Cervical collar or SAM splint in a pre-hospital wilderness environment – Dr Sean Hudson reviews

For some time there has been a debate about the value of cervical collars in the pre-hospital wilderness environment. A recent article has lent weight to the ‘don’t take collars on expedition’ protagonists.

The recent journal of Wilderness and Environmental Medicine: Vol. 20, No. 2, pp. 166–168 compares a molded SAM splint as a collar with the traditional philadelphia collar.

The SAM splint was simply wrapped and molded around the C spine. and degrees of movement of the C spine were tested in all planes.

They found no significant difference in the ability of the 2 collars at limiting movement of the cervical spine. Podolsky and colleagues, in a prior study, found that the Philadelphia collar is as effective as numerous other collars available for cervical spine immobilization.

None of these devices has the broad range of uses that can be performed by a SAM splint (in addition to limiting movement of the cervical spine) The ability to carry one universal device for so many different medical conditions is one of the advantages of the SAM splint. This study helps to validate the practice of using a SAM splint as a universal splint for environments with limited medical supplies.

For more information on Expedition and Wilderness Medicine visit www.expeditionmedicine.co.uk.

Wilderness Medicine resources and training courses.

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