Section III. Immobilization Techniques for Spinal Cord injury - The Central Nervous System

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DO NOT elevate the foot of the spine board too much. If the board is
elevated too much, the patient's bowels and other abdominal viscera
may fall against the underside of the diaphragm and compromise the
patient's breathing mechanism.
A patient who has or who may have a spinal cord injury must be moved carefully.
He must be moved without causing him further injury, pain, or discomfort. Included in
this section is information on the cervical collar and three patient-carrying devices: the
Kendrick extrication device (KED), the short spine board, the long spine board, and the
scoop stretcher.
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:
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.
Using gentle traction to lift the patient's head to an "eyes forward"
(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.
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.

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