Prior to moving a seriously injured victim, it
is desirable to try to stabilize the neck. In the event of the cervical
spine injury, this may prevent further injury during movement. One option
for such stabilization is applying a cervical collar.
This adjustable cervical collar is pre-set to the "regular -
short" position. This position is appropriate for 90% of the
- If the victim is unusually short or a child, change the adjustment
to "Thick - Pedi."
- If the victim is unusually tall, change the adjustment to
- With the head in a neutral position (looking straight ahead, neither
up nor down), slide the collar behind the victims neck, position the
chin notch to fit the chin, and fasten the velcro strap loosely.
- Slide the chin support adjustment upward until there is slight
pressure on the chin. Don't push it up so hard that it extends the
- Re-fasten the velcro strap firmly.
If a cervical collar is not available, other means of supporting the
head and neck can be employed. Boots work reasonably well for this.
In tactical military settings (battle), even if there is a
strong suspicion of a spinal injury, cervical spine immobilization (CSI) may not
be possible. It can take as long as 5 minutes for an experienced paramedic to
perform CSI. In the case of extrication of a victim from a burning tactical
vehicle, it is probably better to quickly get them out, than to run the risk of
explosion during the 5 minutes it might take to apply CSI.
While under fire, it is generally better to take cover,
return fire, and when feasible, remove the victim from danger as quickly as
possible, rather than to run the risk of the victim (or you) taking
additional hits while you are applying CSI.
In the case of penetrating neck wounds, CSI is of possible
benefit to only 1.4% of the victims. In the case of blunt trauma to the neck
(falls, vehicle accidents), most victims to not have a cervical spine
injury, and of those who do, the damage to the spinal cord is most likely
In non-tactical situations, or training situations, CSI
generally should still be employed, as there will be a few victims for whom it
may still provide some benefit.
Adjustable, Ambu Product Number 000-281-000
Weight: 0.32 pounds
Approved for public release; Distribution is unlimited.
The listing of any non-Federal product in this CD is
not an endorsement of the product itself, but simply an acknowledgement of the
Operational Medicine 2001
Health Care in Military Settings
Sick Call ·
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Medicine and Surgery
Department of the Navy
2300 E Street NW
Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
January 1, 2001
United States Special Operations Command
7701 Tampa Point Blvd.
MacDill AFB, Florida
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