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Open AccessJournal ArticleDOI

Reduction in mouth opening with semi-rigid cervical collars

C. M. Goutcher, +1 more
- 01 Sep 2005 - 
- Vol. 95, Iss: 3, pp 344-348
TLDR
Application of a semi-rigid cervical collar can significantly reduce mouth opening and this could hinder definitive airway placement and support removing the anterior portion of the collar before attempts at tracheal intubation.
Abstract
Background Reduced mouth opening may be a major contributing factor to the deterioration in the view obtained at laryngoscopy when a semi-rigid cervical collar is in place. We set out to assess the degree to which mouth opening is restricted by a cervical collar. Methods We measured maximal inter-incisor distance in 52 volunteers. It was measured again after application of each of three appropriately sized semi-rigid cervical collars (Stifneck, Miami J, and Philadelphia). Results Inter-incisor distance was significantly reduced by the application of a cervical collar [No collar 41 (7) mm–mean (sd); Stifneck 26 (8) P P P Conclusions Application of a semi-rigid cervical collar can significantly reduce mouth opening. This could hinder definitive airway placement. Our results support removing the anterior portion of the collar before attempts at tracheal intubation.

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Citations
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Airway management in adults after cervical spine trauma.

TL;DR: There are no outcome data that would support a recommendation for a particular practice option for airway management, but a number of options seem appropriate and acceptable.
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Crossover comparison of the laryngeal mask supreme and the i-gel in simulated difficult airway scenario in anesthetized patients.

TL;DR: Both airway devices had similar insertion success and clinical performance in the simulated difficult airway situation and it is shown that both devices are feasible for emergency airway management in patients with reduced neck movement and limited mouth opening.
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Neuroprotection in traumatic brain injury: A complex struggle against the biology of nature

TL;DR: This review is focused on neuroprotective agents that have recently been evaluated in clinical trials and are currently under clinical evaluation, as well as on those that appear promising and are likely to undergo clinical evaluation in the near future.
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Prehospital use of cervical collars in trauma patients: a critical review.

TL;DR: This critical review discusses the pros and cons of collar use in trauma patients and proposes a safe, effective strategy for prehospital spinal immobilization that does not include routine use of collars.
References
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Journal ArticleDOI

Difficult Airway Society guidelines for management of the unanticipated difficult intubation

TL;DR: The Difficult Airway Society (DAS) developed guidelines for management of the unanticipated difficult tracheal intubation in the non-obstetric adult patient without upper airway obstruction as discussed by the authors.
Journal ArticleDOI

The intubating laryngeal mask. I: Development of a new device for intubation of the trachea.

TL;DR: The aim was to create a new airway system with better intubation characteristics than the LMA, and to eliminate the need for head-neck manipulation and insertion of fingers in the mouth during placement.
Journal ArticleDOI

The effect on laryngoscopy of different cervical spine immobilization techniques

TL;DR: Mouth opening was significantly reduced when patients were wearing cervical collars and this was the main factor contributing to the increased difficulty of laryngoscopy in this particular form of cervical spine immobilisation.
Journal ArticleDOI

Orotracheal intubation in patients with potential cervical spine injuries. An indication for the gum elastic bougie.

TL;DR: The gum elastic bougie is recommended as an aid to intubating the patient with suspected cervical spine injury, particularly when the glottis is not immediately visible.
Journal ArticleDOI

A response to 'Difficult Airway Society guidelines for management of the unanticipated difficult intubation', Henderson JJ, Popat MT, Latto IP and Pearce AC, Anaesthesia 2004; 59: 675-94.

TL;DR: It is shown that during surgical procedures identical to those described here, S100b levels increases are consistent with early damage to the cerebral vasculature, and was evident only when non-specific binding to non-S100b protein was taken into account and subtracted from the readout.
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