Table 4 Estimated collar management risks in functional survivors with negative CS CT and no apparent spinal deficit
Collar management options | Risk | Risk rate | Patients at risk |
|---|---|---|---|
Unstable patients (350 functional survivorsa) | |||
   Early collar removal (no MRI) | CS instability | 2.5% | 9 |
   Cervical collar | ↑ ICP (~5 mmHg) | 35.8% | 125 |
   Prolonged collar use | ↑ ICU complications | 26.2% | 92 |
   MRI (transportation) | ↑ ICP, ↓ BP, hypoxia | 14.6% | 51 |
   MRI (head down) | ↑ ICP (~5 mmHg) | 72.1% | 252 |
   MRI (head down) | Aspiration or VAP | 20.6% | 72 |
High-risk patients (150 functional survivorsa) | |||
   Early collar removal (no MRI) | CS instability | 2.5% | 4 |
   Prolonged collar use | ↑ ICU complications | 26.2% | 39 |
   MRI (transportation) | ↑ ICP, ↓ BP, hypoxia | 14.6% | 22 |
   MRI (head down) | Aspiration or VAP | 20.6% | 31 |
Stable patients (600 functional survivorsa) | |||
   Early collar removal (no MRI) | CS instability | 2.5% | 15 |
   Prolonged collar use | ↑ ICU complications | 26.2% | 157 |
   MRI (transportation) | ↑ ICP, ↓ BP, hypoxia | 9.3% | 56 |
   MRI (head down) | Aspiration or VAP | 20.6% | 124 |