Prehospital Use of Cervical Collars

Much like backboards, the evidence is mounting against their frequent use.

Objectives

• Examine evidentiary support of patient immobilization;
• Evaluate potential harm of using cervical collars in cases suspected spine injury; 

References

1. Hauswald M, Ong G, Tandberg D, Omar Z. Out-of-hospital spinal immobilization: its effect on neurologic injury. Acad Emerg Med, 1998; 5(3): 214–9.

2. Ham W, et al. Pressure Ulcers From Spinal Immobilization in Trauma Patients: A Systematic Review. J Trauma Acute Care Surg, 2014; 76(4): 1,131–41.

3. March J, et al. Changes In Physical Examination Caused by Use of Spinal Immobilization. Prehosp Emerg Care, 2002; 6(4): 421–4.

4. Totten VY, et al. Respiratory Effects of Spinal Immobilization. Prehosp Emerg Care, 1999; 3(4): 347–52.

5. American College of Surgeons Committee on Trauma. Advanced Trauma Life Support, 7th ed. Chicago: American College of Surgeons, 2007.

6. Sundstrøm T, Asbjørnsen H, Habiba S, Sunde GA, Wester K. Prehospital use of cervical collars in trauma patients: a critical review. J Neurotrauma, 2014; 31(6): 531–40.

7. Deasy C, Cameron P. Routine application of cervical collars—what is the evidence? Injury, 2011; 42(9): 841–2.

8. Benger J, Blackham J. Why do we put cervical collars on conscious trauma patients? Scand J Trauma Resusc Emerg Med, 2009; 17: 44.

9. Mobbs RJ, Stoodley MA, Fuller J. Effect of cervical hard collar on intracranial pressure after head injury. ANZ J Surg, 2002; 72(6): 389–91.

10. Durga P et al. Effect of Rigid Cervical Collar on Tracheal Intubation Using Airtraq. Indian J Anaesth, 2014; 58(4): 416–422.

11. Leonard JC, Mao J, Jaffe DM. Potential adverse effects of spinal immobilization in children. Prehosp Emerg Care, 2012; 16(4): 513–8.

12. Haut ER, Kalish BT, Efron DT, et al. Spine immobilization in penetrating trauma: more harm than good? J Trauma, 2010; 68(1): 115–20.

13. Stiell IG, Clement CM, Mcknight RD, et al. The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma. N Engl J Med, 2003; 349(26): 2,510–8.