C-Spine collars.....best for Prehospital use

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1) Advent of adjustable collars has saved on stock needed to be carried
and more importantly, ability to adjust collar size for when collar
initially fitted to sitting patient in vehicle who is then subsequently
repositioned for supine transport on board/mattress to ED. Similar to
'standing takedown' scenario. 

2) In ED, Ideally, same model of collar should continue in use unless
contraindicated. In UK best system is interchangeable replacement stock.
Collar left on patient. Paramedic picks up new from stock cupboard. For
price today mostly used as single-patient use device as almost
impossible to clean Velcro.

3) Personally., I prefer Wizlok because single its adjustable sizing
post is completely accessible from front and can be used without need to
pre-size and lock collar and without removing to adjust size once in
situ. Designed for rough play at scene - you're encouraged to roll it
back on itself and 'soften it up' for a better fit. I've trod on this
many times without breaking adjustment mechanism. Only disadvantage is
post may interfere with managing trache tube which is why not used much
as in-hospital model. As with all disposable plastic collars wear and
tear in multiple use (e.g. training rooms) eventually results in
structural failure but costs are very competitive given the one-for-all
capability.  
http://www.ferno.co.uk/viewproducts/ambulance/Immobilisation-|-Splinting
/52/
No mention of particular needs for kids. I'm often asked youngest age a
collar has been used for. Aspen do a range down to 'infant' size. This
is not normally one used in pre-hospital care as designed for
longer-term use such as ICU but in one case was used successfully in
one-month old (mother was breastfeeding baby while turning into oncoming
traffic outside of a hospital. Mother killed, child was found in foot
well conscious but with suspected SCI).

A range of Ferno products carry x-ray/CT guarantee and standard
improving through years. Also provide non metallic strapping for use in
MRI. Mo-Lift also working on completely MRI compatible scoop stretcher.

Paul Harrison
Clinical Development Officer
Princess Royal Spinal Injuries Centre
Sheffield, UK

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Hillen Gregory
Sent: 14 August 2008 04:10
To: trauma-list at trauma.org
Subject: RE: C-Spine collars.....best for Prehospital use

Dear All,

I am currently ordering in stock for our station and would like to get
some input as to you recommendations/thoughts on the following:
1) Using the adjustable collars vs rigid non-adjustable.
2) On arrival at ED which seems to do the job best.
3) What would you recommend for pre-hospital use?
4) What is used within your service/area and do you feel they are
effective?

I do realise that is up to the training, individual preference, space on
vehicles etc etc but your thoughts would be appreciated.

Regards.
Gregory Hillen
FF/USART/SR Para

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