Care of your Collar

Care of your Collar

This leaflet has been produced to provide you with some basic information to help you protect and care for your skin whilst you are wearing a neck collar. It is not meant to replace information given by your Consultant Surgeon, Orthotist or Physiotherapist but may help to provide some more information.

You should have been informed by your Consultant the reason you need to wear a neck collar. Your collar would have been measured and correctly fitted by a trained professional whilst you were in hospital. This leaflet will give you further advice on how to apply, remove and care for your collar. It will give you advice on cleaning and hygiene purposes. Your Nurse or Physio will advise you on how to care for your collar before you are discharged from Hospital. If you have any concerns after reading this leaflet, your Nurse or Physio will try to alleviate these before you leave hospital.

Purpose of cervical (neck) collar or brace:

1. To support the spinal column and supporting structures such as the ligaments and muscles from loads and stresses that can cause pain and movement in the neck.
2. To maintain spinal alignment and limit movement while the bones and ligaments heal.

In all cases collars should be worn snug and not loose. Wearing it loose may prevent correct healing and cause pressure areas and sores.

Understanding the anatomy and biomechanics of the cervical spine:

• The cervical spine begins at the base of the skull and has a natural curve (lordosis).
• It has seven vertebrae or bones (C1- C7), eight pairs of cervical neck nerves (C1-C8) and six discs between C2-C7.
• It is a highly mobile structure allowing forward, backward and lateral tilt movements and provides a cradle for supporting the head.
• The first vertebra C1 (atlas) articulates with the base of the skull and provides a cradle for supporting the head.
• At the C1-C2 joint the predominant movement is rotation as C1 rotates around the odontoid axis

Products used by Worcestershire Acute Hospitals NHS Trust:

Predominately the Miami J and Aspen Vista collars are used, although other types of collar may be used depending on the injury

The instructions in this leaflet are generic. You will be advised which collar you have before you leave hospital. Please refer to individual manufacturer guidance for sizing, application and patient care.

Aspen Vista Collar

Miami J Collar

Size:
Correct sizing is critical. If the collar is too big or too small it won’t do its job properly and may cause problems. Resizing is indicated if there is a change in any swelling, or if there is increased pressure to the chin, back of your head, collarbone or shoulder. If you have any discomfort or find that your neck is in a painful position please seek medical advice. You should continue to wear your collar but seek advice as soon as possible.

How long will I need to wear the collar?
This varies depending upon your situation and the reason for you needing to wear the collar. You may be given an expected duration of treatment when the collar is first fitted but this may change depending on how your injury responds and heals. You will be reviewed in clinic by your consultant or their team.

Applying and removing your collar

You will need some assistance to do this as you will not be able to remove the collar yourself, someone else will need to slide the back panel in and out. A second pair of hands to hold your head in position will be required.

To remove your collar when you are lying down

• Lie flat in bed with 1 small pillow.
• You must keep your head in a neutral position. You must not move your head side to side or bend your neck backwards and forwards.
• Undo the Velcro straps and remove the front of the collar, then slide the back panel out from under the neck.

To apply your collar when lying down

Slide the back panel carefully behind the neck. Ensuring it is evenly centred. If you have long hair ensure this is outside the collar.

1. Place the front panel under your chin making sure it is in the centre. The sides should be sitting on top of the shoulders.
2. You can then attach the back straps to the front of the collar, one at a time. Make sure the collar feels secure.

 Taking care of your skin whilst wearing a hard collar

• Make sure you check and clean your skin daily whilst wearing a collar. Look for any bruising, abrasions, broken areas or discharge. The ward staff will be happy to show you and your carer how to do this and what to look for. Inform the orthotics department if you notice any damage.
• It’s not recommended to place additional foam or pads under the collar as this can add more pressure to certain points on your skin.
• Make sure you or your carer checks for any red areas, breaks to the skin or tenderness. Please contact us if you develop any sores to the skin under your collar.
• You may wash and dry your skin gently. Make sure your skin is clean and dry before you reapply your clean collar.

Cleaning your collar (One set of one set of liners can be cleaned whilst you use the other set)

1. Clean the front and back panels of your collar and replace the soiled ones as needed.
2. Peel the soiled pads off. Look carefully at the shape when you remove them, so that you can reposition the pads properly.
3. The pads will reattach with Velcro
4. You can wash the pads with mild facial soap and water.
5. Do not use bleach or detergents.
6. You must thoroughly rinse the pads with clean water.
7. Wring out the excess water and gently squeeze in a towel.
8. Lay your pads out to air dry. It should take less than 60 minutes for them to dry.
9. Wipe the plastic collar shell clean with mild soap and water.
10. When you reattach the pads make sure the plastic in the collar does not touch your skin.

Replacement Pads

Aspen Collar Liners

Information to note:

• Your collar should be tight but comfortable. If your collar is not tight it will not support your injury and you may experience additional pain and risk further damage to your neck. If your collar is too loose it can rub your skin and cause irritation to your skin.
• Your collar should be worn at all times unless your Consultant has told you different instructions. You should remove your collar at least once daily for washing and checking your skin and changing your pads.
• The collar will only limit movement in your neck; it will not eliminate it completely. It is important that you monitor your posture to prevent slouching and avoid heavy lifting and carrying.
• Do not wear your collar without the pads.
• You should be able open your mouth to eat comfortably whilst in your collar.

What adaptations will I need to make while I am wearing the collar?

• Please discuss any concerns you have with the ward physiotherapist or occupational therapist before you go home.
• Using a chair with arms makes standing and sitting easier and puts less strain on your neck.
• The collar will restrict your ability to move freely/see your feet. So take care when walking, especially when going down stairs.
• Remove items that may cause you to fall, such as loose rugs and electrical cords.
• It’s advisable to use a non-slip mat in the shower or sit down to wash at the sink. Your Occupational Therapist can advise you on any issues regarding bathing or getting dressed.
• In the kitchen it’s advisable to keep items at waist height so they are easy to reach. Consider utilising on line shopping or ask friends/family to help.
• Follow your physiotherapists instructions regarding getting up from a lying position.
• Refrain from sexual activity until your follow-up appointment unless your consultant specifies otherwise.
• You should not drive a car whilst in a collar.
• You can shower in a collar if you feel safe enough, however when you finish you will need help to remove the collar, dry it and change the liners and re-apply.
• Facial hair and beards increase shear forces and pressure areas, it is therefore recommended you shave regularly (you will need assistance with this).

Training

The following websites may also have some useful information:

• http://www.ossur.co.uk/Injury-Solutions/Spine and click on support documents.
• http://www.aspenmp.com and click on products to choose correct collar and follow links for supporting information/patient handbooks/videos.

Discharge and Follow up:

If you any problems with your collar you can contact the ward, physiotherapist, GP, or the Orthotics Departments where you were initially treated on:

Worcester Royal Hospital    01905 763333
Alexandra Hospital, Redditch    01527 503030

You may be asked to attend for check x-rays to monitor the healing process.

You may be required to attend the Royal Orthopaedic Hospital in Birmingham for your follow up.

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PET@nhs.net

Opening times:
The PALS telephone lines are open Monday to Thursday from  8.30am to 4.30pm and Friday: 8.30am to 4.00pm. Please be aware that a voicemail service is in use at busy times, but messages will be returned as quickly as possible.

If you are unable to understand this leaflet, please communicate with a member of staff.

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