247:, along with access issues for airway management in obtunded patients. Other risks and complications include increased testing and imaging, increased incidence in displacement of spinal fractures in the elderly, limited physical examination of patients, neck pain, pressure ulcers, and increased length in hospital stay. Because of these potential complications, cervical collars are not recommended in trauma patients with isolated penetrating injury and no neurological deficits. This is because the benefit of a potential secondary cervical injury being prevented with a cervical collar is much less than the risks associated with a cervical collar; with the most concerning being trouble accessing a patient's airway. Some medical professionals have even been calling for a ban on cervical collars, stating that they cause more harm than good. There is also very little evidence that shows cervical collars to be actually making a difference in traumatic cervical spine injury.
213:
size must be chosen according to the patient's size and build. The practitioner will then measure the length of the neck. The collar is then placed by one practitioner while the other holds the neck still. Then, the collar should be locked to the ideal neck length according to the specific manufacturer's manual. The chin must be in the chin piece and the collar must extend down to the sternal notch. If the patient has a tracheostomy hole, medical professionals must assure that the hole is midline and accessible in a patient with a cervical collar. Some common errors include incorrect chosen collar size, incorrect technique in placing collar, and incorrect measurement of neck length.
287:
397:
361:
341:
168:
409:
329:
385:
49:
373:
278:
mandible is to be avoided as to not cause the strap of the CPAP to come off. Also, limited head movement while on CPAP is desired to optimize oxygen flow in and out of the device. Cervical soft collars are used to try to achieve both of these goals. In a small study analyzing the use of cervical collars in patients on CPAP ventilation with a history of sleep apnea, a significant benefit was observed.
204:
how much to move one's neck and when patients are preoccupied with performing an activity they are able to move their neck more. This is why in more minor injuries, cervical collars are still placed to remind patients of their injury so they can restrict any activities that may worsen their condition.
216:
Cervical collars and patient's necks should be evaluated and cleaned frequently for hygienic purposes as well as to avoid pressure ulcers. When the neck area is being cleaned, it is again important for two people to help remove the collar. One person must help hold the neck and keep it aligned while
212:
When applying a cervical collar, it must be tight enough to immobilize the neck but must be loose enough to avoid pressure on the vasculature of the neck, strangulation, and pressure ulcers. Ideally, any clothing or jewelry in the neck area should be removed before applying the collar. Next, a collar
266:
who had a cervical collar applied had greater decrease in pain after 6 weeks compared to patients who did not have one applied. When these patients were followed up after six months, almost all of the subjects had complete or near complete resolution of any pain and/or disability, regardless if they
203:
Rigid collars are most restrictive when flexing the neck and least restrictive with lateral rotation when compared to soft collars. Despite this, subjects have similar range of motion when asked to perform activities of daily living. It is thought that these collars provide a proprioceptive guide on
225:
The cervical collar was invented in 1966 by George
Cottrell during the Vietnam war as a way to provide neck immobilization in American soldiers with potential unstable neck injuries. Its use in the prehospital setting in the United States was popularized by orthopedic surgeon, Dr. JD Farrington. In
277:
Patients on CPAP ventilation can often have suboptimal positioning due to pain, discomfort, or lack of knowledge. Similarly to patients with sleep apnea, patients on CPAP need optimization of their neck position to keep their airway clear of any obstruction. Specifically, posterior movement of the
273:
can be worsened by anterior flexion of the neck or posterior movement of the mandible when sleeping supine. Cervical collars are used to prevent these movements when sleeping in these patients. Small scale studies have failed to show any improvement in oxygenation, snoring, and/or apneic episodes
195:
Cervical collars are incorporated into rigid braces that constrain the head and chest together. Examples include the Sterno-Occipital
Mandibular Immobilization Device (SOMI), Lerman Minerva and Yale types. Special cases, such as very young children or non-cooperative adults, are sometimes still
226:
his paper, "Death in a Ditch", Farrington described seeing "sloppy and inefficient removal of victim from their vehicle." He explained how a standardized approach of applying cervical collars before extracting motor vehicle collision victims from their vehicles is necessary to prevent this.
217:
the other unfastens the straps and removes the collar. The area is then cleaned with soap, water, and washcloths. If there is evidence of skin breakdown, other topical agents and even antibiotics may be used if there is evidence of infection as well.
191:
if needed. The rigidness is provided by plexiglass in some models. The most frequently prescribed are the Aspen, Malibu, Miami J, and
Philadelphia collars. All these can be used with additional chest and head extension pieces to increase stability.
274:
with the use of cervical collars at night. These patients can experience discomfort and feelings of strangulation at night if the collar is not fastened properly. Despite this, some practitioners still apply cervical collars for sleep apnea.
186:
straps and (b) removable padded liners. The also contain a back pad, back panel, front pad, front panel, and chin pad. There are air holes throughout the device to provide ventilation to the area but also to allow access for a
234:
As a result of several small randomized clinical trials over the last decade, hospitals and ambulance staff have seen a significant reduction in the number of patients that are being immobilized. This has been due to
987:
135:
Cervical collars are also used therapeutically to help realign the spinal cord and relieve pain, although they are usually not worn for long periods of time. Another use of the cervical collar is for
858:
Miller CP, Bible JE, Jegede KA, Whang PG, Grauer JN (June 2010). "Soft and rigid collars provide similar restriction in cervical range of motion during fifteen activities of daily living".
1111:"Cervical spine collar clearance in the obtunded adult blunt trauma patient: a systematic review and practice management guideline from the Eastern Association for the Surgery of Trauma"
396:
340:
90:
to those who have had traumatic head or neck injuries, although they should not be routinely used in prehospital care. They can also be used to treat chronic medical conditions.
732:
255:
Cervical collars are used much less commonly for things outside of cervical injury and precaution. These uses include cervical radiculopathy, sleep apnea, and patients on
664:
147:. If pain is persistent, the collar might be required to remain attached to help in the healing process. A person may also need a cervical collar, or may require a
1209:
Connell RA, Graham CA, Munro PT (December 2003). "Is spinal immobilisation necessary for all patients sustaining isolated penetrating trauma?".
1001:
360:
580:
1371:"Efficacy of the Addition of a Cervical Collar in the Treatment of Persistent Obstructive Apneas Despite Continuous Positive Airway Pressure"
961:
761:
740:
175:
A soft collar is fairly flexible and is the least limiting but can carry a high risk of further breakage, especially in people with
179:. They are usually made of felt. It can be used for minor injuries or after healing has allowed the neck to become more stable.
501:
634:
1448:
408:
256:
182:
A range of manufactured rigid collars are also used, usually comprising (a) a firm plastic bi-valved shell secured with
903:"Application of Cervical Collars - An Analysis of Practical Skills of Professional Emergency Medical Care Providers"
286:
1160:"New clinical guidelines on the spinal stabilisation of adult trauma patients - consensus and evidence based"
117:. In order to prevent further injury, such people may have a collar placed by medical professionals until
901:
Kreinest M, Goller S, Rauch G, Frank C, Gliwitzky B, Wölfl CG, et al. (2015-11-20). Shamji M (ed.).
445:
126:
328:
1453:
87:
17:
307:
125:
exists. Medical professionals will often use the NEXUS criteria and/or the
Canadian C-spine rules to
708:
663:
Zideman DA, De Buck ED, Singletary EM, Cassan P, Chalkias AF, Evans TR, et al. (October 2015).
1458:
811:"The Effect of Soft and Rigid Cervical Collars on Head and Neck Immobilization in Healthy Subjects"
1244:
Plumb JO, Morris CG (January 2013). "Cervical collars: probably useless; definitely cause harm!".
236:
402:
Neck collar attachment during a military simulation, replacing manual stabilization of the head
263:
244:
493:
486:
581:"INTERNATIONAL TRAUMA LIFE SUPPORT: THE USE OF CERVICAL COLLARS IN SPINAL MOTION RESTRICTION"
240:
197:
769:
1109:
Patel MB, Humble SS, Cullinane DC, Day MA, Jawa RS, Devin CJ, et al. (February 2015).
914:
384:
8:
311:
144:
110:
918:
791:
681:
346:
Front view of a cervical collar. The opening provides anterior access to the neck for a
1395:
1370:
1346:
1321:
1297:
1280:
1186:
1159:
1135:
1110:
1086:
1061:
937:
902:
883:
835:
810:
665:"European Resuscitation Council Guidelines for Resuscitation 2015 Section 9. First aid"
554:
521:
102:
54:
1222:
1400:
1351:
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98:
83:
33:
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822:
676:
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450:
982:
109:
or death. A common scenario for this injury would be a person suspected of having
1411:
927:
871:
642:
455:
440:
262:
In a 2009 study, it was shown that patients with a confirmed recent diagnosis of
148:
136:
94:
1337:
1126:
1025:
Rogers L (2017). "No place for the rigid cervical collar in pre-hospital care".
372:
1443:
1320:
Bordier P, Lataste A, Orazio S, Papin J, Robert F, Bourenane G (January 2021).
347:
1176:
1038:
826:
605:
1437:
1418:
1046:
733:"Office Ergonomics - Other Treatment for Injuries Related to the Workstation"
545:
460:
435:
156:
259:
ventilation. Most studies for these conditions are small scale and limited.
167:
1404:
1355:
1306:
1265:
1230:
1195:
1144:
1095:
1062:"Prehospital use of cervical collars in trauma patients: a critical review"
962:"Cervical Collar: Skin Care Needs of the Patient Wearing a Cervical Collar"
946:
879:
844:
690:
563:
522:"Prehospital Use of Cervical Collars in Trauma Patients: A Critical Review"
176:
114:
1077:
537:
351:
303:
270:
188:
105:, which could be exacerbated by movement of the person and could lead to
64:
53:
A man in a hospital bed wearing a cervical collar following a suspected
985:, Cottrell, George W., "Cervical collar", issued 1966-11-15
465:
1386:
1369:
Prigent A, Grassion L, Guesdon S, Gonzalez-Bermejo J (December 2017).
1368:
1060:
Sundstrøm T, Asbjørnsen H, Habiba S, Sunde GA, Wester K (March 2014).
520:
Sundstrøm T, Asbjørnsen H, Habiba S, Sunde GA, Wester K (2014-03-15).
86:
used to support and immobilize a person's neck. It is also applied by
32:
For the surgical procedure of putting a collar around the cervix, see
430:
425:
317:
Designs range from simple foam collars to complex composite devices.
299:
291:
106:
1164:
Scandinavian
Journal of Trauma, Resuscitation and Emergency Medicine
809:
Barati K, Arazpour M, Vameghi R, Abdoli A, Farmani F (June 2017).
48:
1322:"Soft cervical collar in obstructive sleep apnoea: a pilot study"
152:
183:
140:
1059:
662:
519:
492:(6 ed.). Upper Saddle River, NJ: Prentice-Hall. pp.
171:
A neck collar being placed on a patient by emergency services.
1002:"No place for the rigid cervical collar in pre-hospital care"
765:
736:
712:
638:
609:
118:
1157:
1158:
Maschmann C, Jeppesen E, Rubin MA, Barfod C (August 2019).
808:
196:
immobilized in medical plaster of paris casts, such as the
1278:
1319:
132:
The routine use of a cervical collar is not recommended.
900:
1108:
702:
700:
857:
1279:
Dmytriv M, Rowland K, Gavagan T, Holub D (May 2010).
697:
483:
1419:"Valhalla Adult 360 Plus Device Karting Neck Brace"
1281:"PT or cervical collar for cervical radiculopathy?"
1208:
709:"Physical Therapy and Other Options for Neck Pain"
629:
627:
625:
485:
366:Side view X-ray of the neck with a cervical collar
789:
754:
477:
310:, racers often wear a protective collar to avoid
1435:
599:
597:
725:
622:
790:Kulkarni SS, Meier III RH (1 November 2018).
603:
594:
1115:The Journal of Trauma and Acute Care Surgery
414:Woman wearing a Philadelphia cervical collar
1243:
707:Watson S (21 April 2021). Wheeler T (ed.).
656:
484:Mistovich JJ, Hafen BQ, Karren KJ (2000).
47:
1394:
1345:
1296:
1185:
1175:
1134:
1085:
936:
926:
834:
680:
553:
981:
285:
166:
207:
14:
1436:
1024:
706:
604:DerSarkissian C, ed. (14 April 2021).
267:had a cervical collar applied or not.
97:head or neck injury, they may have a
27:Medical device used to support a neck
959:
575:
573:
515:
513:
320:
129:and determine the need for imaging.
682:10.1016/j.resuscitation.2015.07.031
101:. This makes them at high risk for
24:
1375:Journal of Clinical Sleep Medicine
25:
1470:
1246:The Journal of Emergency Medicine
588:International Trauma Life Support
570:
510:
298:In high-risk motorsports such as
294:rider wearing a sports neck brace
1027:International Paramedic Practice
1006:International Paramedic Practice
488:Brady Prehospital Emergency Care
407:
395:
383:
371:
359:
339:
327:
229:
1362:
1313:
1272:
1237:
1202:
1151:
1102:
1053:
1018:
994:
975:
953:
894:
851:
802:
783:
121:can be taken to determine if a
1285:The Journal of Family Practice
1258:10.1016/j.jemermed.2012.05.031
334:Side view of a cervical collar
13:
1:
1223:10.1016/S0020-1383(03)00070-6
471:
250:
928:10.1371/journal.pone.0143409
872:10.1097/BRS.0b013e3181c0ddad
7:
1449:Emergency medical equipment
1338:10.1183/23120541.00431-2020
1127:10.1097/ta.0000000000000503
446:Kendrick Extrication Device
419:
151:to support the neck during
10:
1475:
220:
31:
1177:10.1186/s13049-019-0655-x
1039:10.12968/ippr.2017.7.1.12
827:10.4184/asj.2017.11.3.390
314:and other neck injuries.
61:
46:
41:
762:"Cervical spinal fusion"
281:
162:
960:Nash J (October 2015).
127:clear a cervical collar
123:cervical spine fracture
93:Whenever people have a
1066:Journal of Neurotrauma
969:Barnes-Jewish Hospital
526:Journal of Neurotrauma
295:
264:cervical radiculopathy
245:traumatic brain injury
172:
157:cervical spinal fusion
155:after surgery such as
1078:10.1089/neu.2013.3094
538:10.1089/neu.2013.3094
289:
241:intracranial pressure
170:
208:Application and care
149:halo fixation device
919:2015PLoSO..1043409K
815:Asian Spine Journal
88:emergency personnel
792:"Spinal Orthotics"
296:
239:such as increased
173:
103:spinal cord injury
78:, also known as a
55:spinal cord injury
1454:Orthopedic braces
1387:10.5664/jcsm.6852
1381:(12): 1473–1476.
1332:(1): 00431–2020.
1326:ERJ Open Research
866:(13): 1271–1278.
645:on 3 January 2008
503:978-0-8359-6064-9
321:Additional images
308:speed-boat racing
99:cervical fracture
72:
71:
34:Cervical cerclage
16:(Redirected from
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898:
892:
891:
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799:
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780:
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777:
768:. Archived from
758:
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748:
739:. Archived from
729:
723:
722:
720:
719:
704:
695:
694:
684:
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654:
653:
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650:
641:. Archived from
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508:
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451:Long spine board
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65:edit on Wikidata
51:
39:
38:
21:
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1459:Protective gear
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1417:
1416:
1412:
1367:
1363:
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1314:
1277:
1273:
1242:
1238:
1217:(12): 912–914.
1207:
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1103:
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1054:
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456:Halo (medicine)
441:Orthopedic cast
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403:
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390:Cervical collar
388:
379:
376:
367:
364:
355:
344:
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210:
165:
76:cervical collar
68:
57:
42:Cervical collar
37:
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23:
22:
15:
12:
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5:
1472:
1462:
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1291:(5): 269–272.
1271:
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1121:(2): 430–441.
1101:
1072:(6): 531–540.
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993:
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850:
821:(3): 390–395.
801:
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724:
696:
655:
635:"Neck Strains"
621:
593:
569:
532:(6): 531–540.
509:
502:
475:
473:
470:
469:
468:
463:
458:
453:
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348:cricothyrotomy
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304:go-kart racing
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84:medical device
70:
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854:
846:
842:
837:
832:
828:
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820:
816:
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805:
797:
793:
786:
772:on 2008-03-30
771:
767:
763:
757:
743:on 2008-03-28
742:
738:
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728:
714:
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703:
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669:Resuscitation
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461:Spinal fusion
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436:Dental braces
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237:complications
230:Use over time
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113:because of a
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91:
89:
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81:
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66:
60:
56:
50:
45:
40:
35:
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19:
1422:. Retrieved
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747:2008-03-07
718:2008-03-07
649:2008-03-07
615:2008-03-07
606:"Whiplash"
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251:Other uses
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546:0897-7151
431:Orthotics
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300:Motocross
292:motocross
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1136:4409130
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