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PROCEDURE FOR APPLICATION & MAINTENANCE OF ASPEN COLLAR
PURPOSE: This procedure guides the caregiver in correctly
placing, cleaning and maintaining the Aspen Collar
EQUIPMENT:
Aspen Collar
Two Aspen Cervical
Collar Sizing Guide Cards
Soap, washcloth and towels
Aspen Replacement Pads (for changing pads)
NURSING ACTION:
1.
The Registered Nurse is responsible for maintaining
the patient's alignment and assuring that the neck of the patient is
stabilized and free of skin breakdown.
2.
Only qualified nursing personnel will apply and
maintain aspen collars after successfully completing competency.
3.
The cervical collar can be permanently removed only
upon written order of the physician after clinical and radiological
clearance.
PROCEDURE STEPS:
Application of Aspen Cervical
Collar
1.
Explain
procedure to the patient and instruct the patient not to move his/her
neck. Assess need for sedation. If condition prohibits use of
sedation, use additional personnel as needed to ensure cervical alignment
is maintained.
2.
Place patient in supine position with arms to the
side, making sure that the patient's head is in proper alignment. Two
persons, one to hold the patient's head in a neutral position and the
second to fit the collar are needed to control for patient movement.
3.
Place the Aspen Sizing Guide against the side of
the head so that the sizing sections are facing outward. The bottom
of the guide should be resting at the top of the trapezius
muscle. Draw an imaginary line from the bottom of the patient's chin
to the color-coding sizing guide and select a collar size. When the
size comes between two sizes, choose the larger of the 2 sizes.
4.
Slide the back of the collar behind the patient's
neck and shoulders. Be sure to get the collar centered between the
scapulae.
5.
Take the anterior portion of the collar and flare
the sides up the patient's chest bringing the collar up under the patient's
chin. While holding the anterior part of the collar, pull the Velcro
tapes on the back laterally and bring around to the front of the collars so
the 2 Velcro sides come into contact with each other.
6.
A properly fitted collar should extend from the
mandible to the sternal notch. The trach
hold and posterior vent hold should be midline. The Velcro straps
extending from the back piece and overlapping the front piece are aligned
equally on each side of the trach hole. The posterior vent hole will
be midline. The chin piece should be flush with the edge of the
chin. You should be able to slip 2 fingers width at chin to ensure
collar is not too tight.
7.
Foam pads should extend beyond plastic at all
points so that no plastic touches the skin. If plastic from the back
piece make contact with the skin of the trapezius,
reattach the back piece Velcro higher on the front piece Velcro.
8.
The superior border of the collar should not extend
above the ear.
9.
If the collar chin piece extends up over the chin,
refit the collar by "molding" it to the patient's chin. If
the chin hangs out way over the chin piece, put the next larger size collar
on the patient.
Care of Skin and the Cervical Collar
1.
Assess skin pressure areas beneath collar and occiput q 12 hours for breakdown.
2.
Cleanse plastic parts of the collar and replace
soiled foam pieces q 12 hrs. Do both more frequently, if needed.
a.
Position patient in supine neutral position.
One person will stabilize neck and maintain alignment at all times.
b.
Release Velcro straps and remove front part of
collar.
c.
Remove the foam pads and clean the plastic part of
the collar with soap and water. Dry thoroughly.
d.
Observe the patient's neck for any signs of
irritation or breakdown.
e.
Wash the neck with mild soap and water.
f.
Dry the neck thoroughly.
g.
Consult ET nurse for any skin breakdown.
h.
Attach a fresh clean set of Aspen
foam pads to the front part of the collar.
i.
Replace the front part of the collar and fasten the
Velcro straps.
3.
Supporting the neck, log roll
the patient to the side position taking care to support the head and neck.
a.
Remove the foam pads from the collar.
b.
Clean the plastic parts of the collar with soap and
water and dry thoroughly.
c.
Observe the backside of the patient's neck for any
irritation or breakdown.
d.
Wash the back of the neck with mild soap and water
and dry thoroughly.
e.
Attach clean fresh Aspen
foam pads to the back piece.
f.
Replace the back part of the collar and fasten the
Velcro straps.
g.
Logroll the patient back to supine position.
h.
Assess collar for proper fit and patient comfort.
Patient/Family Education:
1.
Purpose of the
Aspen Collar
2.
Application and proper fit of the collar
3.
Proper skin care and inspection of face/neck
4.
Proper care of the Aspen Collar
Documentation:
1.
Document initial application of collar, including size.
2.
Document skin assessment q 12 hrs. and PRN.
3.
Document changing of pads
REFERENCES:
(2000). Aspen Cervical
Collar Clinical Product Information. Long Beach, CA.
Aspen Cervical Collar. Aspen Medical
Products website: www.aspencollar.com.
Accessed 10/24/05.
Blaylock, B. (1996). Solving the problem of
pressure ulcers resulting from cervical collars: A step-by-step
approach. Ostomy Wound Management,
42(4): 26-33.
(1996). Penn
State University
Hospital's Cervical
Collar Procedure.
Powers, J. (1997). A multidisciplinary approach to
occipital pressure ulcers related to cervical collars. Journal of
Nursing Care Quality, 12(1): 46-52.
(1998) UCSF Stanford Hospital
and Clinics' Aspen Collar
Procedure.
Webber-Jones, JE et al.
(2002). The
management and prevention of rigid cervical collar complications. Orthopedic Nurse, 21(4): 19-27.
RESOURCE PERSON(S): ; Gloria Gangoso, RN; Pam
LaBorde, RN, MSN
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