Blaylock, B
ET Nursing Department, St. Vincent Medical Center, Toledo, Ohio
Published in Ostomy Wound Management, 1996 May, Vol. 42 (4), 26-33.
Cervical Orthotic devices (cervical collars) are integral to the treatment of patients with suspected or confirmed fracture of the cervical spine. Pressure ulcers can develop under the cervical collar on the occipital protuberance and on the chin due to both prolonged immobilization and the collar construction. A multidisciplinary team at a Northwest Ohio trauma center led an investigation of this problem when a one-day study of pressure ulcer prevalence revealed that 4% of nosocomial pressure ulcers, 2% were attributed to cervical collars.
“… in 1993 an average of 6 cases per quarter were seen.”
(Pg. 27)
“At this trauma center, we had been using a closed cell foam collar for many years.”
(Pg. 28)
“We discovered that another hard cervical collar had been brought into the institution in March 1993, just prior to the development of some of the most severe occipital ulcers.”
(Pg. 28)
“After the educational programs were conducted, … We again concluded/hypothesized that the main contributing factor in the development of pressure ulcers was the type of collar itself, and not the care provided for the patient.”
(Pg. 29)
“The product trial resulted in zero skin breakdown for the 20 patients involved.”
(Pg. 26)
“Repeated CQI studies have demonstrated that the problem of pressure ulcers resulting from cervical collars has been eliminated at this institution.”
(Pg. 32)