Cervical collar R.I.P.?

[deleted171991]

---

Members don't see this ad.

http://www.scancrit.com/2014/04/02/cervical-collar-r-i-p/

And so the rigid cervical collar is laid to rest in the Emergency Medical Service (EMS) of Bergen, Norway. Bergen is the second largest city in Norway, and has an active HEMS department at Bergen University Hospital.

Despite long standing use, there has not been any proven benefit from the use of cervical collars in trauma patients, but instead some increasing (although not very strong) evidence of possible harm and unwanted effects.

1. The cervical collar can lead to increased movement in the upper parts of the neck compared to no collar.
2. In patients with trauma affecting the spine, available evidence points to larger neurological deficits in areas where the cervical collar is routine vs areas where they are not in use.
3. The cervical collar increases ICP because of decreased venous return due venous compression of the neck
4. The cervical collar hampers airway management
5. Cervical collars leads to increased risk of aspiration.​

What d'ya think?

 

[Dwindlin]

These need to go away, much better off putting the patient on the cot/bed at 30 degrees and keeping them comfortable so they don't squirm. I fought for years to get these and long spine boards taken out of our EMS protocols. Was successful with the boards, not so much the collars.

 

[Spinach Dip]

In patients with an unstable c-spine: yes plz. I don't want to wake up paralyzed from c4-down.
In patients with no c-spine injury: completely unneccessary.



....I think the over-use of them is mostly the result of our litigious society. If 1 patient with a not diagnosed-in-the-field c-spine injury does not receive a collar, and wakes up in the hospital paralyzed, there is going to be a multi-million dollar lawsuit which the patient WILL win.

If, however, that same patient does get a collar, but wakes up paralyzed regardless, the hospital has its back covered because all precautions were made.