Improvised vs Standard Cervical Collar to Restrict Spine Movement in the Backcountry Environment

INTRODUCTION: To compare the effectiveness of a molded fleece jacket with that of a standard cervical collar at limiting movement of the cervical spine in 3 different directions. METHODS: This is a prospective study using 24 healthy volunteers to measure cervical flexion/extension, rotation, and lateral flexion with both the fleece collar and the standard cervical collar. A hand-held goniometer was used for measurements. The results were then analyzed for the 3 independent movements using a noninferiority test. RESULTS: The fleece collar was determined to be noninferior at limiting the designated motions. Comfort was greater while wearing the improvised fleece collar. CONCLUSIONS: Our small study demonstrated that mountain travelers and rescuers may be able to use an improvised fleece jacket collar in place of a standard collar if spine trauma is suspected after a backcountry accident. Further research should examine different types of improvised collars, their ability to remain in place over extended evacuations, and when to apply collars to backcountry patients.