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The purpose of this article is to increase knowledge and understanding of cervical collar complications. This educational activity is designed for nurses and other health care professionals who care for patients presenting with cervical collar complications. The multiple choice test that follows this activity was created to evaluate your achievement of the educational objectives listed below. After studying this material, the participant will be able to:
1. Identify the purpose of the rigid cervical collar.
2. List the potential complications of rigid cervical collar use.
3. Describe the nursing interventions which help prevent collar complications.
The rigid cervical collar has been a great addition to the successful management of cervical spine injuries. But the collar has been known to offer a false sense of security in terms of totally preventing additional and further spinal cord compromise and damage. Also, with increased length of collar wear, there is development of skin pressure points and ulcer formation, possible delay in weaning from a ventilator, potential for exposure to transmission of blood-borne diseases. Photographs are used to demonstrate examples of related skin breakdown, show proper collar fit, present the result of ineffective cervical immobilization, and show how to stabilize the head and neck during a collar change. These problem areas are addressed with the dos and don'ts for nursing management
Neck trauma is the most common reason for applying a rigid cervical collar. The purpose of this collar is to restrict neck flexion, extension, lateral tilt (bending), and rotation, thereby reducing the risk of extending the initial neck injury. These collars do not restrict axial loading. Eighty percent of the rigid collars used today include the Stifneck Extrication, Philadelphia, Miami J, and Aspen collars (Askins & Eismont, 1997) (see Figure 1).
The Stifneck cervical extrication collar (see Figure 2) is a one-piece polyethylene rigid collar that is available in six sizes. It is used primarily by ambulance crews at trauma scenes. It is applied to patients with a suspected neck injury. The purpose of the collar is to provide temporary neck immobilization at the scene of the accident and during transport to the acute care facility (Plaisier et al., 1994).
The Philadelphia rigid collar (see Figure 1) is a two-piece, closed cell foam hypoallergenic plastazote...