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Emerg Med J. 2012 Feb;29(2):104-7. doi: 10.1136/emj.2010.092973. Epub 2011 Feb 18.

Value of a rigid collar in addition to head blocks: a proof of principle study.

Author information

  • 1Department of Orthopaedic Surgery 357, Radboud University Nijmegen Medical Centre, Postbox 9101, 6500 HB Nijmegen, The Netherlands. m.holla@orthop.umcn.nl

Abstract

BACKGROUND:

All trauma patients with a cervical spinal column injury or with a mechanism of injury with the potential to cause cervical spinal injury should be immobilised until a spinal injury is excluded. Immobilisation of the entire patient with a rigid cervical collar, backboard, head blocks with tape or straps is recommended by the Advanced Trauma Life Support guidelines. However there is insufficient evidence to support these guidelines.

OBJECTIVE:

To analyse the effects on the range of motion of the addition of a rigid collar to head blocks strapped on a backboard.

METHOD:

The active range of motion of the cervical spine was determined by computerised digital dual inclinometry, in 10 healthy volunteers with a rigid collar, head blocks strapped on a padded spine board and a combination of both. Maximal opening of the mouth with all types of immobiliser in place was also measured.

RESULTS:

The addition of a rigid collar to head blocks strapped on a spine board did not result in extra immobilisation of the cervical spine. Opening of the mouth was significantly reduced in patients with a rigid collar.

CONCLUSION:

Based on this proof of principle study and other previous evidence of adverse effects of rigid collars, the addition of a rigid collar to head blocks is considered unnecessary and potentially dangerous. Therefore the use of this combination of cervical spine immobilisers must be reconsidered.

PMID:
21335583
[PubMed - indexed for MEDLINE]
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