What Ever Happened to Philly Collars?

[Christopher.Collins]

I dont know about other US States and other countries... but here in Connecticut they seem to be extinct.

Note: This is more an opinionated rant than any proven medical or scientifical fact

I LOVED thoes two piece, pre-shapped, foam collars. They required no assembly (yes I know stiff-necks are minimal in that department) and frankly I just think they worked better.

First off I cant tell you how many times Ive broke thoes damn stiff neck collars trying to pop everything into place... and I cant tell you how many times Ive seen them assembled and nearly put on backwards. You can only put on a philly collar one way.

Secondly, I personally like the interchangability of front and back pieces of the philly collar. Many will argue that it is improper and does not provide propper stabilization when 2 different sizes are utilized together. I beg to differ... what if you have a patient who if skinny would have a long neck? Maybe they have a bit of a turkey neck in the front but is otherwise seemingly long slender in the back? Do you want to try and jam all the folds in and cock their head upwards trying to force a Tall size front on? So the Tall back fits best but not the front... how do you address that if it is in fact wrong to interchange peices? And honestly, if someone wants to say that, then anything we do to improvise care and adapt to the surroundings or patient under odd circumstances would be considered wrong. Thus rendering any care not given because of circumstanses neglectful... at least in my opinion as the care could have still been provided adequatley all while not stepping outside your scope of practice.

I also dont know about anyone else, but I just find thoes wonderfull philly collars easier to put on a patient as well. Even lying down I find that I can manipulate their head and neck less when placing the back piece. Why? Because when your puting it on your not folding and bend the damn thing like you must for the one piece stiff necks.

Hell the only thing I can even think of that sucks about the philly collars is storage needs.

Thoughts, feedback? Anyone still use these things? Anyone use both and have a preference?

[Doug]

Excellent question...especially since it seems around here (Western Mass) trauma docs like them better (Miami "J's" too, I think that's how they are spelled.) better than the one piecers. I too like the fact that you can put a small front and attach it to a large back piece. Much less chance of cranking the neck trying to get the velcro to attach too.

[Christopher.Collins]

Also... thoes damn stiff necks have a tendancy to dig into pressure points. What will an uncomfortable patient do? MOVE AROUND! What are we trying to prevent trauma victims from doing... MOVING! So lets put this torture device on that makes them want to pull at it and adjust it.

Ok so I have never had any immobilized patient hold perfectly still... but Ive had less comfort complaints over philly's than I have stiff necks. Yea some will say you can adjust it if the patient is uncomfortable... umm yea unless you have standing orders to discontinue or withold c-spine, the moment you remove that collar you are negligent of your duties.

Having suffered a cervical injury when I was about 16, and constantly being used for backboard training (I carry my 210lbs very well and look about 20lbs lighter) I have worn my share of collars. I know which I would rather wear even as a patient.

[JPINFV]

So lets put this torture device on that makes them want to pull at it and adjust it.

You know, you've basically just described the entire ritual of spinal immbolization.

[crotchitymedic1986]

You pointed out the good points --- now the bad: they tore/cracked easy (if they got squished by something heavier), they were hard to clean blood off of -- making them disposable, and the velcro either tore off or wore out after a few uses.

P.S. And half the time, dumb rookies put them on upside down (atleast one half).

[Christopher.Collins]

At least (on some patients) they still worked upside down And thoes stiff necks break rather easily. Unlike the philly collar though, if someone isnt vigilant in their check sheets or looking over the collar before its used it could snap and not only comprimise c-spine but potentially cut the patients face maybe even eyes.

I bet if they were reengineered today they could be made better.

Sorry, I just fu*king hate thoes stiff necks.

[BushyFromOz]

I cant say i have had an issue with stiff neck collars, do you pre-assemble them and store em in the ambulance or put them together as needed??

[Christopher.Collins]

As needed, Ive rarley seen a moment in any service Ive been in or around that takes them out of the wrapper before stocking them. Every scene is like christmas morning, except with blood, guts and screaming lol :twisted:

Its not so much the assembly time that bugs me though, I dont mind doing it on scene because it takes like 5 seconds... just that alot of times I see that stupid little black nub the chin piece attatches to snap off all to often... or the chin piece gets assembled backwards (depending on the brand and collar type).

[firemed665]

Collars? Collars? Collars? We don't need no stinking collars!!!

Ok, just kidding. The Philly is still alive and well in Indiana. We have both Stiffneck and Philly's. Just depends on what hospital we restock at.