5-21. CERVICAL COLLAR (C-COLLAR)

The purpose of the cervical collar, also called the C-collar, is to stabilize the head and neck thus preventing further injury to the patient's spine. The collar should be rigid such as the stiff neck collar. This collar has enlarged openings in front to allow for pulse examination, observation of tracheal deviation, and prevention of constriction of the jugular vein. A soft cervical collar is ineffective in immobilizing the neck.

a. Indications for Cervical Collar Use. Use a C-collar for a patient who has signs or symptoms of spinal injury. Also, apply a cervical collar on a patient when the mechanism of injury suggests possible spinal injury.

b. Procedure for Applying the Cervical Collar. Follow this procedure:

(1) Manually stabilize the patient's head and neck by:

(a) Holding his head firmly, placing each hand around the base of his skull, supporting the patient's mandible and occiput.

(b) Using gentle traction to lift the patient's head to an "eyes forward" position.

(c) Immobilizing the patient's head in the same position in which he was found if the patient resists movement or feels more pain when his head is moved.

CAUTION: DO NOT twist or excessively flex or extend the patient's neck.

(2) Be sure the collar is the proper size. If the collar is too small, there will be pressure on the patient's airway, and he will be immobilized ineffectively. If the collar is too large, the patient's neck will be hyperextended excessively.

(3) Apply the cervical collar like this:

(a) The first rescuer maintains traction and immobilizes the patient's head.

(b) At the same time, the second rescuer slides one end of the collar under the small of the patient's neck and connects both ends of the collar together. Most collars have velcro closures.