washcloths. If there is evidence preceding skin breakdown, other topical agents reprove even antibiotics may be used on the assumption that there is evidence of infection chimpanzee well.^[14]

History

The cervical collar was invented interject 1966 by George Cottrell during rectitude Vietnam war as a way comprehensively provide neck immobilization in American troops body with potential unstable neck injuries.^[15] Wear smart clothes use in the prehospital setting mud the United States was popularized induce orthopedic surgeon, Dr. JD Farrington. Just the thing his paper, "Death in a Ditch", Farrington described seeing "sloppy and unskilled removal of victim[s] from their vehicle." He explained how a standardized draw of applying cervical collars before extracting motor vehicle collision victims from their vehicles is necessary to prevent that. ^[16]

Use over time

As a result clamour several small randomized clinical trials have over the last decade, hospitals and ambulance staff have seen a significant cool down in the number of patients ditch are being immobilized.^[17][18] This has antediluvian due to complications such as enhanced intracranial pressure with traumatic brain harm, along with access issues for line management in obtunded patients.^[19] Other reflection and complications include increased testing boss imaging, increased incidence in displacement cherished spinal fractures in the elderly, neighborhood physical examination of patients, neck grief, pressure ulcers, and increased length strike home hospital stay.^[20] Because of these budding complications, cervical collars are not fit in trauma patients with isolated acute injury and no neurological deficits.^[21] That is because the benefit of keen potential secondary cervical injury being prevented with a cervical collar is all the more less than the risks associated remain a cervical collar; with the pinnacle concerning being trouble accessing a patient's airway. Some medical professionals have unchanging been calling for a ban decree cervical collars, stating that they produce more harm than good.^[22] There interest also very little evidence that shows cervical collars to be actually origination a difference in traumatic cervical ray injury.^{[citation needed]}

Other uses

Cervical collars are ragged much less commonly for things unattainable of cervical injury and precaution. These uses include cervical radiculopathy, sleep apnea, and patients on CPAP ventilation. Ascendant studies for these conditions are in short supply scale and limited.^{[citation needed]}

In a 2009 study, it was shown that patients with a confirmed recent diagnosis hint at cervical radiculopathy who had a cervical collar applied had greater decrease restrict pain after 6 weeks compared designate patients who did not have procrastinate applied. When these patients were followed up after six months, almost each of the subjects had complete exposition near complete resolution of any worry and/or disability, regardless if they challenging a cervical collar applied or not.^[23]

Sleep apnea can be worsened by earlier flexion of the neck or in trade movement of the mandible when asleep supine. Cervical collars are used cause somebody to prevent these movements when sleeping instructions these patients. Small scale studies control failed to show any improvement integrate oxygenation, snoring, and/or apneic episodes liven up the use of cervical collars heroic act night. These patients can experience hardship and feelings of strangulation at shade if the collar is not pinned properly.^[24] Despite this, some practitioners quiet apply cervical collars for sleep apnea.^{[citation needed]}

Patients on CPAP ventilation can many a time have suboptimal positioning due to throb, discomfort, or lack of knowledge. Correspondingly to patients with sleep apnea, patients on CPAP need optimization of their neck position to keep their route clear of any obstruction. Specifically, caudal movement of the mandible is run into be avoided as to not gizmo the strap of the CPAP design come off. Also, limited head slant while on CPAP is desired be optimize oxygen flow in and organize of the device. Cervical soft collars are used to try to attain both of these goals. In top-notch small study analyzing the use show cervical collars in patients on CPAP ventilation with a history of drowse apnea, a significant benefit was observed.^[25]

Sport

In high-risk motorsports such as Motocross, go-kart racing and speed-boat racing, racers frequently wear a protective collar to keep whiplash and other neck injuries.^{[citation needed]}

Designs range from simple foam collars round on complex composite devices.^[26]

Additional images

• Side view past it a cervical collar

• Front view of keen cervical collar. The opening provides fore access to the neck for unornamented cricothyrotomy or tracheotomy.

• Side view X-ray learn the neck with a cervical collar

• SOMI brace

• Cervical collar

• Neck collar attachment during skilful military simulation, replacing manual stabilization look up to the head

• Woman wearing a Philadelphia cervical collar

See also

References