Cervical collar in trauma conditions: between routine and clinical necessity

Abstract

Background. The cervical collar is a standard component in the initial management of polytrauma patients, intended to prevent secondary spinal cord injuries. However, its use must be clinically justified to avoid unnecessary immobilization. This applies during the primary exam in stage A within the ABCDE approach. Objective(s). Justification for the use of cervical collars in traumatized patients during the primary examination in the prehospital stage and in the ED, to avoid possible secondary complications. Materials and methods. The prospective study was conducted between 01.01.24 and 31.12.24, and included 190 traumatized patients, clinically and paraclinically approached in the ED in the red, yellow, and blue zones. The clinical criteria and the mechanism of trauma for the application of the cervical collar. The data were statistically and analytically processed. Results. In 2024, in the ED, 190 traumatized patients transported by the 112-service benefited from qualified medical assistance: in the red zone 31,57% subjects, in the yellow zone 49,99%, in the blue zone 18,42%. Patients transported with a cervical immobilization constituted 57,89%, and without cervical immobilization 42,11%. Men were 68,42%, and women 31,58%. The average estimated age was 43,6±17,2 years. Mechanism of trauma: in 55,79% - road accidents, catatrauma 24,74%, physical aggression 11,58%, unknown causes 7,89% cases. In 80% cervical trauma was confirmed, and in 20% of cases, this trauma and secondary spinal cord injuries were excluded. Conclusion(s). The use of a cervicostat remains essential in most cases of polytrauma, and rational application, guided by validated clinical criteria and the mechanism of trauma, can improve patient comfort, reduce complications, and optimize resource utilization in emergency departments.