It’s Time to do Away with the Hard Cervical Collar

Darren Braude, MD, Paramedic Professor of Emergency Medicine & EMS University of New Mexico @darrenbraude dbraude@salud.unm.edu

Not talking about this…

Assumption #1

Movement is Bad

F = ma

Assumption #2

Collar prevents said movement

Assumption #3

Benefits outweigh risks

Benefits?

Risks

Unlikely to help

Can clearly cause harm

So what to do?

Thanks Minh! @ketaminh Prehospitalmed.com

Awake and Alert

Patient is in charge

Uncooperative

Limit energy deposition by not restricting motion

Obtunded

Gentle movement, soft “reminder collar” or vacuum

mattress

Ideas in medicine that seemed great at the time…

MAST SUITINTRA-CARDIAC EPI

FLUIDS IN TRAUMA

SPINE BOARDS

BLOODLETTINGLOBOTOMIES

EGDT

HARD COLLARS

Thanks again Minh! @ketaminh Prehospitalmed.com