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In this video, we are going to have a look at sizing, measuring and fitting the cervical collar. On the collar, the first thing we have got is a sizing mark. It's a black line normally on the right side of the collar, which we actually measure from. We measure from the black line to the hard, plastic edge of the collar, not the soft foam. So that's the measuring line, from the black line to the hard edge. The measurements themselves; there are two little arrows which will give you the actual size settings. And there are two dots, which are the locking mechanisms. So, to adjust the collar, we pull the blue dots forward and the collar will ratchet and extend. When we get the right measurement and bearing in mind we are going from the black line to the hard plastic edge, when we are happy that it's the right measurement we then insert the blue buttons and it locks the collar in place.

Also, on the collar, we have got the velcro fitting and a velcro tab. These hold the collar in place when fitted and we also have two little green circles. The two little green circles have little hooks on them and the hooks are there specifically designed to hold the oxygen mask on whilst the collar is fitted. So we don't have to put the strap of the oxygen mask over the head, we attach it to the collar, and it fits with the collar. Once we have got the measurement correct, we then push over from the back, the chin support and the collar is now ready to use.

So what we are going to do now is show you how to measure and fit the collar. The lines we use to measure the collar is the jawline and the actual shoulder itself and we use a level hand to get that measurement. So you place your hand level on the shoulder, don't tip or lift the hand, the hand must be level. And the other important thing is the head must be in neutral alignment. It's no good if the head slump forward or the head is slumped back, neutral alignment is nose over the sternum, so we get a right angle with the jaw.

So once we get the measurement, we remove fingers until we come level with the bottom of the jawline. The bottom of the jawline in this occasion is three fingers from the shoulder. Four fingers is too high. Three fingers is a perfect level line on the jawline. We then transfer that measurement from the black line to the hard plastic edge of the collar itself. So with the buttons pulled forward, the arrows inserted, we expand the collar until we match three fingers from the black line to the hard plastic edge of the collar itself.

Once that's done, we lock off the tabs, so it's now fixed in place. We bring the chin piece to the front, place two fingers through the collar and three fingers on the outside of the collar, and place the collar flat on the chest. It is important we keep the collar flat to the chest because we need the chin to sit into the chin piece of the collar itself. We then slide the collar up underneath the chin, finding the throat or neck with the two fingers, the thumb and the first finger and the three fingers on the outside control the outside of the collar. The collar is then passed behind the patient until the velcro tabs located on the far side.

Once we have the collar in position, we then have to make sure we remove all clothing from underneath the collar itself. Once there is no clothing underneath the collar, we then come to the front and we tighten the collar and lock the velcro home. Now if any clothing gets moved it doesn't affect the collar and the collar fits tightly and snugly around the patient leaving the ears and hair clear but giving support and stability to the neck.

So this time, we are going to actually fit the collar in the prone position, or lying flat. Same technique for measuring, only this time, we use a bent hand because we can't come from behind the patient, so the hand is bent. But again, the measurement is the same, three fingers to the jawline to measure to the side of the collar. Three fingers from the hard plastic edge to the black line. The collar, again, has two fingers through the collar and three fingers on the outside. It is placed flat on the chest and taken up until it meets with the jawline. The collar is then gently squeezed and fed underneath the back of the patient's neck. Once the velcro comes through from the opposite side, we gently and loosely fix it. Again, we remove clothing from underneath the collar and once we've got that clear, we then tighten and again, fix the collar and finish.

So please remember there are more than one type of collar. We have only looked at one type during this video, but other types do exist. Practice makes perfect and you do need to practice this regularly to become good at it. And also remember, C-spine immobilisation must be in place at all times whilst fitting the collar. We have only covered measuring and fitting the collar, not C-spine immobilisation.