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Published Online: 10 March 2014

Prehospital Use of Cervical Collars in Trauma Patients: A Critical Review

Publication: Journal of Neurotrauma
Volume 31, Issue Number 6

Abstract

The cervical collar has been routinely used for trauma patients for more than 30 years and is a hallmark of state-of-the-art prehospital trauma care. However, the existing evidence for this practice is limited: Randomized, controlled trials are largely missing, and there are uncertain effects on mortality, neurological injury, and spinal stability. Even more concerning, there is a growing body of evidence and opinion against the use of collars. It has been argued that collars cause more harm than good, and that we should simply stop using them. In this critical review, we discuss the pros and cons of collar use in trauma patients and reflect on how we can move our clinical practice forward. Conclusively, we propose a safe, effective strategy for prehospital spinal immobilization that does not include routine use of collars.

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cover image Journal of Neurotrauma
Journal of Neurotrauma
Volume 31Issue Number 6March 15, 2014
Pages: 531 - 540
PubMed: 23962031

History

Published in print: March 15, 2014
Published online: 10 March 2014
Published ahead of print: 6 November 2013
Published ahead of production: 20 August 2013

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Terje Sundstrøm
Department of Biomedicine, University of Bergen, Bergen, Norway.
Department of Clinical Medicine K1, University of Bergen, Bergen, Norway.
Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway.
Helge Asbjørnsen
Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
Helicopter Emergency Medical Services, Bergen, Norway.
Samer Habiba
Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway.
Geir Arne Sunde
Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
Helicopter Emergency Medical Services, Bergen, Norway.
The Norwegian Air Ambulance Foundation, Drøbak, Norway.
Knut Wester
Department of Clinical Medicine K1, University of Bergen, Bergen, Norway.
Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway.

Notes

Address correspondence to:Terje Sundstrøm, MDDepartment of BiomedicineUniversity of BergenJonas Liesvei 915020 Bergen,Norway
E-mail: [email protected]

Author Disclosure Statement

No competing financial interests exist.

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