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Emergency medical services (EMS) may place the patient in a cervical collar strapped around the neck, and on a backboard to stabilize the neck to prevent any further neurologic injury. In the emergency department, the doctor will remove the collar and board when appropriate, following the guidelines set forth in the National Emergency X-Radiography Utilization Study (NEXUS):
The doctor will inspect the patient's head and neck for external signs of trauma including bruises, cuts, and abrasions. The patient's neck will be pressed in specific areas to be sure the patient does not perceive any pain or tenderness. The patient may be asked to move their neck in a controlled way to the left, right, up, and down. The patient should tell the doctor if they feel pain in the neck, numbness, or tingling in any of the arms or legs, or any other abnormal feelings during these maneuvers.
If the patient needs X-rays of the neck to make sure there are no fractures or signs of other serious injury, the collar will remain in place to stabilize the neck. If the patient's X-rays are normal, then the cervical collar will probably be removed, and the patient should not need any further X-rays. If the X-rays appear abnormal, further imaging with a CT scan or MRI may be ordered.
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