Abstract
Cervical extrication collars are frequently used in pre hospital stabilization and in the definitive treatment for lesions of the cervical spine. The control of extensionflexion, lateral bending, and rotation given to individual segments is variable with different designs.
Objective: To highlight the patient satisfaction and reported pain perception with immobilization of cervical injury with the extrication collar.
Method: We present prospective cohort of fourteen patients with median age of 28 years with suspected C-spine injury waiting for CT scan. Unreliable patients were defined as those with admission Glasgow Coma Scale score < 15. They were treated with extrication collar immobilization. The initial diagnosis was made by supine cross-table lateral radiograph and then by computed tomographic scan as early as possible. All had no apparent neurologic deficit attributed to the C-spine at admission.
Results: All reported increased level of pain despite administering adequate analgesia. Most patients reported increased pain at the pressure point of the collar.
Conclusion: These cases demonstrate the limitations of current management techniques of suspected cervical fractures in unreliable trauma patients and highlight the lack of appropriate orthosis for cervical immobilization in our institution.
Correspondence should be addressed to: Mr John O’ Dowd, SBPR, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
