This page illustrates the sizing method and application of the STIFNECKTM Extrication Collar. The material is taken from the brochure that accompanies the collar, with the following suggestions:
The page is divided into the method of Sizing, Assembly and Pre-forming, Application and adjustments, and some Additional Considerations.
1. Proper sizing is critical for good patient care. too short a collar may not provide enough support, while too tall a collar may hyperextend. The key dimension on a patient is the distasnce between an imaginary line drawn across the top shoulders, where the collar will sit and the bottom plane of the paitent"s chin.
2. The Key Dimension on the collar is the distance between the sizing post (back fastener) and the lower edge of the rigid plastic encircling band (not the foam padding).
3. When the patient is being held in a neutral position, use your fingers to measure the distance from the shoulder to the chin (Key Dimension.)
4. You can then use your fingers to select the size Stifneck Extrication Collar that most closely matches the key dimensions of the patient.
Note: For more details on the sizing procedure, please refer to the Stifneck In-service Training Video.
5. The collar is assembled by moving the black fastener (sizing post) at the end of the chin piece up the inside wall of the collar and then pushing the black fastener all the way into the small hole. Press firmly
6. Before applying the Stifneck collar, hold it as shown.
7. Flex the collar sharply inward until you can touch your thurb to your fingers. This will pre-form the collar into a cylinder to simplify application.
8. With the patient's head held in neutral alignment, position the chin piece by sliding the collar up the chest wall. Be sure that the chin is well supported by the chin piece and that the chin extends far enough onto the chin piece to at least cover the central fastener. Difficulty in positioning the chin piece may indicate the need for a shorter collar.
9. Re-check the position of the patien's head and collar for proper alignment. MAKE SURE THAT THE PATIENT'S CHIN AT LEAST COVERS THE CENTRAL FASTENER IN THE CHIN PIECE. If it doesn't, tighten the collar further until proper support is obtained. Select the next smaller size if you think further tightening of the collar may cause the patient to become extended.
10. If the patient is supine, begin by sliding the back portion of the collar behind the patient's neck. Be sure to fold the loop velcro inward on the tap of the foam padding to prevent it from collecting debris that could limit its gripping ability. Once the loop velcro is visible, turn all of your attention to positioning the chin piece and attaching the velcro as described in two preceding steps.
11. An alternative is to start by positioning the chin piece and then sliding the back portion of the collar behind the patient's neck.
12. Once positioned, hold the collar in place by using the trach hole (as shown above) You can avoid torquing the neck by using the trach hole as an anchor point while first pulling laterally to tighten and then attaching the loop velcro to the front so that it mates with, and is parallel to, the hook velcro. BE SURE TO MAINTAIN NEUTRAL ALIGNMENT THROUGHOUT THIS PROCEDURE.
1.Do not rely on any cervical collar by itself to adequately motion restrict a patient's cervical spine. Collars are tools to aid in motion restriction. No collar by itself provides sufficient motion restriction.
2. Refer to your EMT/Paramedic Training Manual for information on the use of extrication collars and spinal motion restriction techniques.
3. Do not use an improperly sized collar. Too large a collar may hyperextend a patient's cervical spine; too small a collar may not provide appropriate stability. Special sizes of Stifneck collars are available for children and other individuals with small frames.
4. Follow the directions of your local EMS authorities for the approved use of extrication collars.
