Spinal Solutions
Össur Spinal Solutions
With the only complete spinal care system and a comprehensive acute fracture management offering, Össur offers an unparalleled depth and breadth of orthopaedic product selection and expertise.
Height:
- Measure from the tip of the patient's chin to the top of the sternum in a straight line (Figure 1. "A").
- The measurement corresponds to the HEIGHT of the Collar. If the patient's measurement falls between two consecutive sizes, apply the smaller size first.
Circumference: 
- Measure around the patient's neck (Figure 2. "B").
- The measurement corresponds to the size CIRCUMFERENCE of the Collar. If the patient's measurement falls between two consecutive sizes, apply the larger size first.
Alternative Sizing Method:
Use your fingers to measure the vertical distance from the top of the patient's shoulder to the tip of the chin.
Find the SIZING LINE on the Collar and position your lowest finger on the line. Select the size closest to the height of your fingers.
Application:
Proper application of the Collar is as important as proper sizing for immobilization and patient comfort. The two-piece design consists of a FRONT piece and BACK piece which are packaged as a set.
Always maintain the patient's head in neutral alignment. These directions are guidelines only; follow a qualified healthcare provider's instructions.
| Size Collar: | Find the SIZING LINE on the Collar and position your lowest finger on the line. Select the size closest to the height of your fingers. | |
| Lock Size: | Position the Collar with the selected size. Press the lock into the Collar until secured. Verify by attempting to readjust. If movement occurs, repeat procedure until the Collar is secure. | |
| Adjust Size: | To unlock, simply push the lock to return the lock to its unsecured position. Determine the proper height for the patient and press the lock into the selected size. |
Verify by attempting to readjust. If movement occurs, repeat procedure until the Collar is secure.
| 1. | After selecting the properly sized Collar, apply the Collar to the patient's neck. The chin should be secured by the patented molded chin support. | |
| 2. | If the patient is in a supine position, slide the BACK part of the Collar behind the patient's neck until the hook and loop strap is visible. | |
| 3. | The hook and loop strap is brought around the back of the patient's neck and secured to the hook fastener. | |
| 4. | Before attaching the hook and loop strap, make certain the patient's head and the Collar are in neutral alignment. If the chin is not sufficiently supported, tighten Collar. If additional tightening results in patient extension, select smaller size. |
Removal:
Before removing the Collar, mark the position of the hook and loop strap location to ensure re-application maintains the proper fit.
With the Collar secured on the patient, unfasten the hook and loop strap on the RIGHT side and then the LEFT side. Remove the Collar from the patient.
Range-of-Motion Restriction and Craniofacial Tissue-Interface Pressure From Four Cervical Collars
Ann N. Tescher, RN, PhD, CNS; Aaron B. Rindflesch, PT, PhD; James W. Youdas, PT; Therese M. Jacobson, RN, CNS; Lisa L. Downer, RN, CNS; Anne G. Miers, RN, CNS; Jeffrey R. Basford, MD, PhD; Daniel C. Cullinane, MD; Susanna R. Stevens, MS; V Shane Pankratz, PhD; Paul A. Decker, MS
Journal of Trauma-Injury Infection & Critical Care: November 2007 - Volume 63 - Issue 5 - pp 1120-1126
Abstract:
Background: Occipital pressure ulcers are well-known complications for trauma patients wearing cervical collars. We assessed the effects of four commercial cervical collars (Aspen, Philadelphia, Miami J, and Miami J with Occian back [Miami J/Occian]) on cervical range of motion (CROM) and mandibular and occipital tissue-interface pressure (TIP).
Methods: Forty-eight healthy volunteers (24 men, 24 women; mean age, 38.9 years +/- 10.5 years) were stratified by body mass index. CROM was measured in the seated position without and with collars. Sagittal, coronal, and rotatory CROM was measured with a goniometer. Occipital and mandibular pressures were mapped with subjects in upright and supine positions.
Results: All collars significantly restricted CROM in all planes (p < 0.001). The Philadelphia and standard Miami J collars were the most restrictive. The Aspen collar was the least restrictive for flexion and rotation. The Miami J/Occian back was the least restrictive for extension and lateral flexion. For supine measurements, Miami J and Miami J/Occian back had the lowest mean TIP, whereas Aspen and Philadelphia collars had the greatest (p < 0.001). For upright measurements, the Miami J/Occian back produced the smallest mean TIPs; the other collars, ranked by ascending TIP, were Philadelphia, Miami J, and Aspen (p < 0.001). Philadelphia and Miami J collars had significant collar-body mass index interaction effects on supine occiput mean pressure (p = 0.04).
Conclusions: Miami J and Philadelphia collars restricted CROM to the greatest extent. Miami J and Miami J/Occian back had the lowest levels of mandibular and occipital pressure; these collars may markedly reduce the risk of occipital pressure ulcers without compromising immobilization.
(C) 2007 Lippincott Williams & Wilkins, Inc.
- Full article can be found on The Journal of Trauma website
Improving Practice
Efforts to Reduce Occipital Pressure Ulcers
Therese M. Jacobson, MSN, CNS, CWOCN; Ann N. Tescher, PhD, RN, CCRN, CCNS; Anne G. Miers, MSN, CNS, CNRN; Lisa Downer, MSN, CNS
St. Mary’s Hospital,Mayo Clinic Rochester, Minnesota. Published in Journal of Nursing Care Quality, 2008 Vol. 23, No. 3, pp. 283–288
Abstract:
Cervical collars are necessary to stabilize the cervical spine of trauma patients but are known to contribute to the development of occipital pressure ulcers. A quality improvement project that began on one nursing unit stimulated the development of evidence-based practice guidelines and a multidisciplinary research study. As a result, a standardized plan of care and cervical collar recommendations were implemented, resulting in a sharp decline in the incidence of occipital pressure ulcers.
Results: “On the basis of the study’s findings, it was recommended that the Miami J collar be used as the standard cervical collar for trauma patients and that the Occian Back of the Miami J collar be used when patients were on strict spine precautions or bed-rest. Implementation occurred during first quarter of 2006 and resulted in an 89% reduction in the incidence of occipital pressure sores in 2006 as compared to 2005”. (p. 287)
SORBATEX™
In independent university testing, the Sorbatex Miami J Collar pads outperformed the leading competitive cotton/foam laminated pad.
Information from Grundy Laboratory Report: “Comparison Study of Miami J Collar Pads with Cotton/Foam Collar Pads,” Philadelphia College of Textiles & Science, 1997.
