Immobilization: Head Strap, Chin strap, or Head & Chin straps

F

Freddy_NYC

Forum Probie
Messages
15
Reaction score
0
Points
0
What is the best way to immobilize the pt's head using a Sta-Blok Head Immobilizer (aka shark fins)?
There are two straps provided: velcro head strap and a sticky tape strap for the chin. Iv'e seen people use the sticky strap to go over both the velcro head strap. But Ive also seen people use the chin strap only for the chin as the directions say.
 
Put the head strap over the head. Put the sticky tape strap under the chin. That's the best way to do it. It doesn't immobilize, it only restricts. But it will get the job done.

The best and only way to immobilize is the use of a halo; which requires the application of sedatives and opioites for conscious sedation, and torque wrenches. It's archaic and painful, but it works.
 
Last edited by a moderator:
The latest and greatest term nowadays is spinal motion restriction. I would think, should your pt suffer neurological damage in your care, the attorney will look into your method of restriction. If you deviate from the manufacturer's guildlines, you risk liability. You can potentially be accused of causing/exacerbating the pt's injury by not following the directions. Are you allowed to use towel rolls for head blocks? Freddy, where do you work in NY?
 
Dear 46young,

I'm bran spankn new so any advice is welcome thanks for repy'n to my post. We don't use towel rolls for head blocks and in NYC most EMS uses the laerdal HeadBed™ II Head Immobilization Device. Are towel rolls better?
 
Freddy_NYC said:
Dear 46young,

I'm bran spankn new so any advice is welcome thanks for repy'n to my post. We don't use towel rolls for head blocks and in NYC most EMS uses the laerdal HeadBed™ II Head Immobilization Device. Are towel rolls better?
Click to expand...

Ha! Anything is better than the Head Bed 2s. I like towel rolls because they kindof conform to the pts head, but then again I dont like them because they sometimes seem too "squishy" (for lack of a better word). We use re-usable vynal covered foam blocks and 2 inch tape. (One strip low across the forhead and one strip under the chin.) From what I have seen and used out there, I like that best so far. It just seems to me that all the disposable stuff is practically worthless when it comes to trying to immob. a pts head.
 
Last edited by a moderator:
I just tell the patient, "this device is a REMINDER NOT TO MOVE YOUR HEAD. WE SUSPECT THAT YOU HAVE A SPINAL INJURY AND MOVING COULD CAUSE PERMANENT, IRREVERSIBLE DAMAGE." and document placement and explanation. Do you have patients flopping around when they are supposed to be immobilized? Maybe ask the driver to slow down on the turns?! :)
 
We use the same head beds and I use the Velcro strap for the top, and I use like 2 inch cloth tape over the chin and back underneath the board.
 
Volunteer_EMT_Ph said:
Do any of you guys tried using duct tape? Is it ok to use such tape for head immobilization?
Click to expand...

Perhaps for the chin, and only if they have short hair and no beard. Otherwise, no. All with Firecoins on this one. Duct tape leaves a helluva residue behind, not to mention the pain of removing, even on a young healthy individual with good skin condition!

Sort of related: Used duct tape on my car once to cover the trim and windows while I prepped it for a good coat of flat black. The tape left behind a nasty residue, had to use a razor blade on the glass and some of the trim got wrecked.
 
Thank you guys for your replys

I guess what I'm trying to ask is I've seen people immobilized (spinal motion restrictioned) with:

Head strap only
Head and chin strap

Is there any reason for not using a chinstrap?
 
Oh dear, vomiting on a backboard, not fun.
So to be clear you're saying head and chin strap. However if there is a possibility of Vomit/Nausea no chinstrap?

Thanks
Freddy
 
In EMS, you will find a lot of variables that affect what you do as a Medic/ EMT so there is no real cookie cutter answer to your question. You will find out a lot of what we do in EMS is that way.
 
In THEORY, shouldn't the tape not affect the opening of the mouth if it's properly placed on the hard plastic of collar?

LA County "recommends" that a chin strap not be used except over rough terrain or when moving a KED'ed patient onto backboard and such, so I haven't often used it... So would like to hear thoughts from others on its actual (rather than theoretical) risks / benefits.
 
I agree. Duct tape indeed leaves a lot of residue that's hard to remove, and it's also painful, though I haven't used it on a pt's head.

One question about the straps: which is better, one that secures to the head block or one that secures to the spineboard?
 
Correct Why would you be puttign tape in contact with the skin?


Bottom tape is on collar top but has a 4x4 between the head and tape or tape gets doubled. I'd freak if i saw tape on skin like that. There I no need.

Rid i dont follow with the vomiting?
 
Scout said:
Correct Why would you be puttign tape in contact with the skin?

Bottom tape is on collar top but has a 4x4 between the head and tape or tape gets doubled. I'd freak if i saw tape on skin like that. There I no need.
Click to expand...

Don't come up my way! Protocols say 2 inch tape right on the forehead just above (if not on<_<) the eyebrows. (Plus the tape under the chin.) The only time we are even allowed to think about doubling the tape over is when the pt is elderly and/or has very fragile skin that the regular cloth tape would lift right off. (We may be starting to carry paper tape for this. Put down a layer of paper tape first, then 2 inch tape over that.) Frankly, I don't see what the big deal is with people doing everything possible to keep tape off skin. What would be more importaint to you, your eyebrows, or the ability to walk? (Not that taping the head eliminates the risks. But if I had a busted neck, I'd want to be as immobilized as you can get. In the field, that means full spinal precautions. It seems to me that when the tape is not in contact with the skin, the pt is able to move their head alot more.)
 
So on laerdal's website they have a picture of someone on a backboard
no chin strap.
http://www.laerdal.com/doc/7160084/Sta-Blok-Head-Immobilizer.html

The website says a "Blue Security strap" (sticky tape) is included to provide extra stability. Do you suppose the blue strap is for extra head strap stability since the head is only secured by velcro.

To secure the chin. I will secure using tape from the ambulance. Sounds good?
 

Attachments

  • ADHUDWYF.jpg
    ADHUDWYF.jpg
    9.2 KB · Views: 589
Freddy_NYC said:
Dear 46young,

I'm bran spankn new so any advice is welcome thanks for repy'n to my post. We don't use towel rolls for head blocks and in NYC most EMS uses the laerdal HeadBed™ II Head Immobilization Device. Are towel rolls better?
Click to expand...

I used the head bed in NY, and I think they suck. They fail to secure the head if the pt is moved up/down stairs with a more vertical position. I make towel rolls by placing the first the long way, and folding each side about 1/3 of the way in, leaving about a 1-1 1/2" space of single thickness running down the entire length. I take a second towel, place it the same way, but staggered about 8 inches or so below the first one. I fold this so the ends meet in the middle, to acheive double thickness the whole way. I then roll the second towel up, then continue by picking up the first towel and rolling it over and with the second one. This results in a cylindrical roll, firm enough for cervical restriction applications. A sheet can be used for the second towel, for more stability. Make sure to tape it. We also use the trauma weave for the body. This has proven effective in securing the pt, and not allowing them to slide up or down. If you use regular straps, I recommend using cravats to make stirrups for the feet, looped through the bottom of the board, to prevent the pt from slipping. If you don't do this, and you need to raise the board to navigate stairs or a tight elevator, the C-collar will choke the pt(bad). I also advocate using 2 inch tape along the chin of the collar, and the pt's forehead, to add stability to the restriction, and to lessen the pt sliding. I like to run the forehead tape back down toward the shoulders on either side, and run the ends of the chin tape up to the top of the board, in a crisscross pattern. This goes for te head bed, as well.
 
You must log in or register to reply here.
Back
Top