How Trauma Collars Give You Cancer.

We've all been there, driving along quite happily and in the blink of an eye the impossible has happened and we're now staring at a broken car. With any luck it was only minor and it was only the car that was damaged. Regardless someone, somewhere called an ambulance and, before you know what's happening, you're having the roof of the car cut off and a god-awful collar placed around your slightly aching neck.

I hate cervical collars. As an Emergency doctor I considered it my first job in trauma to get it off (not as ATLS state to get one on)! Collars are an example of Western medicine at its worst; refusing to listen to the patient and instead following dogmatic rubbish. I've seen one persons death expediated by a cervical collar and another person almost killed.

The first was a poor lady that had been run over by a truck. When she came in she was screaming 'Get this collar off me, its killing me!'. I wasn't leading the arrest but if I had been that collar would have been taken off immediately. Theres a little thing in medicine called consent and clearly there was no consent for that collar. Two minutes later she was dead.

A 'well fitting collar' is a nightmare for trauma care.

A 'well fitting collar' is a nightmare for trauma care.

No-one logged 'cause of death' as 'collar' because clearly it was the truck. What the collar did was additional; it asphyxiated an already damaged airway; splinted an already damaged chest and pissed-off to the point of sedation (and hence her death) a severely injured woman.

One would think, that in this age of evidence based medicine there would be studies galore showing how wonderful these things are. Not at all. In fact there are none that show benefit (For the 'evidence' read this article or this or this). Basically, at some point in the past, someone thought that putting collars onto potentially injured necks was a good idea. That idea became dogma and then an industry grew up around it. Every year in the USA alone millions of these disposable pieces of trash get thrown away to join the giant pacific garbage patch.

Arguably the only people who should have collars put on them are people who actually want a collar. I would always precede removing the collar by the simple question 'Would you prefer that collar on or off?' Anyone who wanted one made me highly suspicious of an injury. No-one who didn't ever had a significant injury.

So whats the harm in putting one on? Well for starters the chances are that some-ones going to want to start irradiating you, and nowadays that means CT scans. The best evidence now is that 1 in a thousand CT scans is going to give you a fatal cancer. Incredibly that crappy bit of plastic might give you cancer.

So collars cost millions a year, increase costs, delay treatment, increase morbidity (of minor neck injuries), increase mortality and have never been shown to work. 

Why do we use them? Because doctors don't think for themselves and follow dogma... and people make money by selling them.

What does work then? Acupuncture, accepted by the WHO to successfully treat neck pain.


daniel keownComment