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

Abstract

Background/ObjectiveThe 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 MethodsWithin 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.ResultsThe 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.ConclusionDespite 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.

Subjective safety and self-confidence in prehospital trauma care and learning progress after trauma-courses: part of the prospective longitudinal mixed-methods EPPTC-trial

“…In the period, up to one year, own training could also lead to improvement. However, this still appears to be important because the correct application of the cervical collar is often faulty [ 21 ].…”

Assessment of the Cervical Collar Application Impact on the Conditions of Intubation and the Feelings of Patients — Pilot Study

“…Stabilisation of the cervical spine in case of suspected spine injury is one of the basic procedures that should be performed by paramedics while securing a trauma patient [1,2]. One of the most common methods for securing the cervical spine is the cervical collar, which is intended to assist the rescuer with the maintenance of neutral alignment, prevention for lateral sway and anterior-posterior flexion and extension of the cervical spine during transport and routine patient care on movement [3][4][5]. In many cases, however, patients with head injuries experience altered consciousness and obstruction of the airway.…”

Cadaveric study of movement in the unstable upper cervical spine during emergency management: tracheal intubation and cervical spine immobilisation—a study protocol for a prospective randomised crossover trial

“…Maintaining a secure airway and cervical spine immobilisation are often required in most patients with unstable cervical spine injury; some critical patients even require tracheal intubation 10–12. However, tracheal intubation and application of a cervical collar in the setting of unstable cervical spine can potentially exacerbate cervical spinal cord injury 13–16.…”

“…[10][11][12] However, tracheal intubation and application of a cervical collar in the setting of unstable cervical spine can potentially exacerbate cervical spinal cord injury. [13][14][15][16] Previous studies suggest that the main movement of the cervical spine during tracheal intubation is extension; the maximum movement occurs in the atlanto-occipital level, followed by atlanto-axial level, and below C3 segments show less movement.…”