Cervical collars and immobilisation: A South African best practice recommendation

Area of Science:

• Emergency Medicine
• Trauma Care
• Neurosurgery

Background:

• Spinal injuries from trauma can have severe consequences.
• Traditional spinal immobilization with trauma boards and cervical collars is standard but carries risks.
• Recent evidence questions the necessity of motion restriction for all trauma patients.

Purpose of the Study:

• To review international guidelines for spinal protection during transport.
• To adapt these guidelines for the South African context.
• To inform best practices in managing suspected spinal injuries.

Main Methods:

• Review of international guidelines on spinal motion restriction.
• Analysis of risk factors for spinal injury.
• Evaluation of different spinal immobilization techniques.

Main Results:

• A thorough patient assessment, including high and low-risk factors, is crucial.
• Not all trauma patients require spinal motion restriction.
• Vacuum mattresses are preferable to trauma boards for motion restriction.

Conclusions:

• Patient assessment should guide the need for spinal motion restriction.
• Internationally validated assessment strategies should be implemented.
• Motion restriction methods should be situation-dependent, favoring vacuum mattresses over trauma boards.