emDocs - July 12, 2016 - By Bucher J and Joseph J - Edited by: Koyfman A and Singh M
"Introduction:
A few months ago we covered an article considering the evidence and myths surrounding the pre-hospital use of the long backboard for spinal immobilization in trauma patients with suspected spinal cord injuries (http://www.emdocs.net/pre-hospital-management-of-spinal-injuries-debunking-the-myths-of-the-long-backboard/). This time, we will consider the utility of another device reflexively applied to these patients – the rigid cervical collar. From the NAEMT to PHTLS and ATLS, c-spine stabilization is considered a major priority after the ABCs. Pre-hospital EMS protocols dictate that whenever a patient admits to neck pain or any neurological symptoms following trauma, applying a rigid plastic, often ill-fitting, uncomfortable cervical collar is mandatory. The purpose of these devices is to prevent further motion of the cervical spine by maintaining in-line stabilization that could theoretically worsen a c-spine injury, convert a partially unstable fracture into an unstable fracture or a convert a partial spinal cord injury into a complete spinal cord transection. This bears us to ask the question – what evidence exists to support the use of these devices?
Based on the available data, it does not appear that cervical collars have any appreciable positive effect on patient care. However, at this point in time, they are the recommended treatment option. Hopefully this knowledge will help your daily practice by understanding the effects of cervical immobilization."