Cervical Collars in Trauma? Rethink that!

We take a lot of things for granted.

So much that we do in medicine is "just what we were taught." It is set in stone, it is the way we've always done it because it makes sense and to do otherwise would be wrong, dangerous, or crazy.

There is strong inertia in health care and it can take ages before we question our assumptions; when we do, and we find our assumptions are incorrect, again it takes ages before we accept and employ the updated approach. 

Let me rock your world:

Original graphic by @skimightythings. This appeared in the Scancrit blog post and I could not help but share it here!

Original graphic by @skimightythings. This appeared in the Scancrit blog post and I could not help but share it here!


The International Liaison Committee on Resuscitation (ILCOR) reviewed this question: "Among adults and children with suspected traumatic cervical spinal injury (P), does spinal motion restriction (I), compared with no spinal motion restriction (C), change neurological injury, complications, overall mortality,  pain, patient comfort, movement of the spine, hospital length of stay (O)?"

The answer? 'No. Not really.' And, there's even a smidgeon of evidence that putting collars on people might harm them.

In line with what is being done in Norway already, this is the conclusion that ILCOR arrived at in in their draft guidelines:

We suggest against spinal motion restriction, defined as the reduction of or limitation of cervical spinal movement, by routine application of a cervical collar or bilateral sandbags (joined with 3-inch-wide cloth tape across the forehead) in comparison to no cervical spine restriction in adults and children with blunt suspected traumatic cervical spinal injury (weak recommendation, very low quality of evidence).
Values and preferences statement: Because of proven adverse effects in studies with injured patients, and evidence concerning a decrease in head movement only comes from studies with cadavers or healthy volunteers, benefits do not outweigh harms, and routine application of cervical collars is not recommended.

Thanks to @smooremd for sending this my way. Learn more in the Scancrit blog post.

Source: http://www.scancrit.com/2015/02/12/cervica...