Safety training
G WO Advanced Rescue Training Standard / V6 02032026
ANNEX 3 - HEAD SUPPORT DURING RESCUE
1.
Introduction , purpose and scope
This annex provides guidance on if, when and how a cervical collar may be used in Advanced Rescue Training (ART).
Current most international and national evidence (ERC, AHA , ANZOR and more ) does not support routine use of rigid cervical collars in the prehospital setting. Collars may be associated with harm and should therefore be used only in selected circumstances, for the shortest possible time and by sufficiently and correctly trained personnel .
The annex:
a.
summarises the key evidence basis;
b.
describes principles for non -routine collar use in ART;
c.
outlines risks and mitigation measures; and
d.
clarifies the role of collars and alternative head -support methods in training.
It does not override national clinical guidelines or local medical governance. Where local guidance is stricter (e.g. “no collar use”), that shall take precedence.
2.
Evidence summary
2.1 International first -aid and EMS guidance
1. Systematic reviews and international guidelines (e.g. ILCOR, ERC, AHA, ANZCOR) conclude that:
b. There is no high -quality evidence that semi -rigid collars improve neurological outcome in suspected spinal injury.
c. Collars may increase intracranial pressure, complicate airway management, cause pressure injuries and delay extrication and transport.
d. Routine application of cervical collars by first aid providers is therefore not recommended; priority is given to:
d.i
spinal motion restriction in a natural, neutral position;
d.ii
manual support of the head/neck where needed;
d.iii self- or minimally assisted extrication when safe.¹
–³
2.2 Danish national guideline
Global Wind Organisation ©2026 / www.globalwindsafety.org
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