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

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.

The Norwegian guidelines for the prehospital management of adult trauma patients with potential spinal injury

“…Consequently, several organisations and authors have promoted a more selective strategy [2, 44, 46]. This controversy has generated regional variations in stabilisation strategies within the Emergency Medical Services (EMS) [44].…”

Kurzdarstellung

“…Dieses Vorgehen basiert eher auf Fachmeinungen und Übereinkünften als auf wissenschaftlichen Erkenntnissen [891,892]. Darüber hinaus sind klinisch relevante Komplikationen beschrieben worden, wie z.…”

Präklinische Akutbehandlung von Wirbelsäulenverletzungen

“…Von diesen Patienten weisen mehreren Studien zufolge aber nur 3% eine Verletzung der Wirbelsäule auf, davon allerdings 20% eine Rückenmarkläsion [2]. Hochrechnungen zufolge gelten ca.…”