• Joseph Yard, Peter B Richman, Ben Leeson, Kimberly Leeson, Guy Youngblood, Jose Guardiola, and Michael Miller.
• CHRISTUS Health/Texas A&M Residency in Emergency Medicine, Corpus Christi, TX, USA.
• J Emerg Trauma Shock. 2019 Apr 1; 12 (2): 141-144.

BackgroundPrior research has revealed that cervical collars elevate intracranial pressure (ICP) in patients with traumatic brain injury. Two recent small studies evaluated the change in optic sheath nerve diameter (ONSD) measured by ultrasound as a proxy for ICP following cervical collar placement in healthy volunteers.ObjectiveWe sought to validate the finding that ONSD measured by ultrasound increases after cervical collar placement within an independent data set.MethodsThis was a prospective, crossover study involving volunteers. Participants were randomized to either have the ONSD measured first without a cervical collar or initially with a cervical collar. Two sonographers performed independent ONSD diameter measurements. Continuous data were analyzed by matched-paired t-tests. Alpha was set at 0.05. The primary outcome parameter was the overall mean difference between ONSD measurements with the cervical collar on and off. Multiple linear regression was performed to examine the relationship between variables and the primary outcome parameter.ResultsThere were 30 participants enrolled in the study. Overall mean ONSD for participants without the collar was 0.365 ± 0.071 cm and with the collar was 0.392 ± 0.081 cm. The mean change in ONSD for participants with and without the collar was 0.026 ± 0.064 cm (95% confidence interval of difference: 0.015-0.038; P < 0.001). Multiple regression analysis did not identify any variables associated with the variation in ONSD observed for collar versus noncollar.ConclusionsWe confirmed that ONSD does vary by a measurable amount with placement of a rigid cervical collar on healthy volunteers when assessed by ultrasound.

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