This document discusses the evidence for and against cervical spine (c-spine) immobilization in trauma patients. While c-spine immobilization has long been standard practice, recent studies show little evidence that it prevents secondary c-spine injury and evidence that it can cause complications. Immobilization may increase intracranial pressure, interfere with airway management, and cause pressure ulcers. The document concludes that c-spine fractures are rare, immobilization has not been shown to improve outcomes, and it can harm some patients, making clinical decision-making difficult.
Polytrauma and multiple traumata are medical terms describing the condition of a person who has been subjected to multiple traumatic injuries. This will be more prevalent in our country
Successful management of Polytrauma must achieve the following goals, 1- Keep someone alive that would be dead without you 2- Prioritize treatment to prevent killing someone 3- Treat extremity injuries to return the patient to a functional life. The Priorities are 1- Life threatening, 2- Limb threatening, 3- Function threatening. The question about the best strategy in the management Polytrauma and the choice between an Early Total Care (ETC) vs. Damage Control Orthopedics (DCO) will be answered in this presentation.
Polytrauma and multiple traumata are medical terms describing the condition of a person who has been subjected to multiple traumatic injuries. This will be more prevalent in our country
Successful management of Polytrauma must achieve the following goals, 1- Keep someone alive that would be dead without you 2- Prioritize treatment to prevent killing someone 3- Treat extremity injuries to return the patient to a functional life. The Priorities are 1- Life threatening, 2- Limb threatening, 3- Function threatening. The question about the best strategy in the management Polytrauma and the choice between an Early Total Care (ETC) vs. Damage Control Orthopedics (DCO) will be answered in this presentation.
polytrauma lecture prepare by three medical student in Kerbala university / college of medicine department of surgery to presented as seminar
for download as ppt
https://drive.google.com/open?id=1bc3HMEeJyhrOwag-AvTFMmPVKi12O1PU
INITIAL ASSESSMENT OF TRAUMA PATIENTS....(INSPIRED FROM CTLS AND ATLS GUIDELI...Prerna Biswal
THIS PRESENTATION WAS MADE AT IMA HOUSE IN BHUBANESWAR,ODISHA, BY DR.NIBEDITA PANI,HOD ,DEPT. OF ANAESTHESIOLOGY AND DR.PRERNA BISWAL,PG,ANAESTHESIOLOGY,SCBMCH,CUTTACK,
polytrauma lecture prepare by three medical student in Kerbala university / college of medicine department of surgery to presented as seminar
for download as ppt
https://drive.google.com/open?id=1bc3HMEeJyhrOwag-AvTFMmPVKi12O1PU
INITIAL ASSESSMENT OF TRAUMA PATIENTS....(INSPIRED FROM CTLS AND ATLS GUIDELI...Prerna Biswal
THIS PRESENTATION WAS MADE AT IMA HOUSE IN BHUBANESWAR,ODISHA, BY DR.NIBEDITA PANI,HOD ,DEPT. OF ANAESTHESIOLOGY AND DR.PRERNA BISWAL,PG,ANAESTHESIOLOGY,SCBMCH,CUTTACK,
Cervical spine clearance lecture given to 1st-year emergency medicine residents at Duke University. Covers indications for applying cervical collar, types of collars, types of imaging of the spine, and when to remove the collar.
Standing 101 is for Physical Therapists, Occupational Therapists, and Assistive Technology Professionals. It covers the history of standing therapy for the disabled, including research studies on standing programs. It also discusses the different types of standing frames including: prone standers, supine standers, and sit to stand standers. It concludes with information on funding and documentation for standing equipment and writing a letter of medical necessity for standing.
Introducción básica en la Ecografía clínica. Descripción de los cortes de estudio más sencillos así como de los hallazgos más frecuentes. Iniciación al manejo de la Ecografía.
Dr. Donald Corenman (http://neckandback.com 970.479.5895) is a spine surgeon and spinal cord expert practicing at the Steadman Clinic in Vail, CO. He created this Power Point presentation on cervical spine injury and the evaluation of the cervical spine with an injury. The cervical spine (C spine) represents the neck area of the upper spine.
This presentation--clearing the cervical spine--offers an in-depth look at cervical spine injury of the neck (C spine) including fractures, cervical nonskeletal injuries, and also offers a 3-view radiograph approach into the exam.
Dr. Corenman is a spine expert and treats nonskeletal injuries such as ligamentous instability, sciwora and central cord injury. He is an expert in myelopathy, sciatica, degenerative disc disease, scoliosis and slipped disc.
Sternal Fractures & Dislocations - EMGuidewire Radiology Reading RoomSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Sternal Fractures and Dislocations and is brought to you by Carrie Bissell, MD, Aaron Fox, MD, Kendrick Lim, MD, Stephanie Jensen, MD, and Olivia Rice, MD. It is has special guest editor: Sean Dieffenbaugher, MD and Laurence Kempton, MD
This is an old article circa 2002 that is an excellant overview of selective spinal immobilization. Since I am having trouble finding it online anymore, I put it here for all to read and enjoy. I did not write it nor do I came any copywrite for it.
Whiplash describes a range of injuries to the neck caused by or related to a sudden distortion of the neck. The typical clinical picture in whiplash injury is that following the injury there is no obvious immediate pain.
Also visit: http://www.ineuro.be/Welcome.html - A must have for every osteopath and health care provider. Simple to use and no unnecessary information. It keeps your knowledge sharp for daily patient care!
Also look for iBooks in the iBook store from Luc Peeters and Grégoire Lason.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. Aims and Objectives
Why do we immobilise the c-spine in
trauma?
Why has this been under scrutiny?
So what should I do?
3. Evidence for C-Spine
Immobilisation in Trauma
C-spine immobilisation in trauma has been standard teaching
in trauma courses for the last 30 years
"The staff must be continually cognizant that injudicious
manipulation or movement, and inadequate immobilisation
can cause additional spinal injury and decrease the patient's
overall prognosis” ATLS(1)
Figures quoted for c-spine injury in polytrauma range from 212%(2-4)
Missing unstable c-spine fractures can have severe
physical, social and economic complications
4. Evidence for C-Spine
Immobilisation in Trauma
High risk factors:
- Head injury: relative risk of 8.6(6)
- Reduced GCS: The prevalence in alert patients of c-spine
injury was 2.8%, whereas un-evaluable patients have a
prevalence of 7.7%(5)
- Penetrating neck trauma
- Mechanism (fall from > 3feet, axial loading, MVA >100km,
MVA with rollover/ejection, motorised recreational vehicle)
5. So Why Think About It?
Contradictory evidence regarding secondary c-spine injury:
- One study suggested only 20% of patients with a c-spine
injury actually have a spinal cord injury(6)
- Retrospective study comparing neurological outcome in
patients with a cervical spine injury who were immobilised
versus not immobilised showed no difference in outcome(7)
6. So Why Think About It?
Another retrospective study suggests that only 0.03% to 0.16%
of all out-of-hospital trauma patients may be expected to have
secondary injury, with the minimum number of indiscriminately
immobilized patients needed to prevent one secondary injury is
thus likely between 625 and 3333 trauma patients(6)
In a multi-centre study of more than 30,000 patients with
penetrating trauma, 443 (1.43%) had spine fractures, and 116
(0.38%) had unstable spine fractures. Of those with unstable
spine fractures, 86 (74%) had completed spinal injuries prior to
immobilization. The authors concluded that in order to
potentially benefit one person with spinal immobilization, 1,032
people would have to be immobilized. But in order potentially
harm/contribute to one death, just 66 would have to be(8)
7. So Why Think About It?
Does c-spine immobilisation actually reduce movement?
- Collars are often poorly fitted and poorly tolerated.
Inappropriately sized or applied collars exaggerate vertebral
mal-alignment
- Collars may actually promote paradoxical motion of vertebrae
- Even correctly fitted collars allow over 30° of
flexion/extension and rotation(9)
8. So Why Think About It?
Spinal boards are uncomfortable!
- 21% of patients with cervical spine pain and 33% of patients
with lumbar spine pain while immobilised on a long board
experienced complete resolution of their symptoms once
removed from the board(10)
9. So Why Think About It?
C-spine immobilisation can cause significant
complications, often within 48-72 hours
10. C-Spine Immobilisation and
Raised ICP
Postulated that c-spine collars restrict venous drainage from
the brain and increase ICP
Evidence suggests that on average they raise ICP by
4.6mmHg(11, 12) and the higher the baseline ICP, the greater
the increase(11)
Given that CPP = MAP-ICP, may worsen neurological
outcome and promote secondary neurological injury
11. Airway Compromise and C-spine
Immobilisation
Makes airway management more difficult
- Several studies have shown that 7 to 28% of patients with
trauma require definitive airway management(13)
- Airway obstruction is a preventable cause of trauma-related
deaths
- The presence of c-spine precautions limits airways
manoeuvre's and increases difficulty of visualisation of vocal
cords
12. Ulceration from C-Spine
Immobilisation
Pressure necrosis leads to ulceration, infection, and
ultimately sepsis
Experimental studies have suggested that a constant
pressure of 70 mm Hg for more than two hours produces
tissue ischaemia and irreversible tissue damage(13)
Prolonged collar use in unconcious patients can cause
decubitus ulceration in up to 31% of patients(14)
13. So Why Don’t we Just Collar Every
Trauma?
- Difficult central venous cannulae insertion and increased risk
of line-associated bacteraemia
- Increased risk of pulmonary thromboembolism
- Increased risk of infection including ventilator-associated
pneumonia
- High staffing requirements
14. So Why Don’t we Just Collar Every
Trauma?
-
Increased intracranial pressure
Makes airway management more difficult
Difficult central venous cannulae insertion
Increased risk of pulmonary thromboembolism
Pressure necrosis leading to ulceration, infection and sepsis
Increased risk of infection including ventilator-associated
pneumonia, line-associated bacteraemia
- High staffing requirements
15. So What Does the Evidence Say?
A Cochrane review in 2009 which set out to look at the
evidence for spinal immobilisation in trauma (including
traditional immobilisation vs no immobilisation) found NO
RCT’s!
16. So What Do I Do?
Conscious patients: Canadian c-spine rules
Obtunded patients
- ? remove collars for intubated patients with possible head
injury
General principles
- Convert those who you are not able to clear clinically (e.g
intoxicated) into philly collar
- ? Quicker consultant radiology reporting of CT
- Any patient not tolerating c-spine precautions, remove them!
17. Summary
C-spine fractures are rare but have potentially devastating
complications
C-spine immobilisation has no evidence to suggest it is
effective in reducing the complications of c-spine fractures
C-spine imobilisation can be detrimental to
patients, particularly those who are polytrauma patients with
head injuries/requiring ICU
Lack of evidence makes decision-making difficult
18. References
1)
2)
3)
4)
5)
6)
7)
Committee on Trauma, American College of Surgeons (2008). ATLS: Advanced
Trauma Life Support Program for Doctors (8th ed.). Chicago: American College of
Surgeons
MacDonald RL, Schwartz ML, Mirich D. Diagnosis of cervical spine injury in motor
vehicle crash victims: how many X-rays are enough? J Trauma 1990;30: 392-7.
Chiu WC, Haan JH, Cushing BM, Kramer ME, Scalea TM. Ligamentous injuries of
the cervical spine in unreliable blunt trauma patients: incidence, evaluation and
outcome. J Trauma 2001;50: 457-63.
Demetriades D, Charalambides K, Chahwan S, Hanpeter D, Alo K, Velmahos G, et
al. Nonskeletal cervical spine injuries: epidemiology and diagnostic pitfalls. J Trauma
2000;48: 724-7.
Milby AH, Halpem CH, Guo W and Stein SC. . Prevalence of cervical spinal injury in
trauma. Neurosurg Focus. 2008;25(5):E10.
Sundheim S and Cruz M. The Evidence for Spinal Immobilization: An Estimate of
the Magnitude of the Treatment Benefit. Ann Em Med 2006; 48 (2): 217-218.
Hauswald M, Ong G, Tandberg D, Omar Z: Out-of-hospital spinal immobilisation: its
effect on neurologic injury. Academic Emer Med 1998, 5(3):214-9.
19. References
8.
9.
10.
11.
12.
13.
14.
Haut ER, Kalish BT, Efron DT, et al. Spine immobilization in penetrating trauma:
more harm than good? J Trauma, 2010; 68: 115–20, discussion 20–1.
James CY, Riemann BL, Munkasy BA, Joyner AB: Comparison of Cervical Spine
Motion During Application Among 4 Rigid Immobilization Collars. J Athl Train
2004, 39(2):138-145
9) Barney RN, Cordell WH, Miller E: Pain associated with immobilisation on rigid
spine boards. Ann Emerg Med 1989, 18:918.
Hunt1, S. Hallworth1, M. Smith2. The effects of rigid collar placement on intracranial
and cerebral perfusion pressure.Anaesthesia. Article first published online: 20 Dec
2001.
Davies G, Deakin C, Wilson A. The effect of a rigid collar on intracranial pressure.
Injur. Anaesthesia. 1996; 27: 647–9.
Morris CGT and McCoy E. Cervical immobilisation in ICU: friend or foe?.
Anaesthesia. 2003. 58; 11: 1051–1053
Kosiak M: Etiology of decubitus ulcers. Arch Phys Med Rehabil 1961, 42:19-29.