I've been insane busy with work and baby 3.0 and the fire company, so I've not spent as much time in "equippyness" as I'd like.

Fortunately, about a month ago, we had a freak rain storm and got 6.5" of rain in under 2 hours and it flooded my basement, destroying the walls and finished interior. Why "fortunately?" because this was - at long last - the motivation I needed to go back into the emergency kits and supplies and to readjust things to the reality of Baby 3.0. That was a bit of packing and re-packing, and then I did a test camping trip with the older kids, adjusted long-term kit a bit, and that's all fine.

It's the fire company that's been most influential in the kit packing, and a while ago, I posted my non-hypothetical kit that I have in the Jeep at all times. That's not changed much, excepting that I've added a few extra small towels and a cheap Cervical Immobilization Device (CID) to the kit. This was brought on by the fact that we had an ABSURD number of motorcycle wrecks in the area this summer (all in the same exact location, too), and I found myself, time and again, packaging banged up folks for air medical evacuation, and head immobilization is just one of those "must-do" things.

Working in NYC most days has been great, but it's so easy to relax and slip off guard. There was a "white powder" scare at the NY Times Building, directly where I come into the city, and there have been various booms and crashes all year long, including the steam pipe rupture that killed a guy and several crane collapses.

The everyday carry has really matured, and my computer backpack makes a great jumbo EDC bag that's "business acceptable" (and carried my computer and a LOT of extra gear.

One of the most used things in my EDC was a Radioshack portable scanner, which I used to pick up all kinds of handy information. I wish there wasn't so much Digital traffic these days, I can't afford the expensive Digital Scanners, but more and more services are going digital.

Anyway, stocking up where I should, shedding loads where I can. How about you

Disorganized and unprepared.

Earlier this summer I had the impulse to grab the cervical collar that my mom wore in to the hospital, to keep it in the back of my car for just such an incident. My problem is I have no experience in fitting collars, they differ according to the individual, and most responders would be on scene within minutes of me anyway. Hold the head, that should be plenty for me.

So I'm not suited to follow your example, but I'm curious though, in terms of packaging banged up folks, do you apply the CID alone, or do you also apply some form of collar? Does it complicate or compliment what the EMTs want to do to these victims before air evac?

A C-collar is a CID (Cervical Immobilization Device). Best bet...if you do NOT know how to use it....don't.

There are many types of collars..... to small or large doesn't matter.....they would both be ineffective. C-collars are also just a part of the 'immobilization'. Alone....they may help- some - but they are not the end all....holding in line stabilization is best..as well as keeping them calm and still.

The collar is applied and the patient is placed onto the LSB (long spine board) and HID's (head immobilization device) are placed. The patient is then strapped (there are many configurations of strapping) to the LSB. It is time consuming and involved.

Well, I'm a trained First Responder and just about done with my EMT, need some more hours and that's finished, so it does not complicate anything. The CID i have is a basic set of foam tubes, it's good enough until someone with a properly sized collar shows up. You can make your own basic "CID"-y thing with a towel rolled into a "U" shap or just use kneel and hold - gently - the patients head so they don't twist/roll/move. Don't move. Did I mention that? The point is inline immobilization.

And out here, EMS response time can be 15-20 minutes, sometimes longer, so we more often than not are doing a lot of really basic stabilization and immobilization before the Paramedics arrive anyway. If they are alive when we get to them, all we need to do is keep things from getting any WORSE, but we don't make them BETTER.

That makes sense - don't worry, I'm not tempted to try anything I'm not trained and qualified for. I was confusing the HID with Martin's CID. Thanks for the explanation!

I've seen some inflatable immobilizers, thoughts from the EMT's?

And yes, I'm over-prepared, I just read an article that the Hayward fault (which I reside on top of) has a big shake about every 140 years, and guess what?, the anniversary was last week, so I have 140 gallons of stored water (one for each year or just a weird coincidence), about 30 of gasoline, and 30 days of freeze dried/MRE/canned food. And the stuff to cook and serve it, I am a bug in proponent since in California I would run out of fuel before getting anywhere significantly out of the fray....

On top of piles of first aid stuff, seeds, reference materials, tools, varmint weapons and ammo (for eating, not defending), and a small motorhome with generator (if safety becomes too cumbersome and bug out is the alternative left).

My wife thinks I'm losing my Prepared with restraint status, yukyuk.

The object of immobilizing the neck is, of course, to prevent damage to the spinal cord in case there is a fracture of the spine resulting from some sort of accident. A significant percentage of neck fractures have no symptoms the victim can feel or signs the rescuer can detect. Neck fractures are not diagnosed in the field; they are presumed from the forces and mechanisms of injury the patient was exposed to. Lack of precautionary immobilization or improper handling and immobilization techniques injure and kill people every year.

There are three basic devices that are used to immobilize the neck prior to moving the patient. But before applying any device, it is necessary to prevent the patient's neck from being moved. First, simply tell the patient, if conscious, not to move. Second, hold the patient's head in place to prevent it from moving in relation to the rest of the body.

The first device to be applied is a cervical collar, commonly called a "C-collar." It is a rigid collar applied around the patient's neck. It is not the same as a soft foam "whiplash" collar. It is not particularly effective at preventing head and neck movement, but it does somewhat limit the range of that movement, and it may serve as a reminder to a patient not to move. Therefore, it is necessary to continue holding the head until the other two devices are applied. Applied correctly, it is uncomfortable. It used to come in a variety of sizes, but now usually comes in three adjustable size ranges: Adult, Pediatric, and Infant.

The remaining devices are a long spine board (LSB), or "backboard," which somewhat resembles a surfboard with holes along the sides for feeding straps through,and a cervical immobilization device (CID), which secures the head in place, sometimes referred to by a variety of brand names. The patient, wearing a c-collar but still being held by the head, is moved to the LSB using specific techniques designed to keep the head and body in line. The patient is secured to the LSB with straps, and then the head is secured in the CID, which is in turn affixed to the LSB. The patient now, hopefully, is pretty much entirely immobilized and can't move his neck or back, and can be safely moved by carrying the LSB to the ambulance or whatever.

But, for 1st aiders and first responders, the question is whether or not you need to move the patient at all. Manual c-spine control i.e., holding the head in place, is the appropriate standard of care, assuming you don't need to move the patient before the ambulance arrives.

However, if you do need to move the patient, it is usually because of some immediate hazard, like like a car fire encroaching upon the patient. In such cases, you probably will need to move the patient from danger ASAP, and may not have time to apply immobilization equipment. If you can apply a c-collar quickly first, great. If not, do what you have to do, and try to minimize movement of the head, preferably by someone else helping you by holding it as you drag the patient to safety.

The two things I would encourage you NOT to do, if you can avoid doing so, is to apply a c-collar then let go of the head, or to move the patient unnecessarily.

Spinal immobilization is not rocket science, but it does require some equipment, training, and hands-on experience. It also takes more than one rescuer get a patient onto a LSB and CID.

In disaster situations, or where "professional" help is otherwise unavailable, you can improvise. A door, reasonably flat surfboard, plywood sheet, or similar object can do for a backboard. The patient can be duct-taped to it, which actually works better when using stuff like doors that are wider than the patient, or straps can be improvised. Try not to use ropes or other thin material that will cut into the patient's flesh, cut off circulation, and do additional damage.

A couple of rolled up towels or other objects can be placed alongside the patient's head to keep it from moving, and taped in place, including a tape across the patient's forehead. Pinch the tape together lengthwise were it contacts the patient's forehead, so it doesn't adhere. The c-collar can be omitted. They are marginal performers at best, and improvised c-collars are likely to be worse than useless. This is one thing a SAM splint cannot do.

Jeff

Thanks, Jeff, good advice............

Excellent post Jeff.

Although less than ideal*, the SAM splint can actually be used to improvise a reasonable c-collar in the absence of an actual device. This link shows the wrap technique to fashion one in the field - scroll down to the tenth video to view.

Jim

*The SAM video shows the PT's head being moved around a lot more than one would ever like to see, although this could be somewhat minimized if the c-collar were to be fashioned while the PT was in the supine position.