The rigid cervical collar has been a great addition to the successful management of cervical spine injuries. But the collar has been known to offer a false sense of security in terms of totally preventing additional and further spinal cord compromise and damage. Also, with increased length of collar wear, there is development of skin pressure points and ulcer formation, possible delay in weaning from a ventilator, potential for exposure to transmission of blood-borne diseases. Photographs are used to demonstrate examples of related skin breakdown, show proper collar fit, present the result of ineffective cervical immobilization, and show how to stabilize the head and neck during a collar change. These problem areas are addressed with the dos and don'ts for nursing management.
Joan E. Webber-Jones, EdM, RN, C, ONC, is a Nurse Educator for Surgery at Fletcher Allen Health Care in Burlington, Vermont.
Carmel A. Thomas, BSN, is an Assistant Nurse Manager in a general surgery acute care unit at Fletcher Allen Health Care in Burlington, Vermont.
Robert E. Bordeaux, Jr., LPN, is a Staff Nurse at Fletcher Allen Health Care – Spine Institute of New England in Williston, Vermont.