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Prehospital use of cervical collars in trauma patients: a critical review.

Authors
  • Sundstrøm, Terje
  • Asbjørnsen, Helge
  • Habiba, Samer
  • Sunde, Geir Arne
  • Wester, Knut
Type
Published Article
Journal
Journal of Neurotrauma
Publisher
Mary Ann Liebert
Publication Date
Mar 15, 2014
Volume
31
Issue
6
Pages
531–540
Identifiers
DOI: 10.1089/neu.2013.3094
PMID: 23962031
Source
Medline
License
Unknown

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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