Application of Cervical Collars – An Analysis of Practical Skills of Professional Emergency Medical Care Providers

Background/Objective The application of a cervical collar is a standard procedure in trauma patients in emergency medicine. It is often observed that cervical collars are applied incorrectly, resulting in reduced immobilization of the cervical spine. The objective of this study was to analyze the practical skills of trained professional rescue personnel concerning the application of cervical collars. Material and Methods Within emergency medical conferences, n = 104 voluntary test subjects were asked to apply a cervical collar to a training doll, wherein each step that was performed received an evaluation. Furthermore, personal and occupational data of all study participants were collected using a questionnaire. Results The test subjects included professional rescue personnel (80.8%) and emergency physicians (12.5%). The average occupational experience of all study participants in pre-clinical emergency care was 11.1±8.9 years. Most study participants had already attended a certified training on trauma care (61%) and felt "very confident" in handling a cervical collar (84%). 11% applied the cervical collar to the training doll without errors. The most common error consisted of incorrect adjustment of the size of the cervical collar (66%). No association was found between the correct application of the cervical collar and the occupational group of the test subjects (trained rescue personnel vs. emergency physicians) or the participation in certified trauma courses. Conclusion Despite pronounced subjective confidence regarding the application of cervical collars, this study allows the conclusion that there are general deficits in practical skills when cervical collars are applied. A critical assessment of the current training contents on the subject of trauma care must, therefore, be demanded.

[1]  J. L. Jenkins,et al.  Assessing attitudes toward spinal immobilization. , 2013, The Journal of emergency medicine.

[2]  B. Swartman,et al.  Does ATLS trauma training fit into Western countries: evaluation of the first 8 years of ATLS in Germany , 2013, European Journal of Trauma and Emergency Surgery.

[3]  N. Theodore,et al.  Guidelines for the management of acute cervical spine and spinal cord injuries: 2013 update. , 2013, Neurosurgery.

[4]  E. Helseth,et al.  The epidemiology of traumatic cervical spine fractures: a prospective population study from Norway , 2012, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.

[5]  K. Deep,et al.  Cervical Spine Immobilization in Sports Related Injuries: Review of Current Guidelines and a Case Study of an Injured Athlete , 2012, The open orthopaedics journal.

[6]  K. Inaba,et al.  The changing epidemiology of spinal trauma: a 13-year review from a Level I trauma centre. , 2012, Injury.

[7]  P. Ivancic Effects of orthoses on three-dimensional load–displacement properties of the cervical spine , 2012, European spine journal.

[8]  P. Cameron,et al.  Routine application of cervical collars--what is the evidence? , 2011, Injury.

[9]  R. Favory,et al.  Unintentional strangulation by a cervical collar after attempted suicide by hanging , 2010, Emergency Medicine Journal.

[10]  K. Mattox,et al.  Extrication collars can result in abnormal separation between vertebrae in the presence of a dissociative injury. , 2010, The Journal of trauma.

[11]  A. Clarke,et al.  Ankylosing spondylitis: inadvertent application of a rigid collar after cervical fracture, leading to neurological complications and death. , 2010, Acta orthopaedica Belgica.

[12]  James D. Kang,et al.  Assessing range of motion to evaluate the adverse effects of ill-fitting cervical orthoses. , 2009, The spine journal : official journal of the North American Spine Society.

[13]  C. Goutcher,et al.  Reduction in mouth opening with semi-rigid cervical collars. , 2005, British journal of anaesthesia.

[14]  Glenn R Rechtine,et al.  The effectiveness of extrication collars tested during the execution of spine-board transfer techniques. , 2004, The spine journal : official journal of the North American Spine Society.

[15]  B. Munkasy,et al.  Comparison of Cervical Spine Motion During Application Among 4 Rigid Immobilization Collars. , 2004, Journal of athletic training.

[16]  R. Mobbs,et al.  Effect of cervical hard collar on intracranial pressure after head injury , 2002, ANZ journal of surgery.

[17]  B. Bell,et al.  Exacerbating cervical spine injury by applying a hard collar , 1999, BMJ.