Patient education: Cervical collars for children (The Basics)

What are cervical collars? — 

A cervical collar, or "C-collar," is a type of neck brace. They are sometimes called "cervical immobilizers" or just "neck braces."

The neck has 7 bones that are stacked on top of each other. These bones are called the "cervical vertebrae." They make up the top part of the spine, called the "cervical spine." Ligaments attach the bones to each another. A thick bundle of nerves called the "spinal cord" runs through the cervical vertebrae, and connects the brain to the rest of the body. C-collars help protect the cervical spine.

There are different types of C-collars:

●Rigid C-collars (figure 1) – These are usually made of hard plastic and foam. They usually have a piece that goes under the chin. They keep the neck very still. These are usually used after surgery or a serious injury, such as a neck fracture. They support the head and limit how much a child can move their head and neck while they heal.

●Soft C-collars – These are made of foam. They give the neck some support and limit side-to-side movement. They might help with neck pain. But doctors generally do not recommend people wear these, especially for long periods of time. This is because they can actually make the neck muscles weak and slow down improvement. If your child uses a soft C-collar, they should only wear it for less than 3 hours at a time each day, and for no more than 1 to 2 weeks.

This article focuses on rigid C-collars. If you are interested in using a soft C-collar for your child's neck pain, talk to their doctor or nurse.

How should my child wear the C-collar? — 

You will learn how your child should wear the collar in the hospital. At home, you need to help them clean and adjust the collar, and check their skin for problems.

Before you go home with the collar, make sure you know:

●When your child should wear it – They might need to wear it all the time. Follow their doctor's or nurse's instructions.

●What kind of help the child will need – For example, you might need to put the collar on, or wash their hair or help them do other tasks while they wear the collar. For some tasks, you might need another adult to help you.

In most cases, your child will need to wear the collar all the time. But you will still need to clean their neck under the collar and check for skin irritation about once a day.

Each collar is slightly different, so follow the instructions for your child's specific collar.

To take the C-collar off and check the skin:

●Make sure the child is calm. They should be lying down, unless the doctor said you can remove the collar while they are sitting up. It might help to ask another adult to help you. They can help keep the child still if needed.

●Carefully undo the straps on the side of the collar. Open the collar, and slide it out from under the child's neck. Move slowly, and be gentle.

●The child should hold their head still and not move too much while the collar is off.

●While the collar is off, clean your child's neck area and check for any skin irritation. You can also clean the collar.

●Then, you can put the collar back on. Make sure the child's chin rests in the chin piece, and the back piece is centered on the back of their neck. Fasten the straps.

After you check your child's neck and fasten the collar again, check the fit:

●The collar should be snug, but not uncomfortable.

●Your child's head and neck should not be able to move very much once the collar is on. If their head and neck are moving a lot, try putting on the collar again. If you are still having trouble, call their doctor or nurse.

●Your child should be able to breathe and swallow normally.

●Their ears should be free.

●Their chin should rest on top of the chin piece. Make sure it does not slip inside the brace.

●No plastic should be touching the child's skin, only the foam liners.

What else should I know? — 

The exact instructions depend on what type of collar your child has and why they need it. Ask questions if there is anything you do not understand. Talk to your child's doctor or nurse about whether there are things your child shouldn't do while wearing the collar.

Some general tips:

●Clean the collar once a day:

•Handwash any plastic pieces with mild detergent, and dry with a towel.

•Some rigid C-collars come with removable liners for the chin, front of the collar, and back of the collar. Handwash the liners with mild detergent. Let the liners air dry. Follow the collar manufacturer's instructions for how to change the liners.

●When you take the collar off for cleaning, check your child's neck for redness, sores, and skin irritation. If they have any of these and they do not go away within 20 minutes after removing the collar, tell their doctor or nurse.

●Make sure your child uses good posture while wearing the collar. They should try not to slouch.

●Do not let the child do any heavy lifting or heavy exercise of any kind while wearing the collar.

●Your child should sleep with the collar on, unless the doctor tells you they shouldn't.

●Remind your child to be careful when walking, since the collar makes it hard to look down.

●Do not let your child drive with a C-collar, if they drive.

●Ask your child's doctor about bathing. Unless instructed otherwise, they should wear the collar in the shower or bath. After they wash, you might need to take the collar off to clean the child's neck and change any pads.

●Keep the collar away from heat or flames.

When should I call the doctor? — 

Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●Your child's arms or legs are weak, numb, or tingling.

●Your child has trouble breathing, swallowing, eating, drinking, or talking.

Call the doctor or nurse for advice if your child:

●Can move their neck or head easily with the collar on

●Has pain in or around their ears or face

●Has skin irritation that does not go away within 20 minutes of opening or removing the collar

More on this topic

Patient education: Cervical collars for adults (The Basics)
Patient education: Neck fracture (The Basics)