c-collar for 7 month old?

[jkrewko]

what size would you use. all the pedi collars i have seen still look to large for a child that small. advice, equipment i can check out online? suggestions etc..

 

[MMiz]

The pediatric cervical collars I've seen have one for 0-6 months. If they're too big then I'd use towels and tape to immobilize the pediatric patient.

 

[abckidsmom]

Towels and tape. I have only immobilized a baby that small two or three times, ever, and at least one of those times was in the car seat they were in.

You need earplugs if you make the decision to immobilize a young infant.

 

[bigbaldguy]

Saw a baby coming in to an ER once pulled out of a bad accident with very possible cervical injury. Kid was still in car seat and they just filled voids around kid with whatever they had on hand then duck taped the kid down like a cacoon. Inelegant but very effective. They even put a strip across the kids forehead to prevent him from moving head. The kid might have lost some skin when they cut him out but he was definitely immobilized.

 

[depri]

Saw a baby coming in to an ER once pulled out of a bad accident with very possible cervical injury. Kid was still in car seat and they just filled voids around kid with whatever they had on hand then duck taped the kid down like a cacoon. Inelegant but very effective. They even put a strip across the kids forehead to prevent him from moving head. The kid might have lost some skin when they cut him out but he was definitely immobilized.

Sounds like another bullet point to add to the list of things duct tape is good for/can fix: stabilization of possible cervical injuries. Do what you gotta do.

 

[abckidsmom]

Sounds like another bullet point to add to the list of things duct tape is good for/can fix: stabilization of possible cervical injuries. Do what you gotta do.

It's fairly standard, guys, the strip of wide tape across the forehead. And it's medical tape, not duct tape.

 

[ArcticKat]

You need earplugs if you make the decision to immobilize a young infant.

That works for all patients I immobilize. The car seat is a spectacular immobilization device and although once it's in an accident it should be replaced, it's typically still sufficient for transporting an infant in and, in many cases, is X-ray translucent.

 

[bigbaldguy]

It's fairly standard, guys, the strip of wide tape across the forehead. And it's medical tape, not duct tape.

This was actually plain old duct tape, this was Houston FD. They use a lot of it in these parts for spine board strap downs Ect. I suspect they used it in this instance because the child was really trying to wiggle. In a long transport time situation the kid invariably gets their head out. I've had problems getting medical tape to work in a similar situation. If I were almost positive that a child in a car seat had a neck injury I think I would skip the medical tape and Also go for the duct tape. I've never had to secure a really a tiny baby though.

Oh wait do you mean it's not "duct tape because it's being used as medical tape" kind of thing lol sorry I'm an idiot.

 

[Nerd13]

I like to call duct tape 'Universal Rescue Tape'. Makes me feel better about it haha.

 

[depri]

Haha "Universal Rescue Tape." I like the sound of that; gotta make it more professional.

 

[JJR512]

Wow!

In my service, if I needed a C-collar for an infant, I would just grab the infant-sized C-collar (the one marked "Infant" on it). It never would have occurred to me to use towels or duct tape. Thanks for all the great tips! ^_^

(Our infant C-collars are made by Ambu, if anyone's interested.)

 

[frdude1000]

We were taught in class to fold a blanket into a long rectangle and wrap it around an infants neck. You can use a KED with blankets and padding to immobilize the infant once collared.

 

[Nerd13]

As far as actual collars go we have pediatric adjustable collars that have three sizes, the smallest being infant. It's really, really tiny. I can see it actually fitting but I can also imagine it would be pretty scary for a little one. Thankfully, I haven't had to use it yet. We also have some old stiffneck peds sizes in the stock but the adjustable ones are a lot easier to size and use.

I also forgot to mention that I've seen some companies use Coban to immobilize the head to the board. It had to be pretty tight but it actually looked pretty comfy and did a pretty good job of immobilizing.

 

[Handsome Robb]

For what its worth, we use duct tape and disposable head blocks to immobilize the head of patients on the ski hill, but thats an extreme environment.

Back on topic, I have always been told in the case of an MVA with a child restrained in a car seat to leave them in the seat and pad the voids.

Not in a seat and no collar to fit, lots and lots of towel rolls.

 

[MedicBender]

We have always used CPR boards or a child immobilization board for infants.

Maryland protocol states infants are not to be immobilized in car seats. I understand their logic, however it seems like there is more risk in moving the infant from one seat to another.

Here's an example of the board we use http://www.med-worldwide.com/pediatric-immobilization-board-plastic-clips-al-l484c-p72615

 

[Handsome Robb]

With all due respect to the MDs that wrote Maryland's protocols, have they ever tried to move an infant from a car seat to a infant LSB while maintaining C-spine? lol

 

[AUSEMT]

wiggling makes it worse???

I recently had a 3 yr old with suspected C-spine injuries after he fell backwards off a bench and lost consciousness mid-examination, had the Chief medical officer with me (he has a PhD- irrelevant but cool). the MOI wasn't that severe and he had no immediate/ obvious indications of a spinal, so we decided to forgo C-collar and just use sand bags and manual in-line because the collar causes children so much discomfort that they wiggle and generally exacerbate injuries....
just an idea for mild MOI's and no obvious indications?

 

[mikie]

With all due respect to the MDs that wrote Maryland's protocols, have they ever tried to move an infant from a car seat to a infant LSB while maintaining C-spine? lol

Yes, in the pediatric ED when they are removing the patient from the damaged car seat to a board till c-spine is cleared.

 

[usafmedic45]

Maryland protocol states infants are not to be immobilized in car seats. I understand their logic, however it seems like there is more risk in moving the infant from one seat to another.

Just another example of why Maryland is pretty much only useful as an example of how not to run an EMS system.

Yes, in the pediatric ED when they are removing the patient from the damaged car seat to a board till c-spine is cleared.

Everywhere else just x-rays or CTs them in the seat unless resuscitation is necessary. But then again, Shock Trauma isn't really a trauma center so I imagine they do it their own little way just like everything else.

 

[mikie]

Everywhere else just x-rays or CTs them in the seat unless resuscitation is necessary. But then again, Shock Trauma isn't really a trauma center so I imagine they do it their own little way just like everything else.

You're right about that, Shock Trauma is a PARC- Primary Adult Resource Center. I believe their minimum age (technically they can accept any patient; it's the consulting physicians discretion when you consult anyway) is 15...correct me if i'm wrong fellow MDers...

Now at Hopkins, a Level 1 Peds, you're right, they'll likely just snap shots bedside, but as someone mentioned, we're not supposed to transport them in their seat if it was involved in a MVA (possible unforeseen carseat damage, i suppose is one rationale)