Which of the following is a contraindication to cervical stabilization?

• A. Penetrating injury to the head and/or neck with no evidence of spinal injury
• B. Injuries that may compromise patient assessment, airway management, ventilation, and/or hemorrhage control if the c-collar is placed
• C. Patient in cardiac arrest
• D. None of the above

Answer: (A)

Penetrating injury to the head or neck with no evidence of spinal injury is a contraindication to applying a cervical collar because immobilizing the neck can get in the way of life-saving steps. In penetrating trauma, the priority is securing the airway and ensuring ventilation, along with rapid hemorrhage control. A rigid collar can make airway management more difficult (for example, during suctioning or intubation) and can impede direct access to neck wounds to control bleeding. It also can obscure neurologic signs or mask evolving problems. If there’s a true suspicion of spinal injury, immobilization is warranted, but in a penetrating head/neck injury without spinal injury evidence, the collar is avoided to not delay critical interventions.