Immobilizing the cervical spine using a collar. Complications and nursing management

Using a collar to immobilize the cervical spine is a standard health care intervention for patients with cervical spine injuries. Although there is little research into the nature and extent of possible iatrogenic complications resulting from this intervention, anecdotal information suggests that prolonged use a cervical collar may case skin ulcers and infections. Further, the stabilizing effect of a cervical collar may impart a false sense of security as it permits fine flexion and extension movements. Compounding the potential untoward effects of this intervention, is the lack of research concerning nursing care implications. As a first step to examining the problem, the author surveyed trauma and neuroscience centres throughout Canada to determine: what immobilization devices are currently used; patient problems associated with these devices; nursing care interventions employed including hygiene and transfer techniques; and the outcomes of these interventions. The findings describe the relative efficacy of different products and nursing interventions as reported by the surveyed groups. Further, the findings offer direction for future research that will quantitatively investigate the patient care outcomes associated with specific interventions.