XCollar™ Application Manual
Application in the Neutral Position
Step 1 - Extend and Unfold
Remove XCollar from bag (Pic 1) and ensure that it is extended to its longest setting. Unfold the back extension piece and lock it in place (Pic 2)
- Before positioning the XCollar around the patient's neck, a second rescuer must be holding manual cervical immobilization. This must be maintained as mandated by local protocols and as required by each specific emergency.
Step 2 - Place Behind Patient's Neck
Hold the XCollar with one hand from the top of the Back Support. The collar should be placed as close to the patient's back or skin as possible (Pic 3). Avoid placing over thick clothing as this may cause the collar to need future adjustment after clothing is removed (Pic 4).
Step 3 - Encircle Patient and Connect Buckle
Encircle the XCollar around the patient's neck, slide the buckle into the buckle receiver and lock in place (Pic 5). Position chin strap on the patient's chin and below the lower lip while holding the XCollar's Chin Piece at the bottom of the chin/jaw line (ensure padding material is making contact with the patient's skin.) If needed, on very small patients, tighten Chin Strap to obtain snug fitment. On large size patients loosen Chin Strap. Do this only as required. The patient's jaw must rest on the XCollar's Chin Piece and jaw padding as shown on Pic 6.
Step 4 - Adjust Side Straps
While holding the XCollar securely at the chin area near the buckle with the left hand, initiate circumferential fitment by adjusting the side straps. First, use your right hand to adjust the buckle strap by undoing the Velcro strap, pulling it until a snug fit is achieved, then folding it back to re-secure the Velcro. It is very important not to over tighten this first side strap as one could move the XCollar out of alignment on the patient. When doing this, always hold the XCollar with the other hand and use equal opposing force to avoid patient movement (Pic 7).
Next, switch hands and adjust the right side using same procedure. To ensure symmetry and neutral position look through the side sight windows at the color-coded numbered scale located on each side of the collar. Same colored numbers will give you an exact reference for proper fitting (Pic 8). Always communicate with your partner holding manual cervical immobilization and checking for proper alignment to achieve optimum results.
- Always keep one hand on the XCollar's chin piece to apply opposing force while adjusting the strap to avoid movement of the cervical spine.
Step 5 - Extend Adjustable Chest Support
For vertical fitment, hold the chin piece in place with your index fingers as you apply downward pressure with your thumbs on the blue and yellow push tabs (Pic 9). This will move the Adjustable Chest Support downward until it rests securely on the patient's chest.
Note: It may be necessary to pull back slightly to unlock the locking buttons before moving the Adjustable Chest Support downward. Ensure for proper neutral position of the cervical spine (Pic 10). Lock the Adjustable Chest Support in place by pinching closed the left and right locking buttons (Pic 11).
- Avoid hyperextension or flexion of the cervical spine at all times by carefully fitting the XCollar to the patient while holding manual cervical stabilization.
Step 6 - Attach X Straps
To complete the application procedure and to achive the highest degree of cervical stabilization, the diagonal X Straps must be properly paced. While holding the left side of the Adjustable Chest Support with the right hand, pull the left side X Strap out with your left hand making sure it is fully deployed. Pull snugly on the X Strap and use equal opposing force to hold the left side of the Adjustable Chest Support (Pic 12).
Keeping snug tension on the X Strap, wrap it around by placing it directly below the patient's chin and clear of the tracheal access opening. The colored straps should fit between the four guide tabs below the chin. Next, pull the strap diagonally up toward the patient's right side and attach it to the same color Velcro on the XCollar Chin Support (Pic 13).
To attach the right side X Strap, repeat the procedure used for the left strap using the left hand to hold the right side of the Adjustable Chest Support. Use the right hand to pull snug and attach the right side X Strap (Pic 14 and Pic 15).
- The XCollar is intended for use by properly trained emergency professionals only. All instructions must be read and understood completely prior to application. Permanent injury may result from use other than as directed by local protocols and/or pertinent medical directives.
Note on Airway Management
Airway management and placement of an advanced airway may require the rescuer to loosen the Chin Strap. To loosen the Chin Strap, release the Velcro and pull the Chin Strap away from the chin.