Patient education: Cervical collars for children (The Basics)

What are cervical collars? — A cervical collar, or "C-collar," is a type of brace for the neck. They are sometimes called "cervical immobilizers" or "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. Some people find that they help with neck pain. But doctors generally do not recommend that people wear these, especially for long periods of time. This is because they can actually make the neck muscles weak. If your child uses a soft C-collar, they should only wear it for less than 3 hours at a time.

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 C-collar while they are 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, make sure that you know:

●When your child should wear the collar – In some cases, they might need to wear the C-collar all of the time. Follow the doctor or nurse's instructions.

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

In most cases, your child will need to wear the C-collar all of the time. But you will still need to clean their neck under the collar and check for skin irritation about once a day. Each C-collar is different, so follow the doctor or nurse's instructions for your child's specific collar.

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

●Make sure that the child is calm and sitting still. 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 pull it away from the skin. 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, you can clean your child's neck area and check for any skin irritation. You can also clean the collar.

●After you check and clean the neck area, you can put the C-collar back on. Make sure that the child's chin rests in the chin piece, and that the back piece is centered on the back of the child's neck. Fasten the straps.

Once you have checked your child's neck and fastened the collar again, check the fit:

●The C-collar should be snug, but not uncomfortable.

●Your child's head and neck should not be able to move very much once the C-collar is on. If your child's head and neck are moving a lot, try putting on the collar again. If you are still having trouble, call your 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 that it does not slip inside of 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 C-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. Hand-wash the liners with mild detergent. Let the liners air dry. Follow the collar manufacturer's instructions on how to change the liners.

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

●Make sure that your child uses good posture while wearing a C-collar. They should try not to slouch.

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

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

●Do not let your child drive with a C-collar, if they drive. Ask your child's doctor about bathing. They should not wear the collar in the shower or bath.

●Keep the C-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.

●Your child has trouble when they breathe, swallow, eat, drink, or talk.

Call the doctor or nurse for advice if:

●Your child is able to move their neck or head easily with the brace on.

●They have pain by the ears that seems to be coming from the neck or cheeks.

●They have skin irritation that do not go away within 20 minutes of opening or removing the collar.

●Their arms or legs are numb or tingling.

More on this topic

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