“Absence of clinical findings reliably excludes unstable cervical spine injuries in children 5 years or younger…DON’T X-RAY”
C-Collar
Spinal Immobilization in Trauma Patients – The Facts
- There is no high-level evidence that prehospital spinal immobilization positively impacts patient-oriented outcomes
- Spinal Immobilization Does NOT Help Immobilize the Cervical Spine
- Spinal Immobilization Does NOT Decrease Rates of Spinal Cord Injury
- Spinal Immobilization Increases the Difficulty of Airway Management
- Spinal Immobilization Can Cause Pressure Ulcers
- Spinal Immobilization Changes the Physical Exam
- Spinal Immobilization Worsens Pulmonary Function
- Spinal Immobilization Increases Intracranial Pressure
- There is no evidence that immobilizing awake, alert patients without deficits/complaints provides benefit
- Selective spinal immobilization protocols can help identify patients at low risk for injury and avoid immobilization
Goodbye C-Collar
Published reports of early secondary neurologic deterioration after blunt spinal trauma are exceptionally rare and generally poorly documented. High-risk features may include altered mental status and ankylosing spondylitis. It is unclear how often events are linked with spontaneous patient movement and whether such events are preventable.
EMS: C-Collars…time to dump them!
Conclusions These data support the findings of the proof of concept study, for haemodynamically stable patients controlled self-extrication causes less movement of the cervical spine than extrications performed using traditional prehospital rescue equipment.
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APLS like everyone else has finally gotten rid of the cervical collar…have you?
“Consider protecting the cervical spine if the mechanism of injury suggests the possibility of a cervical spine injury. If protection is considered necessary, start with manual in-line stabilisation (MILS) by a competent assistant or if this is not possible, consider using head block and appropriate strapping”
The cold season is coming around…get yourself a Soft Cervical Collar
The soft cervical collar keeps your neck warm. Not much else.