Cervical collar effect on pulmonary volumes in patients with trauma

According to Advanced Trauma Life Support (ATLS) for trauma patients, a cervical collar should be applied initially. Patients on backboards with a cervical collar mostly complain of dyspnea and tend to take the collar off or roll themselves off the backboard. The purpose of this study is to investigate the effect of collar removal on lung volumes and dyspnea in patients with GCS 15.

In a physiological study, 50 trauma patients with a GCS of 15 were enrolled. We measured lung volumes before and after the application of a cervical collar in patients.

The average FEV1 in patients with and without a cervical collar was 89.08 ± 17.59 (% of predicted) and 98.26 ± 17.74 (% of predicted), respectively. The average FEF25-75 in patients with a cervical collar was 90.80 ± 26.07 (% of predicted) and in patients without a cervical collar it was 101.90 ± 23.06 (% of predicted). The average FEV1/FVC in patients with a cervical collar was 95.30 ± 18.55 % and in patients without a cervical collar it was 99.14 ± 18.12 %.

The FEV1, FEV6, FEV1/FEV6, PEF, FEF25-75, FVC, FEV1/FVC parameters of pulmonary function tests were significantly increased after collar removal.

Cervical collar applications in trauma patients cause a significant decrease in lung capacity and spirometry parameters. Patients suffering from lung diseases and respiratory distress require special attention which means that the cervical collar should be removed as soon as cervical injuries are ruled out so as to avoid hypoxia.