Tom, you are so right. Medical treatment should (must) be based on what is best for the patient, not what would look best in court. My training tells me that if I suspect a spinal injury. the patient should be immobilised with a collar and long board. A collar alone does not provide sufficent immobilisation. I can foresee an interesting legal case: "well, you must have suspected a spinal injury because you collard me. But you didn't immobilise the rest of my spine. Therefore you are negligent and I will have thousands of dollars compensation, please" If a patient presents at A&E wearing a c-collar, is there a danger that a spinal injury is automatically assumed, and the patient treated accordingly - possibly to the detriment of other injuries? Conversely, if in the US this is normal practice, could we have a "cry wolf" situation here where a genuine spinal injury is overlooked? Finally - I know someone who is allergic to c-collars. Seriously allergic (like needing hospital within 10 minutes of wearing one). Now THAT could make an interesting court case if one were put on unnecessarily.