Your Child’s Cervical Collar: How to Remove, Care for Skin, and Reapply It

Important Information:

A cervical spine collar helps keep your child’s neck stable and protects it while healing from an injury. It prevents movement that could cause further damage. Extra care is needed while your child wears the collar.

Patient instruction:

Safety

• Your child must wear the cervical spine collar at all times.

• Make sure the chin rests at the front edge of the chin piece when the collar is properly applied.

• The collar should fit snugly to prevent neck and head movement but should not pinch the skin.

• Keep an extra collar ready for use.

• If your child wears the Aspen Vista collar, do not allow them to play with the dial in front of the collar.

Activity

• Choose quiet activities like crafts, reading, or video games.

• Avoid activities that involve head-turning, running, jumping, contact sports, or anything where your child could fall, like climbing, or bike riding.

• Your child may go to school.

• Use a very flat pillow or no pillow when your child sleeps.

Daily skin care

Two people should help with collar care: one person holds your child’s head still, while the other performs the care.

Your child can wear the collar during a bath or shower. Perform skin care after bathing. To avoid redness or sores from pressure, moisture, heat, or dirt:

1. Remove the collar at least once a day to clean your child’s skin.

2. Wash the neck and face with mild soap, rinse, and pat dry.

3. Replace moist or dirty pads with clean, dry ones.

4. Check for redness or sores. Call your healthcare provider if you notice any.

Instructions for collar removal, skin care, and reapplication:

1. Gather supplies before asking your child to stay still.

• Soap

• Washcloth

• Towel

• Clean, dry replacement pads

2. Remove the collar

• Decide which person will remove the collar and which will help your child to stay still. It can be helpful to distract your child with music or a story.

• Have your child lie on their back in bed. Distract them with music or a story if needed.

• One person holds the head steady, keeping it straight and facing up.

• Unfasten the Velcro straps and remove the front piece of the collar. Note where the straps end on the front of the collar. This will help when you reapply and tighten the collar.

• Slide out the back piece of the collar while keeping the head still.

3. Skin care

• Gently wash the skin with mild soap, rinse, and pat dry.

• Look for any redness or sores during cleaning.

4. Reapply the collar

• Remove the current pads and attach clean, dry pads to the collar.

• Follow the instructions for the type of collar your child has below: Aspen® or Vista.

General collar care

• Clean pads every 1–2 days or whenever wet or dirty.

• Hand wash pads with mild soap, rinse well, and air dry on a towel. Avoid bleach or harsh detergents.

• Wipe the plastic shell with mild soap and water, then rinse and dry it.

Applying the pediatric Aspen collar: for children under 55 pounds (25 kg) 

Steps for placement:

1. Make sure your child is still lying flat on their back.

2. Slide the back panel of the collar behind their neck, keeping the head straight and still. Press down on the bedding behind your child’s neck to create space.

3. Gently squeeze the collar in half horizontally forward.  See picture below.

4. Scoop the front panel up and under your child’s chin. Ensure the chin piece reaches the front edge of the chin and the sides of the collar rest over the shoulders.

5. Loosely attach the Velcro straps from the back panel to the front panel to hold it in place.

6. While holding the front of the collar with one hand, peel the back panel Velcro onto the side of the front panel. 

7. Repeat on the opposite side, and alternate sides, until the collar is secure and centered.

Check the fit:

1. The chin dots indicator on the chin pad should be hidden when properly applied.

2. Ensure the Velcro® straps extend past the green mark for a secure fit and proper overlap of the front and back panels. If needed, evenly tighten and re-tighten the straps until there is no slack.

3. The flex tabs should bend slightly, spreading the support across the upper chest for stability.

Applying the Aspen Vista collar: for children over 55 pounds (25 kg)

1. Pre-form the back ends of the side panels by squeezing each end forcefully so they stay curved when released as shown below.

2. With your child lying flat on their back and their head held straight (midline position), press the back panel of the collar down to compress any bedding.

3. Check that the words on the Velcro straps are facing upright. Slide the back panel behind your child’s neck. Center it so the loop straps are positioned between the ear and shoulder. Be sure the padding extends beyond the plastic edges to prevent the plastic from cutting into the skin.

4. Set the collar to its lowest height. Pull the sides of the front panel apart and position the chin piece so it touches your child’s chin.

5. “Dial up” the height of the collar by pulling outward on the dial and turning it clockwise. Stop turning when it becomes difficult to turn further and the foam pad on the chin piece compresses.

6. While holding the front panel in place, attach the Velcro straps on both sides.

7. Tighten the collar:

   • Hold the front panel at the opening.

   • Peel back one loop strap.

   • Push inward on the back edge of the side panel while pulling the strap outward.

   • Lift the strap and reattach it securely.

   • Repeat on the other side, tightening equally to remove all slack and keep the back panel centered.

   • Adjust the pads so they adhere to the Velcro. The pads must cover all edges of the plastic to keep the plastic from touching the skin.

Call your CHOP healthcare provider with questions, concerns or if:

• Your child has increased pain, numbness, or tingling.

• Your child re-injures their neck.

• The collar does not keep your child’s head in the correct position.

• Redness under the collar lasts longer than 20 minutes.

• You need more replacement pads.

Contact the team who ordered the cervical spine collar:

• Neurosurgery: 215-590-2780

• Orthopedic surgery: 215-590-1527

• Trauma/general surgery: 215-590-5932

Reviewed December 2024 by Jessica Osipowicz, CRNP