Brywczynski et al reviewed the need for cervical spine immobilization for a patient with a penetrating neck injury. The authors are from Vanderbilt University.

Patient selection: penetrating neck injury


A cervical collar may be applied at the scene to stabilize the neck in event of fracture of the cervical spine.


Disadvantages of the cervical collar:

(1) prevents early detection of an expanding hematoma in the neck

(2) may delay recognition of a compromised airway


Some observations from previous studies:

(1) most cases with penetrating injury involving the spinal cord are fatal

(2) the incidence of an unstable vertebral fracture is low, especially if there are no neurologic deficits


Some authors believe that the risk of a cervical collar outweigh the benefits.

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