Abstract
In this commentary we argue that fully alert, stable and co-operative trauma patients do not require the application of a semi-rigid cervical collar, even if they are suspected of underlying cervical spine fracture, unless their conscious level deteriorates or they find the short-term support of a cervical collar helpful. Despite the historical and cultural barriers that exist, the potential benefits are such that this hypothesis merits rigorous testing in well-designed research trials.
Highlights
"The staff must be continually cognizant that injudicious manipulation or movement, and inadequate immobilisation can cause additional spinal injury and decrease the patient's overall prognosis"
The underlying premise seems intuitively sound, but has been carried to lengths that are more harmful than helpful to the vast majority of trauma patients. In this commentary we argue that fully alert, stable and co-operative trauma patients do not require the application of a semi-rigid cervical collar, even if they are suspected of underlying cervical spine fracture, unless their conscious level deteriorates or they find the short-term support of a cervical collar helpful
Despite the historical and cultural barriers that exist, the potential benefits are such that this hypothesis merits rigorous testing in well-designed research trials
Summary
"The staff must be continually cognizant that injudicious manipulation or movement, and inadequate immobilisation can cause additional spinal injury and decrease the patient's overall prognosis". The above quote exemplifies an approach to cervical spine management that has prevailed in the developed world for almost three decades. The underlying premise seems intuitively sound, but has been carried to lengths that are more harmful than helpful to the vast majority of trauma patients. In this commentary we argue that fully alert, stable and co-operative trauma patients do not require the application of a semi-rigid cervical collar, even if they are suspected of underlying cervical spine fracture, unless their conscious level deteriorates or they find the short-term support of a cervical collar helpful. Despite the historical and cultural barriers that exist, the potential benefits are such that this hypothesis merits rigorous testing in well-designed research trials
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