This makes them at high risk for spinal cord injury, which could be exacerbated by movement of the person and could lead to paralysis or death.

[4] In order to prevent further injury, such people may have a collar placed by medical professionals until X-rays can be taken to determine if a cervical spine fracture exists.

[5] 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.

[2][3][6] Cervical collars are also used therapeutically to help realign the spinal cord and relieve pain,[7] although they are usually not worn for long periods of time.

[9] 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.

[citation needed] 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.

[10] Examples include the Sterno-Occipital Mandibular Immobilization Device (SOMI), Lerman Minerva and Yale types.

[13] Cervical collars and patient's necks should be evaluated and cleaned frequently for hygienic purposes as well as to avoid pressure ulcers.

[16] 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.

[17][18] This has been due to complications such as increased intracranial pressure with traumatic brain injury, along with access issues for airway management in obtunded patients.

[20] Because of these potential complications, cervical collars are not recommended in trauma patients with isolated penetrating injury and no neurological deficits.

Small scale studies have failed to show any improvement in oxygenation, snoring, and/or apneic episodes with the use of cervical collars at night.

[citation needed] Patients on CPAP ventilation can often have suboptimal positioning due to pain, discomfort, or lack of knowledge.

In a small study analyzing the use of cervical collars in patients on CPAP ventilation with a history of sleep apnea, a significant benefit was observed.