Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [91], C).
2. 2.Show
   Wash hands thoroughly with soap and water or use an alcohol‐based handrub.
   To reduce the risk of contamination and cross‐infection (NHS England and NHSI [83], R; WHO [132], C).
3. 3.Show
   Ensure the bed is at the optimum height for the handlers. If two handlers are required, try to match the handlers’ heights as far as possible.
   To minimize the risk of injury to the practitioners (Smith et al. [118], C).
4. 4.Show
   Ensure that there are sufficient personnel available to assist with the procedure.
   Because one staff member is needed to maintain spinal alignment and one or two are needed to apply the collar (MASCIP [69], C).

Procedure

1. 5.Show
   Measure the neck using a sizing guide (provided by the manufacturer) and then select the most appropriate size collar.
   To ensure correct sizing for spinal stability and comfort, and to minimize skin damage. E
2. 6.Show
   The lead practitioner stabilizes the patient's neck, supporting the patient's head without obstructing the ears so that the patient can hear explanations. The first assistant gently feeds the back piece of the collar into position, pressing it into the mattress (Action figure 7.30)
   To immobilize the patient's head. E

   To ensure spinal alignment is monitored throughout the procedure (MASCIP [69], C).

   To minimize movement of the spine and to ensure correct positioning of collar. E
3. 7.Show
   The front piece is then brought into position by the assistant, who scoops the collar up and under the chin (Action figure 7.31).
   Scooping enables best fit and comfort of collar. E
4. 8.Show
   The collar is secured with Velcro fastenings (Action figure 7.32).
   To ensure it remains securely in place. E

Post‐procedure

1. 9.Show
   Check the comfort and fit with the patient.
   For patient comfort. E
2. 10.Show
   Remove the collar daily to check the skin and pressure areas and for hygiene purposes.
   To maintain skin integrity. E
3. 11.Show
   Reassess and record neurological symptoms. In the event of any worsening pain or neurological symptoms, arrange for a reassessment by the medical team.
   To ensure clinical status is maintained (MASCIP [69], C).