Removal of C-Spine Collar

Medical Directive ID: 
EMG-2014-005
Lead Contact Person: 
Audrey Wharton
Physician/Nurse Lead: 
Christine MacDonald
Dr. Adam Dukelow
Program: 
Emergency Medicine - Adult Emergency Department at Victoria Hospital
Approval By: 
Medical Advisory Committee
Original Effective Date: 
Wednesday, January 11, 2012
Revised Date: 
Wednesday, June 24, 2015
To Be Reviewed Date: 
Sunday, June 24, 2018
This Medical Directive Applies to the following sites: 
LHSC-VH
This Medical Directive Applies to the following patient population: 
Out-Patients
Adults
Order: 

**This directive is a renewal and will replace directive #EMG-2011-004**

 

  • Qualified Registered Nurse (RN) in the Victoria Hospital (VH) Adult Emergency Department may remove the cervical collar on emergency patients in accordance with the conditions identified in the  Canadian Cervical-Spine Rule (CCR) (Stiell,I.,Clement,C.,O’Connor,A.,et al. CMAJ, August 10,2010,182(11),pp.1173-79).
  • Implementers will evaluate the patient for inclusion and exclusion criteria to determine eligibility for appropriateness of applying the CCR (Canadian Cervical-Spine Rule) using the LHSC checklist Emergency Department Checklist Cervical Spine (C-Spine) - (NS6698) for assessment and documentation. This assessment will include the evaluation of neck tenderness and range of motion, when appropriate- and  may require removal of tape and neck restraints as well as temporary loosening of the C-Spine collar - for assessment (NS6698, attached)
  • If the patient is determined to no longer require C-Spine immobilization according to the CCR, then the RN will remove the C-Spine collar and any other neck restraints as per the directive.
Click the link to view the entire medical directive in detail: 

Signatures

SurnameKnown ByDate Signed
AguannoAlainaAug 4 2015 12:28:39:947PM
AndersonScottMar 31 2016 12:44:28:033PM
ArbeauRyanAug 4 2015 08:06:50:553AM
BhimaniMunsifMar 15 2016 06:52:30:720AM
BrineMegganAug 13 2015 09:45:02:087AM
ChurchKaralynMar 29 2016 07:59:55:490PM
CoomeGrantSep 1 2015 10:08:27:900AM
CunninghamChristyMar 29 2016 11:40:44:597AM
DagnoneRobert VicoAug 11 2015 02:00:01:170PM
DavisMatthewJul 28 2015 03:03:13:137PM
DonovanKeithApr 1 2016 03:30:32:610PM
DreyerJonAug 10 2015 10:13:30:163AM
DukelowAdamJul 28 2015 06:40:17:833PM
EdmondsMarciaJul 27 2015 02:32:47:497PM
El-HalabiWaseemMar 6 2016 06:28:16:323PM
ElsadiSalmanFeb 14 2017 01:27:13:997PM
FotheringhamMaryMar 31 2016 05:53:54:953PM
FoxcroftLauraSep 8 2015 11:38:23:550AM
FussJeffreyJul 24 2015 11:17:30:140AM
GiffinDawnJul 27 2015 01:05:32:140PM
HamesHeatherJul 31 2015 11:40:40:160AM
HaneyElizabethJul 24 2015 08:37:37:467AM
HassaniBehzadAug 4 2015 09:00:11:493AM
JonesAndrewAug 31 2015 02:37:25:870PM
LewellMichaelFeb 21 2016 01:16:37:423PM
LoubaniTarekAug 2 2015 04:54:00:060PM
MacDonaldChristieAug 10 2015 05:42:00:723PM
MalSameerJul 25 2015 08:15:57:290PM
MaxwellH BrentFeb 16 2017 11:18:50:640AM
McCauleyWilliamJul 24 2015 06:17:01:610AM
McConnellAllisonMar 13 2019 08:04:40:587PM
MeiwaldAllisonJul 26 2015 04:52:13:310PM
MillardWandaNov 19 2015 02:54:12:550PM
MosdossyGregoryAug 17 2015 05:53:47:460PM
MurphyDavidAug 4 2015 11:10:27:700AM
MyslikFrankAug 22 2016 11:48:02:977AM
NgVictorAug 5 2015 02:10:01:040PM
OuelletteDavidJul 27 2015 04:04:37:840AM
PeddleMichaelSep 25 2015 01:31:00:403PM
PillonSylviaAug 4 2015 03:53:59:480PM
PriceLauraAug 13 2015 08:52:07:300PM
PringleDerrickMar 12 2016 01:01:33:200PM
ReddyRameshMar 28 2016 01:59:16:293PM
ReganKellyAug 5 2015 01:21:47:813PM
RichardsonChristineAug 25 2015 02:47:45:173PM
RoebothamRoyAug 3 2015 06:12:49:787PM
SedranRobertJul 24 2015 10:16:43:590AM
ShahAmitJul 26 2015 10:22:22:807PM
ShepherdLisaJul 26 2015 08:02:52:820AM
SkoretzTerrySep 24 2015 10:53:09:153PM
TanakaPeterMar 1 2016 10:23:24:583PM
TheakstonKarlAug 17 2015 07:14:27:203AM
ThompsonDrewJul 27 2015 08:40:45:947AM
ValdisLaurenAug 28 2017 01:50:56:043PM
WoolfreyKarenAug 24 2015 05:15:18:990PM
YanJustinJul 24 2015 10:43:49:227AM