Immobilization of the neck with a cervical collar

Authors: Simulation and Certification Center

Editor: Rednenko V.V.

Clinical situation:  

A man, 30 years old, diving into a lake hit his head to the bottom. Friends pulled him out of the lake. The casualty lies on the shore, complains of sharp pain in the neck. You suspect a cervical spine injury. There is no mobile connection in this location. Site of accident is save. You have a first aid kit and a set of cervical collars.

Prepare the victim for transportation to the place where the ambulance can arrive by immobilizing the cervical spine with cervical collar. 

Equipment for the practical skill:

• simulator (simulated patient);
• universal first aid kit;
• set of cervical collars.

The procedure for performing a practical skill:

• Introduce yourself.
• Identify patient.
• Obtain informed consent to the procedure:
  • give all the information to the person about what the procedure involves, including the benefits and risks, whether there are reasonable alternative, and what will happen without this procedure;
  • explain what you are going to do;
  • ask the patient to consent to procedure.
• Prepare a cervical collar:
  • select the splint of the required size; if there’s no time for precise measurements, you can estimate based on body type:
    • XS/S – children, petite women;
    • M – average adult (height ~165–180 cm);
    • L/XL – large/stocky men (broad shoulders, muscular neck). 
  • unfasten and open it (disconnect the front and back part).
• Position the victim on a flat surface face up, ensuring immobility in the cervical spine.
• Place the back part of the neck collar under the cervical spine, lifting the victim's head slightly, excluding the turn and flexion of the cervical spine.

• Provide a contact of the upper side of the back part of the collar is in the occipital tuber.
• Place the front part of the collar above neck, ensuring a contact to the angles of the lower jaw and chin.

• Unite the front and back of the collar with the fastening elements (Velcro tapes).

• Check that the cervical collar is correctly applied:
  • the head must remain neutral - no tilting or hyperextension$
  • if the person is conscious, ask him whether the cervical collar prevents him from breathing and swallowing, or whether it causes pain;
  • if the person is unconscious, check his pulse on the carotid artery, using a special hole on the front surface of the cervical collar, and assess the person breath.