Your child needs to wear a cervical collar for various reasons. Find out why they might need one and how to properly care for your child and their collar.
Key points
Collars are prescribed for various reasons such as injuries or post-surgery. A well-fitted collar allows the neck to be centrally aligned.
Collars provide support and stability by restricting movement while the neck is healing from an injury or surgery.
Your child should wear the collar as prescribed. Some children can remove it to shower while others are required to wear it continuously. Your child’s health-care team will instruct you on how and when your child is to wear their collar.
Your child should see their health-care provider if they have increasing pain or headaches, new numbness or tingling or skin breakdown.
Introduction
Collars are prescribed for various reasons including fractures, ligamentous injuries of the spine, torticollis, infections and tumors. Cervical collars immobilize and centrally align the neck, provide support and stability and help reduce pain while your child’s neck is healing.
There is a cost associated with cervical collars. Most extended health plans cover the cost. Make sure your health-care provider gives you a prescription. If there are any financial limitations, please contact your child’s health-care team.
The most common brands of rigid collars used at the Hospital for Sick Children are the Aspen and the Vista.
Aspen collarVista collar
Preparing for the procedure
Safety tips for cervical collars
If your child needs to wear a cervical collar for any reason, follow these safety tips:
Wear the collar as prescribed.
Children in collars should not sit in the front seat of a car.
Adolescents in collars should not drive.
No sports or physical activities until your child is cleared by their health-care provider.
Checking for a well-fitted collar
A well-fitted collar allows your child’s neck to be centrally aligned so that it can heal properly.
The collar should be moderately snug on your child. Your child should not be able to move their head or neck, but they should not be in any pain.
The head should be maintained in a neutral position. It should not be turned to either side and not in an extended or flexed position.
The size or tightness of the collar may need to be adjusted due to changes in the amount of swelling. Reassess the fit once the child is sitting upright.
Collar fit
Tips to check if there is a correct fit:
The chin plastic piece should be flush (level) with the end of the chin. The chin dots on the chin pads should be hidden.
The Velcro extends past the mark and the front/back panel overlap.
The FlexTabs in the front and back of the collar should be bent to spread the support.
Skin assessment
You will need to assess your child’s skin at least two times a day for:
redness
break down (sore, raw skin resulting from too much pressure on the skin for a long time)
odours
Wash your child’s face and neck at least once per day. Do not apply any moisturizers or powders to the skin.
Cleaning the collar pads
The collar pads should be washed every 24 hours
Hand wash dirty collar pads with mild soap and water
Air dry pads
Do not machine wash or dry collar pads
Procedure
Changing the collar pads
When a collar has been prescribed to be worn 24/7, make sure there are at least two care providers available (you and one other person) while changing the collar pads. Having two care providers available helps to ensure the child does not move, providing ongoing cervical immobilization.
When you are changing the collar pads, assess the skin for signs of irritation or infection.
To find out how to change the collar pads, watch this video or follow the written instructions below the video:
Your child should be lying flat with their head in a neutral position and arms by their sides. Their head should not be turned to either side and should not be in an extended or flexed position.
Top viewLateral view
Care provider 1 will ensure your child does not move and will maintain cervical alignment by placing both of their hands around the sides of the child's head and neck.
Care provider 2 will be changing the pads. Additional care providers may help to turn and wash your child, if needed.
Remove the front of the collar and slide the back of the collar off.
Care provider 1 should ensure your child does not move and maintains cervical alignment.
Assess the skin for redness, breakdown and pressure sores. Clean front of the skin with soap and water. Dry thoroughly.
Remove the soiled front pad and attach a clean pad to collar.
Remove the soiled back pad and attach a clean pad to collar.
Side view
Log roll the child to their side. Your child’s arms should be at their sides, with palms resting on their thighs. Be careful not to twist or bend your child’s body or neck as you roll them.
Assess the skin for redness, breakdown and pressure sores. Clean the skin with soap and water. Dry thoroughly.
Logroll your child back to a supine position.
Replace the back of the collar by sliding it under the child’s head and neck and then replace the front portion of the collar. Attach the Velcro straps.
Tighten the collar straps and recheck for proper fit. See the above section called "Checking for a well fitted collar" for instructions.
Vista collars only: Follow the additional instructions from your child’s health-care provider.
Follow-up care
Follow-up care
Your child should wear the collar as prescribed. Some children may be required to wear the collar while showering and sleeping. Your child’s health-care team will tell you if this applies to your child.
The collar must be worn as directed by your child’s health-care team. Your child must wear the collar until they are reassessed in the neurosurgery clinic or at their primary care provider’s office.
When to seek medical attention
When to seek medical attention
Contact the prescribing team if the collar is becoming worn down and/or the Velcro straps are becoming unstuck. Extra collar pads may be purchased separately.
Contact your child’s primary-care provider if your child has:
increasing neck or back pain and pain medications are not helping
worsening or new skin breakdown
dizziness
increasing headaches
Call 911 or take your child to the nearest emergency department if your child has:
