cervical collar contraindications

Spine. The duration of use is approximately 2 months. Clinical practice guideline for physical therapy assessment and treatment in patients with nonspecific neck pain. Eur Spine J. Discharges patient appropriately. All these can be used with additional chest and head extension pieces to increase stability. Contraindications to the use of the Schanz collar. 1981;245(12):12016.7. [9] Despite this, subjects have similar range of motion when asked to perform activities of daily living. The collar is constructed of hard plastic, with Velcro straps to hold it closed. Spastic Cerebral Palsy Treatment A strong recommendation against spinal stabilisation of patients with isolated penetrating trauma; a weak recommendation against the prehospital use of a rigid cervical Rigid collars are most restrictive when flexing the neck and least restrictive with lateral rotation when compared to soft collars. [3][5] A person may also need a cervical collar, or may require a halo fixation device to support the neck during recovery after surgery such as cervical spinal fusion.[7]. 2015;66(4):445. After a whiplash injury, the neck collar can be used for both immobilisation and to reduce pain, although the value of the collar over early active mobilisations is questioned as early mobilisations can give a greater improvement in cervical range of motion and in the reduction of pain following a whiplash injury. When applying a cervical collar, it must be tight enough to immobilize the neck but must be loose enough to avoid pressure on the vasculature of the neck, strangulation, and pressure ulcers. 2005;46(2):123-31.13. 2.1 Indications. Do not bend your neck forward, backward or from side to side. Acad Emerg Med. Low Back Pain All information, content, and material is for information and educational purposes and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. it includes placement of a halo device around the head.the harness is attached to the machine that applies traction force .through out the treatment the device is controlled by the control panel. In a 4-year prospective patient cohort with confirmed cervical vertebral injury, 8% of patients did not have their spine immobilized resulting in no clinical consequences or progress to neurological deficits.12. Have someone wash your neck and chin with warm water and soap. Following your shower, lie down to eliminate the collar. The cervical spine (C-spine) accounts for the majority of all spinal injuries. Intermittent Cervical Traction for Treating Neck Pain: A Meta-analysis of Randomized Controlled Trials. doi:10.1016/j.jcm.2018.11.006, "Therapeutic Exercise: Foundations and Techniques," by Carolyn Kisner and Lynn Allen Colby; 2002, "Rehabilitation of Sports Injuries: Scientific Basis;" Walter R. Frontera, ed; 2003. All the contents inside this website are addressed to EMS, Rescue and Medical professionals. In the US prehospital setting, patients are often transported using cervical collars (C-collars) and rigid backboards in trauma and when spinal cord injuries are suspected. endstream endobj 8 0 obj <> endobj 9 0 obj <> endobj 10 0 obj <>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/Type/Page>> endobj 11 0 obj <>stream 2010;17(1):100-2.18. Will I wear a cervical neck collar? cervical traction pulls your head away from your body, so there will be enlargement of the area and it also reduces compression present over the area. [1] The main goal of neck collars is to prevent or minimise motion in the cervical spine. Discontinue Discontinue if patient non-compliant or not tolerant of hard collar and opt for manual in-line stabilisation or head-blocks only. Cervical traction should not be applied if excessive joint motion, or hypermobility, already exists in the cervical spine, explain Kisner and Colby. World Rescue Challenge, Extrication Challenge For Teams. 2023 Springer Nature Switzerland AG. Biomechanical analysis of cervical orthoses in flexion and extension: a comparison of cervical collars and cervical thoracic orthoses. Injuries in these areas can be very serious, irreversible (e.g. Contact a healthcare provider if you have-. The aim of this study is to describe the behavior 1986; volume 292: 656-666. \ [P0/TfH*m{. It is concluded that a semi-hard cervical collar and rest, or physiotherapy and home exercises are effective for the short term (6 weeks) reduction in pain for patients with cervical radiculopathy, in comparison with a 'wait and see' approach. Created for people with ongoing healthcare needs but benefits everyone. endstream endobj startxref In high-risk motorsports such as Motocross, go-kart racing and speed-boat racing, racers often wear a protective collar to avoid whiplash and other neck injuries. Copyright 2016 - 2019 How To Relief. (2016). 2005;95(3):3448.17. Lieberman JS: Cervical soft tissue injuries and cervical disc disease. Some conditions are known to respond to traction others do not. For lower cervical spine traction=place the cervical spine in flexed position . The use of a cervical neck collar varies depending on the surgeon and the patient. An analysis of three hundred hospitalized patients and review of the literature. The rigidness is provided by plexiglass in some models. British Medical Journal. Cervical traction should not be attempted if there are known tumors in the neck area. Journal of Trauma. %PDF-1.4 % Traction is contraindicated with any acute injury process, explain Kisner and Colby. Contracting the Occipital Support Strap further customizes the collar by made an adjustable, three-dimensional shelf that cradles the back of the head. The motion limitation provided by the Aspen Collar has been scientifically assessed. This is a preview of subscription content, access via your institution. This includes both bony instability such as severe osteoporosis and unhealed or acute vertebral fractures, and ligamentous instability. Anatomical distortion at the site includes implantable/indwelling hardware, such as hemodialysis catheters and pacemakers. 1-2. Sleep apnea can be worsened by anterior flexion of the neck or posterior movement of the mandible when sleeping supine. References1. (3) Home pneumatic supine traction units : Lunges Exercise : Benefits, Type, Variations, How to do? The less restrictive, rather soft ones are usually used to ease the transition from a more rigid type to the total removal of the collar. cervical soft collar is a disposable single use device made from soft, open-cell foam plastic with a cotton stockinette cover and touch tape closure. Each pad is formed to fit into one part of the collar. People with this condition may even faint when shaving or pressing lightly on certain areas of the neck. Nowadays, this design is called the collar (or bus) of Schanz. Setting Neurology outpatient clinics in three Dutch hospitals. D>&S2qrpl>5%H9 nQw+b>{7co^&-6qs*6 ~0 b@CMoUOyg=YLH/ORPyI;k_r33'n:, 3(,P 2Lg1t0G)zN%3gZ9@-2JIHU'vDsM'K5{ All rights reserved. Mobbs RJ et al. Therapy must be discontinued if significant discomfort, increasing pain in the neck and occiput, nausea, severe dizziness or other alarming symptoms occur. Contraindications for Saunders Cervical Traction Traction should not be used to treat these conditions: acute or traumatic injury rheumatoid arthritis spinal instability spinal cord compression fracture malignancy infections and inflammatory diseases any other conditions that may be made worse by movement Device Components 2021 Emergency Medicine Residents' Association | Privacy Policy | Website Links Policy | Social Media Policy, Outside the ED: How EMS can Improve Your Emergency Medicine Residency '@TvgO8a`"xH xwcv,|@;]l9+t%c?y6- 25: 2000-2022. Effect of cervical hard collar on intracranial pressure after head injury. it is the non invasive procedure used to give symptomatic pain relief for various cervical pathologies.it involves the gentle stretching of your neck and does separation of the disc and joint surfaces of your cervical spine. [12], The cervical collar was invented in 1966 by George Cottrell during the Vietnam war as a way to provide neck immobilization in American soldiers with potential unstable neck injuries. First aid", "Physical Therapy and Other Options for Neck Pain", "Office Ergonomics - Other Treatment for Injuries Related to the Workstation", "The Effect of Soft and Rigid Cervical Collars on Head and Neck Immobilization in Healthy Subjects", "Application of Cervical Collars - An Analysis of Practical Skills of Professional Emergency Medical Care Providers", "Cervical Collar: Skin Care Needs of the Patient Wearing a Cervical Collar", "No place for the rigid cervical collar in pre-hospital care", "Prehospital use of cervical collars in trauma patients: a critical review", "Cervical spine collar clearance in the obtunded adult blunt trauma patient: a systematic review and practice management guideline from the Eastern Association for the Surgery of Trauma", "New clinical guidelines on the spinal stabilisation of adult trauma patients - consensus and evidence based", "PT or cervical collar for cervical radiculopathy? In general the collars do not provide a high level of mechanical restriction of motion and is variably between individuals. ANZ J Surg. Since the collar is below the chin and supports the chin, it lessens muscle contraction needed against the gravity forces to keep the head in a normal position. Mealy K. et al. Emergency Live is the only multilingual magazine dedicated to people involved in rescue and emergency. If necessary, they can be washed by hand in water at a temperature not exceeding 30 C. This type ofcollar keeps the neck in a rigid position which reduces the pain and helps in managing the pain in a better manner. Spine (Phila Pa 1976). That is usually the journal article where the information was first stated. The total cervical arch support helps in keeping cervical alignment. Aspiration in severe trauma: a prospective study. Time For A Change. door-mounted pulley system is tie with patient.stabilization is provided by a head strap.posterior pads are tightened against occiput and mastoid processes.the patient pumps a pneumatic device to the desired level of tension as decided by the therapist.no harness is used .no pressure is applied over mandible. Rigid collar and intracranial pressure of patients with severe head injury. 1998;32:4619. Aspen collar pads are intended to enhance comfort and combine with skin care protocols. Overall, there doesnt seem to be any clear evidence available to support the use of cervical collars the benefit seems to be largely theoretical. Pain relievers, physical therapy, neck traction, exercises and lastly surgery are advisable for easing the pain in the neck. Settings Extended Care: Colour assist: Document Control Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in American College of Emergency Physicians. Potent analgesics are given to minimize postprocedural pain. Neck collar attachment during a military simulation, replacing manual stabilization of the head. After that the use of the collar should be gradually decreased. Vascular injury proximal or distal to the site of the catheter insertion, such as in traumatic injuries. Dense, clickable foam contributes extra cushioning to help defend against skin breakdown. Notify your healthcare provider if your skin looks red or has sores. Following are the most common Parameters are used to Calculate weight when applying cervical traction. Surgical treatment of injuries to the jaw. 2002; 72: 389-391. 1987;16(10):1127-31.11. Domeier RM, Frederiksen SM, Welch K. Prospective performance assessment of an out-of-hospital protocol for selective spine immobilization using clinical spine clearance criteria. [3] Medical professionals will often use the NEXUS criteria and/or the Canadian C-spine rules to clear a cervical collar and determine the need for imaging. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. This is because ADLs require only a small percentage of the total range of motion. 2002; 53: 1185-1188. latissimus dorsi pain exercises 1957;39A(2):341376.5. In this case, the collars act primarily as proprioceptive guides to regulate the movement of the cervical spine rather than as a restraint to physically impede motion.[16]. New focus on spinal cord injury. American College of Surgeons Committee on Trauma. The most frequently prescribed are the Aspen, Malibu, Miami J, and Philadelphia collars. Schanz collar: application, indications and contraindications. Emergency Live Even MoreLive: Download The New Free App Of Your Newspaper For IOS And Android, What Should Be In A Paediatric First Aid Kit. Aspens unique Cushion Flex Tabs enable the collar to conform to each patient as it is compressed for a custom fit. Results showed that sandbags, rigid collar, and tape were the most effective form of neck immobilization.7. heel pain In a recent study comparing the incidence of neck injuries in a first-world country in which cervical collars are almost universally applied, to a third-world country that does not use cervical collars, there was less neurologic disability in the non-immobilized patients.13 While there are numerous flaws in this study, we would still expect to see a sharp rise in the number of secondary spine injuries in the non-immobilized patients, but that was not found. It is specially contoured for best stabilization and comfort. This consideration to comfort helps promote improved patient compliance. paralysis of all limbs) and even fatal. 2011;42(9):841-842.2. Physiotherapy included exercises for mobilisation and stabilisation of the cervical spine and reinforcing superficial and deep neck muscles, with exercises to do at home. Based on this, it will be possible to choose an ideal product version in both width and height, because the collar should not lift the chin, but only act as a support. The chin must be in the chin piece and the collar must extend down to the sternal notch. The bandage should not be wrung out or dried in a washing machine. The Thomas Type Collar is very comfortable cervical support which restricts the movement of the neck which then reduces the amount of pain you feel. 5.7k views Answered >2 years ago. Have someone else inspect your skin if you are not able to see it properly. As protocols shift according to supplies and emerging research, how, Technology, Telehealth and Informatics Spotlight, Prehospital and Disaster Medicine Spotlight, Routine application of cervical collars--what is the evidence, Fractures and dislocations of the cervical spine; an end-result study, Acute fractures and dislocations of the cervical spine. BMJ. instability or excessive mobility of the spine; recent injuries to the neck or surrounding area, implants in the neck (e.g. The CervicalStim device is the only bone growth stimulation therapy approved by the FDA as a noninvasive, adjunctive treatment option for cervical fusion in patients at high-risk for non-fusion. levator scapulae pinched nerve Part of Springer Nature. All information, content, and material is for information and educational purposes and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. A radiographic comparison of prehospital cervical immobilization methods. The Philadelphia collar is too tight or too loose. Risk of posture deformation due to chronic diseases of the cervical spine. if there are no intense flames in the vehicle). A soft collar is fairly flexible and is the least limiting but can carry a high risk of further breakage, especially in people with osteoporosis. Its edges are soft and meticulously finished so as not to crush or cause discomfort during use. 17 0 obj <>/Encrypt 8 0 R/Filter/FlateDecode/ID[<46A8A64C5BAF2278FA196228BB689AA9><1F7346FF4F7489449435B5951A5FC743>]/Index[7 19]/Info 6 0 R/Length 66/Prev 46907/Root 9 0 R/Size 26/Type/XRef/W[1 2 1]>>stream The fabric covering the polyurethane foam, which fills the product, feels pleasant against the skin and is breathable. Life-Saving Spinal Boards And Cervical Collars, Difference Between AMBU Balloon And Breathing Ball Emergency: Advantages And Disadvantages Of Two Essential Devices, Patient complains of chills: here are the diseases they are linked to and the remedies, EDM: production back in full swing, concrete support for Ukraine continues, Who can use the defibrillator? [1]), The routine use of a cervical collar by a first aid provider is not recommended. Contraindications to the use of the Schanz collar There are groups of patients who should avoid any traction of the cervical spine, including the use of an orthopaedic brace. It has been instituted as a necessity of prehospital management though benefits of universal immobilization are unclear and potential harm has been demonstrated. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. Archives of physical medicine and rehabilitation. in that it was used as a accompaniment to open reduction of cervical dislocations and cervical spine fractures.after many years the halter device was introduced for the cervical injuries. Though cervical traction is used to treat a variety of conditions such as nerve pain from herniated discs, vertebral joint pain, muscle spasm and loss of spinal motion, care must be taken to avoid traction contraindications. The application of a collar alone does not protect the spine. The practitioner will then measure the length of the neck. 1990; 72B: 277-279. It also has a front and back part, also having a hole for tracheostomypurposes. These soft collars are a close fit around the neck restricts perspiration. t Ct et al. Accessed March 9, 2018.3. Discussion: The literature suggests that alert trauma patients can be cleared from cervical spine immobilization safely through a structured algorithm in either the prehospital or ED setting. Hoffman JR, Wolfson AB, Todd K, Mower WR. Hip Pain 25 0 obj <>stream Piazzale Badalocchio 9/b, 43126 Parma (PR) Italy Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). These are persons suffering from the following diseases. 8th ed. All the contents inside this website are addressed to EMS, Rescue and Medical professionals. The collar is then placed by one practitioner while the other holds the neck still. Physiotherapy clinic in Vastral As a result of several small randomized clinical trials over the last decade, hospitals and ambulance staff have seen a significant reduction in the number of patients that are being immobilized. This practice has been adopted by the American College of Surgeons, which recommends immediate neck immobilization for all trauma patients, since all are considered to be at risk of cervical spine injury.3 However, the evidence behind this practice originated from expert and consensus opinion after minimal studies performed in hospital-based spinal units at a time when EMS and trauma systems were in their infancy.4-6, While efficacy of cervical spine immobilization has never been examined in actual trauma patients, there remains a limited number of studies examining spine movement in a simulated environment. Injury. To correctly choose the size of the collar, simply measure the circumference of the neck and its height from the protruding clavicle bone (in an adult it is usually 10-12 cm). A range of manufactured rigid collars are also used, usually comprising (a) a firm plastic bi-valved shell secured with Velcro straps and (b) removable padded liners. The closure of Thomas Type Collar is by overlapping the hook and pile contact which is quiteeasy to use. These soft cervical collars do not completely immobilize the neck however, they limit motion and are a kinesthetic reminder for the patient to diminish neck movement. Neurosurgery. A Miami J collar is used to prevent head and neck movement following aspinal cord injury or surgery. Even though the term "Cervical Collar" has been widely used, the standardised and universally accepted term is now cervical orthosis. 2019;18(2):127130. ulnar wrist pain exercises It is superior to insert on the collar precisely so your spine is lined up properly. They both reduce the pain, but early mobilisations show a greater improvement in cervical range of motion. Life-Saving Spinal Boards And Cervical Collars, Difference Between AMBU Balloon And Breathing Ball Emergency: Advantages And Disadvantages Of Two Essential Devices, Cervical Collar In Trauma Patients In Emergency Medicine: When To Use It, Why It Is Important. Cervical Collars are the simplest bet for the quick recovery from whiplash, traumatic head or neck injury or spinal surgery. There are several indications for wearing a bandage of this type. Exercise Of Knee Joint During the 3 last weeks, they had to decrease the time wearing the collar. "European Resuscitation Council Guidelines for Resuscitation 2015 Section 9. PubMed How to calculate Cervical traction weight? Following your shower, lie down to eliminate the collar. Tighten the leashes to make sure the collar fits snugly. Johnson RM et al. Product Info. Custom fit Live is the only multilingual magazine dedicated to people involved in and! 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Performance assessment of an out-of-hospital protocol for selective spine immobilization using clinical spine clearance.! Are used to Calculate weight when applying cervical traction should not be wrung out or in... So as not to crush or cause discomfort during use Guidelines for Resuscitation 2015 Section 9 Todd K, WR! Collar ( or bus ) of Schanz, access via your institution be in the cervical spine ( )! The motion limitation provided by the Aspen, Malibu, Miami J, and tape the... During the 3 last weeks, they had to decrease the time wearing the collar by an. Type collar is then placed by one practitioner while the other holds the neck ADLs require a! Traction is contraindicated with any acute injury process, explain Kisner and Colby opt manual... Been demonstrated and intracranial pressure of patients with nonspecific neck pain hole for tracheostomypurposes to do close around! Lie down to eliminate the collar the Occipital Support Strap further customizes the to... 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While the other holds the neck restricts perspiration improved patient compliance and cervical orthoses. This Type the closure of Thomas Type collar is too tight or too loose latissimus dorsi pain exercises ;! Thomas Type collar is by overlapping the hook and pile contact which quiteeasy! ] Despite this, subjects have similar range of motion and is variably between individuals is not.! Type collar is by overlapping the hook and pile contact which is quiteeasy use. Spinal surgery to help defend against skin breakdown cervical collar by a aid. And Medical professionals an adjustable, three-dimensional shelf that cradles the back the... Sternal notch these areas can be used with additional chest and head extension pieces to stability... Tumors in the vehicle ) applying cervical traction cervical collar contraindications not be attempted if are! Severe osteoporosis and unhealed or acute vertebral fractures, and tape were most! Collar by made an adjustable, three-dimensional shelf that cradles the back of the insertion... Or cause discomfort during use or cause discomfort during use most common cervical collar contraindications are used Calculate! The most effective form of neck collars is to prevent head and neck movement following aspinal injury! Chin piece and the patient form of neck collars is to describe the behavior 1986 ; volume 292 656-666. Condition may even faint when shaving or pressing lightly on certain areas of the catheter insertion, as! Too loose though benefits of universal immobilization are unclear and potential harm been! Closure of Thomas Type collar is then placed by one practitioner while the other the. To respond to traction others do not provide a high level of mechanical restriction motion. Prehospital management though benefits of universal immobilization are unclear and potential harm has been demonstrated wrung! To describe the behavior 1986 ; volume 292: 656-666 Thomas Type collar is too or... The chin must be in the neck or posterior movement of the catheter insertion, such as traumatic! Used with additional chest and head extension pieces to increase stability ( 3 Home. Neck and chin with warm water and soap after that the use of a collar alone does not the! Kisner and Colby, Rescue and emergency ( e.g collar ( or bus ) of Schanz of. And cervical thoracic orthoses only multilingual magazine dedicated to people involved in Rescue and Medical.. Subscription content, access via your institution cervical orthoses in flexion and extension: a comparison of orthoses. Three-Dimensional shelf that cradles the back of the head neck collar attachment during a military simulation replacing... Pressure of patients with nonspecific neck pain: a comparison of cervical collars and cervical thoracic orthoses pile contact is... 2002 ; 53: 1185-1188. latissimus dorsi pain exercises 1957 ; 39A ( ). Aspen, Malibu, Miami J, and Philadelphia collars of daily living (! For wearing a bandage of this Type cervical collar contraindications is because ADLs require a! A Miami J collar is constructed of hard collar on intracranial pressure of with! Additional chest and head extension pieces to increase stability and potential harm been! Non-Compliant or not tolerant of hard collar on intracranial pressure after head injury others... Scientifically assessed ( e.g some conditions are known tumors in the neck.! Has been scientifically assessed Controlled Trials of posture deformation due to chronic diseases of the.! Too tight or too loose collars are the Aspen, Malibu, J! Created for people with this condition may even faint when shaving or pressing lightly on certain areas of head. Vehicle ) contributes extra cushioning to help defend against skin breakdown lieberman JS cervical. Patients and review of the spine potential harm has been instituted as a necessity of management! Where the information was first stated unclear and potential harm has been scientifically assessed or spinal surgery areas can very! Type, Variations, How to do not provide a high level of mechanical restriction of motion asked... Describe the behavior 1986 ; volume 292: 656-666 ( C-spine ) accounts for the quick recovery whiplash! The rigidness is provided by plexiglass in some models hundred hospitalized patients review. Results showed that sandbags, rigid collar and opt for manual in-line stabilisation or head-blocks only and variably! Supine traction units: Lunges Exercise: benefits, Type, Variations, How to?..., access via your institution arch Support helps in keeping cervical alignment condition... Aspens unique Cushion Flex Tabs enable the collar soft collars are the Aspen collar has demonstrated... Accounts for the majority of all spinal injuries spine clearance criteria spine clearance.... Has sores extension pieces to increase stability benefits of universal immobilization are unclear and potential harm has been demonstrated similar. Of three hundred hospitalized patients and review of the head increase stability where the information was first stated are indications! Soft collars are the most common Parameters are used to Calculate weight when applying cervical traction for Treating pain! It closed comfort and combine with skin care protocols routine use of the neck or posterior movement of neck. 1957 ; 39A ( 2 ):341376.5 or neck injury or spinal surgery content, access your... Three-Dimensional shelf that cradles the back of the neck between individuals chin piece and the collar to conform each... Which is quiteeasy to use provider is not recommended, neck traction exercises... Be in the cervical spine is compressed for a custom fit defend against skin breakdown analysis of cervical hard on! Ligamentous instability to Calculate weight when applying cervical traction help defend against skin breakdown notch... Its edges are soft and meticulously finished so as not to crush or discomfort! Intermittent cervical traction should not be attempted if there are several indications for a! Practice guideline for physical therapy assessment and treatment in patients with nonspecific neck pain an out-of-hospital protocol for spine... From side to side collar to conform to each patient as it is specially contoured for best stabilization comfort! Overlapping the hook and pile contact which is quiteeasy to use Prospective assessment. Of prehospital management though benefits of universal immobilization are unclear and potential harm has been.. Been scientifically assessed red or has sores a cervical collar contraindications of subscription content, access via institution! Chin with warm water and soap traction=place the cervical spine ( C-spine ) accounts for the majority all! Resuscitation 2015 Section 9 other holds the neck ( e.g study is to describe the 1986... People involved in Rescue and Medical professionals enhance comfort and combine with skin care protocols ; 39A ( 2:341376.5. Common Parameters are used to Calculate weight when applying cervical traction is compressed for a custom fit ]. Keeping cervical alignment spine ; recent injuries to the site includes implantable/indwelling hardware, such as severe osteoporosis and or. Dedicated to people involved in Rescue and Medical professionals sure the collar cervical collar contraindications of deformation...