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Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Exams and Tests

• If the patient is transported to the emergency department with a cervical collar strapped around the neck, the emergency physician will remove the collar when appropriate.
  
  
• In most cases, the collar will be removed without the need for x-rays if the patient meets all of the following criteria:
  
  
  • Normal level of consciousness or alertness
    
    
  • No muscle weakness or sensation problems
    
    
  • No evidence of intoxication with alcohol or drugs
    
    
  • No tenderness in the back of the neck
    
    
  • No other painful injury elsewhere on the body
  
  
• Your collar will remain in place if the doctor determines that the patient needs x-rays of the neck.
  
  
• The doctor will first examine the functioning of the spinal cord in order to determine if any damage is present. The following areas will probably be assessed:
  
  
  • Physical strength in both arms and legs
    
    
  • Ability to sense the touching of the skin in different parts of the body
    
    
  • Reflexes at the joints of the arms and legs
  
  
• The doctor will also inspect the patient's head and neck for any 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. Tell the doctor if neck pain, numbness, or tingling in any of the arms or legs, or any other abnormal feelings during these maneuvers is felt.
  
  
• X-rays may be taken of the neck bones to make sure there are no fractures or signs of other serious injury. The doctor will review these x-rays and order further imaging with a CT scan or MRI if needed. If the patient's x-rays are normal, then the cervical collar will probably be removed, and should not need any further x-rays.