WO1998043568A1

WO1998043568A1 - Cervical collar

Info

Publication number: WO1998043568A1
Application number: PCT/US1998/005887
Authority: WO
Inventors: Jason P. Feingold
Original assignee: Feingold Jason P
Priority date: 1997-03-28
Filing date: 1998-03-26
Publication date: 1998-10-08
Also published as: AU6585398A

Abstract

A cervical collar (10) having a base member (12) defining a first adjustable opening (20) and a support member (8) defining a second adjustable opening, the first opening (20) being independently adjustable from the second opening, is disclosed. The collar (10) may include at least one adjustable connection for selectively adjusting and securing the base member and the support member in fixed relation, one above the other. The cervical collar may be adjusted while on the patient to provide a custom fit for the patient, and may be utilized to additionally provide gentle traction to the patient.

Description

CERVICAL COLLAR

Description

1. Technical Field The present application relates to a cervical collar, and more particularly to an adjustable cervical collar for applying gentle traction to a patient.

2. Background of Related Art

Cervical collars are employed in the medical field to stabilize patients who have neck and/or spinal related injuries or operative procedures. One type of cervical collar is the cervical extrication collar, which is utilized by emergency personnel such as medics to stabilize accident victims who may have sustained spinal injuries, prior to securing the patient to a spine immobilization board. Conventional extrication collars come in a range of sizes and are generally a one-piece construction which wraps around the neck of the patient, for example, see Prior Art Fig. 1. Such conventional collars are applied to the accident victim after a medic has first stabilized the patient and brought the patient into an "eyes-forward", or neutral position. To bring the patient into the neutral position the medic, who is preferably positioned behind the patient, first places each hand around the base of the patient's skull by supporting the mandible with the index and long fingers and the occipital portion with the thumbs and the palms. The medic then firmly grasps the patient's head while simultaneously pulling the head gently and firmly away from the trunk of the body, thereby applying gentle traction to lift the head as the medic turns the head to the front. Generally, a force of approximately 10 lbs is required as the realignment of the head on the trunk of the patient is gradually accomplished. After proper alignment in the neutral position is achieved, one medic will continuously support and stabilize the head with gentle, manual traction, as a second medic determines the proper size extrication collar to utilize on the patient. Gentle traction is applied to prevent spinal cord compression during patient movement and transport, caused in part by the weight of the patient's head.

To determine the proper size collar, the second medic first determines the approximate distance between the top of the patient's shoulder, where the collar will sit, and the bottom plane of the patient's chin. Finding the proper size collar to utilize is important, as too short a collar may not support the patient in the neutral, "eyes-forward" position, while too tall a collar may hyper extend the neck of the patient. Thus, medics carry a number of different size collars with them to an accident scene in order to have different size collars readily available. Conventional collars of the type shown in Fig. 1 may include a sizing post to help the medic compare the distance measured on the patient to the distance of the collar. After the medic believes he has chosen the correct size collar, the medic then places the collar around the neck of the patient. Unfortunately, due to the imprecise method of determining proper size and the limited number of available sizes relative to the broad range of patients, it may be necessary for the medic to try more than one collar on a patient before the best possible fit is attained. Removing and replacing a missized collar may jeopardize the stabilized position of the patient's head, while also increasing the time spent on the patient prior to transport. Once the most appropriate size collar is determined, the medic places the extrication collar around the neck of the patient. Conventional extrication collars provide some support to the patient's neck while also acting as a reminder to the patient not to move their neck, but such collars are not known to be capable of replacing and maintaining the gentle manual traction and stabilization given by the medic's hands. The actual medical benefit of conventional collars is, therefore, limited. This is exemplified by the continued need for the medic to provide manual gentle traction and stabilization of the patient's head, even after the conventional collar has been applied, and throughout the entire extrication process (Fig. 1), until the patient is fully secured to a spine immobilization board. Thus, one medic must continue to provide manual traction, while the other medic begins to conduct a secondary assessment, i.e. checking the patient for injuries, taking vital signs, questioning the patient, etc.

To help reduce the need for multiple size extrication collars, one style conventional collar, the subject of U.S. Patent No. 5,593,382 and available under the brand name Sure-Loc™ from Sure-Loc Inc. of Boynton Beach, FL, allows for vertical adjustment of the front and rear of the collar. Adjustment of the Sure-Loc collar is achieved by independent adjustment of a mandible support located in the front portion of the collar, which vertically adjusts under the chin by a single post and pin arrangement, and separate adjustment of an occipital support located in the rear portion of the collar, the occipital support likewise adjusting by a single post and pin arrangement. Although offering some sizing flexibility, often an adequate fit is still not achieved as this style collar does not have a large degree of adjustability to readily conform to a wide range of patients. In addition, this collar does not provide and/or maintain the desired manual gentle traction and/or stabilization of the patient's head, gentle manual traction must, therefore, still be applied by the medic. Another style conventional collar, available under the brand name Stifneck Select™ from Laedral Medical Corporation of Armonk, New York, also allows for vertical adjustment of the front of the collar. Adjustment of the Stifneck Select™ Collar is achieved by a mandible support in the front of the collar, which vertically adjusts by a post and pin arrangement on both sides of the chin. Although providing some sizing flexibility, this collar only has four distinct vertical positions and the collar's chin piece is not readily adjusted when the collar is on the patient. Therefore, if the collar is missized, the collar should be taken off the patient, adjusted and reapplied. In addition, this collar also does not provide and/or maintain the desired manual gentle traction and/or stabilization of the patient's head, gentle manual traction must, therefore. still be applied by the medic.

Another cervical collar, the subject of U.S. Patent No. 4,582,051, allows for circumferential as well as vertical adjustment of the collar about the patient's neck area. The collar includes an upper, flexible support which extends circumferentially around the patient's neck and a lower, flexible support which extends around the shoulder region of the patient. The upper and lower supports each include Velcro® fasteners which allows the circumference of the upper and lower supports to be individually adjusted. In addition, the two supports are spaced vertically from one another with the vertical spacing being independently adjustable. The front half of the upper support has an enlarged, cup-shaped mandibular support plate attached thereto, for supporting the lower jaw of a patient, with a plastic bar extending from the mandibular support plate and fastened to the front of the lower support. Likewise, the rear half of the upper support has an enlarged, cup-shaped occipital support plate attached thereto, for supporting the occipital portion of the patient's head, with a plastic bar extending from the occipital support plate and fastened to the rear of the lower support. The plastic bars extending from the occipital and mandibular supports are fastened to the lower support by Velcro® fasteners, in order to allow for vertical adjustment of the upper support with respect to the lower support. Although providing increased sizing flexibility, the collar disclosed in the '051 patent does not provide and/or maintain the desired manual gentle traction and/or stabilization of the patient's head, as the vertical adjustment of the mandibular and occipital supports are limited to the plane below the patient^'s head. Gentle manual traction must, therefore, still be applied by the medic. There is therefore needed a cervical collar which will custom fit a wide range of patients, is readily adjustable while on the patient, and which preferably is capable of providing and maintaining evenly distributed gentle traction to the patient, as desired, while adequately restricting rotational movement, lateral movement and both flex and extension of the patient's neck and spinal area.

Summary In accordance with the present invention, there is provided a cervical collar which is selectively adjustable to provide a custom fit to a patient. The cervical collar includes a base member defining an adjustable first opening connected to a support member defining an adjustable second opening. The base member is preferably configured to fit over the shoulders and clavicle of a patient, while the support member is preferably configured to support a patient's head. The support member may be adjusted relative to the base member and the first opening is independently adjustable from the second opening. The cervical collar may be adjusted to provide gentle traction to a patient, is adjustable when on the patient, and may be utilized as an extrication collar.

Brief Description of the Drawings

Various embodiments are described herein with reference to the drawings, wherein:

Figure 1 is a perspective view of a prior art cervical extrication collar being applied to a patient;

Figure 2 is a front perspective view of a first embodiment of a cervical collar, according to the present invention;

Figure 3 is a rear perspective view of the cervical collar of Fig. 1 ;

Figure 4 is a left side view of the cervical collar of Fig. 1 ;

Figure 5 is a left side view of a second embodiment of a cervical collar according to the present invention, utilizing an adjustable post and pin arrangement; Figure 6a is a left side view of a second alternate embodiment of a cervical collar according to the present invention having side connection members for connecting a mandible support to an anterior portion and an occipital support to a posterior portion;

Figure 6b is a left side view of a third embodiment of a cervical collar according to the present invention having adjustable engagement members on the rear portion of the collar and including a single front connection member for connecting the mandible support to the anterior portion of the collar;

Figure 7a is a front perspective view of a fourth embodiment of a cervical collar according to the present invention, shown on the patient;

Figure 7b is a left side view of the embodiment of Fig. 7a;

Figure 7c is a rear perspective view of the embodiment of Fig. 7a;

Figure 8 is an enlarged perspective view of the embodiment of Fig. 7; Figure 9 is a rear perspective view of the embodiment of Fig. 7;

Figure 10 is a left side view of the embodiment of Fig. 7, showing rotation of the support member relative to the base member;

Figure 11 is a perspective view of a fifth embodiment of cervical collar according to the present invention; Figure 12 is a left side view of the embodiment of Fig. 11 ; and

Figure 13 is a cross sectional view through line 13-13 of the embodiment of Fig. 1 1.

The figures are meant to further illustrate the present invention and not to limit the scope thereof.

Detailed Description of the Preferred Embodiments

Referring initially to Fig. 2, there is illustrated a perspective view of a first embodiment of a cervical collar 10 in an assembled configuration, according to the present invention. Collar 10 includes a base member 12 having a front, or anterior portion 14 and a rear, or posterior portion 16, and also includes a support member 18 adjustably engageable with the base member 12, the support member 18 acting as a support for a patient's head during use. Collar 10 is preferably formed of an x-rayable, radiolucent plastic, such as high density polyethylene, the plastic preferably being stiff enough to support the weight of a patient's head. The collar may also include a thin foam liner (not shown), for example 1/4 inch thick polyolefin, to provide added comfort to the patient. Alternatively, the collar may be formed of any material or combination of materials, preferably of medical grade, which would provide support and comfort to a patient during use, for example a foam material, as is known to those of skill in the art.

Base member 12 includes a bottom edge 23 defined by the bottom edges 25, 26, of the anterior portion 14 and posterior portion 16, respectively. Bottom edges 25, 26 are preferably configured to generally conform and fit over the contour of a patient's shoulders and clavicle. such that the base member 12 is supported by the upper trunk of a patient during use. Base member 12 also includes a generally oval or circumferential first opening 20 which is circumscribed by upper edges 22. 24 of the anterior and posterior portions, respectively. Opening 20 receives the neck of the patient, and as such should be adjustable from approximately 17 to approximately 25 inches wide, so as to fit a majority of patients. The anterior and posterior portions are preferably adjustably connected by a pair of engagement members 28 and 29 (Fig. 3) to effectuate adjustment of opening 20. In the present embodiment, engagement members 28, 29 each include a serrated strap 30,

32, respectively. One strap preferably extends from either side of the anterior portion, with each strap 30, 32 being releasably secured within a corresponding ratcheting member 34, 36. Serrated straps 30, 32 are preferably designed to move freely in one direction, as represented by arrow "A" (Fig. 4), through ratcheting members 34, 36, respectively, but are preferably prevented from moving in a second direction, as represented by arrow "B", without first releasing ratcheting members 34, 36, as is known in the art. Ratcheting members 34, 36 are preferably mounted to either side of posterior portion 16 for incremental engagement and securing of serrated straps 30 and 32, although the ratcheting members and serrated straps may be otherwise disposed on the collar, for example, the serrated straps may be on the posterior portion as shown in Fig. 6b, or may be on the interior of the collar. Other engagement members which are releasably securable and preferably incrementally adjustable may also be utilized, for example posts and holes (Fig. 5), knob(s) (Fig. 1 1) and other fasteners, as are known to those of skill in the art. Although the anterior and posterior portions are shown as separate members connected by a pair of side engagement members 28, 29, the anterior and posterior portions may, alternately be connected on any portion thereof and may, additionally, be formed as a unitary member having an opening adjustable by a single engagement member.

The use of engagement members 28, 29 allows the anterior portion and posterior portion to move relative to each other, thereby selectively adjusting the circumference of opening 20. In use, adjustment of opening 20 allows collar 10 to be selectively sized about the neck of the patient, depending upon the size of a particular patient, with adjustment being preferably made while the collar is on the patient, as described in greater detail below. Engagement members 28, 29 additionally provide a "quick release" mechanism for collar 10 as they are readily disengaged by releasing the ratcheting members 34, 36 to disengage straps 30 and 32, respectively. Once released, the anterior and posterior portions may be disconnected and separated, if desired. Base member 12 provides a foundation for support member 18 which is adjustably secured to base member 12. Support member 18 includes a mandible support 38 for engaging and supporting the lower jaw of the patient, and an occipital support 40 for engaging and supporting the rear portion of the patient's head. A second opening 74 is defined by the interior surface of the occipital support and the interior surface of the mandible support. Opening 74 is adjustable about the patient's neck and head, form approximately 17 to 25 inches, and may be adjusted together with or independently of opening 20. The mandible support 38 includes an upper edge 40 and a lower edge 42, and preferably is contoured to the general configuration of a human chin, when assembled. As shown in Fig. 2, the mandible support preferably is configured in a generally "U" shape, including a curved, front section 44 and a pair of side extensions 46 and 48. Front section 44 may preferably include a ledge 50 formed therein, the ledge being configured and sized to engage and support the lower jaw of the patient within front section 44. As shown in the embodiment of Figs. 7 -10, the mandible support may additionally be configured as two individual support members 49, 51 so as to provide for adjustment of the mandible support about the lower jaw of a patient. Adjustment may be achieved, for example, by utilizing a selective, incremental adjustment mechanism 53. The adjustment mechanism 53 may preferably include a tab 55 having a slot 57 with a plurality of adjustment holes 59 formed therethrough, the tab extending from one of the mandible support members 49 and being received within a slot (not shown) formed in the opposing mandible support member 51. The opposing member 51 may further include an actuation button 61, the actuation button having an internally disposed engagement member (not shown) for mating engagement within slot 57, so as to secure the position of the support members 49 and 51 relative to each other. Actuation button 61 is preferably biased in order to be flush with the mandible support, and includes a slightly raised portion 63 so that a medic may easily locate and actuate the button. The adjustment mechanism 53 is also preferably designed so that a medic may simply squeeze support members 49 and 51 together, or toward each other as indicated by arrow "C", with the tab 55 readily moving into support member 51 as the engagement member moves between the plurality of adjustment holes 59, until the desired sizing is obtained. As shown in Fig. 8, the plurality of adjustment holes are designed to allow tab 55 to move in the direction of arrow "C" while preventing movement in the direction of arrow "D", when mated with the engagement member. Therefore, in order to move the support members apart, or away from each other as indicated by arrow "D", the actuation button 61 is depressed so that the engagement member is moved from engagement within slot 51, thereby allowing tab 55 to move from within support member 51. Alternatively, other methods for adjusting the mandible support may be utilized, as will be known to one of skill in the art. Referring again to Figs. 2 and 3, occipital support 40 preferably includes a lower section 54 adjustably and releasably engaged to the mandible support, and an upper section 52 extending upwardly from and supported by the lower section. As described above with respect to the anterior and posterior portions, the mandible and occipital supports may be connected by a pair of side engagement members 62 and 64 (Fig. 3). The engagement members 62, 64 each preferably include a serrated strap 66, 68, one strap extending from either extension of the mandible support. The straps 66, 68 are each releasably secured within a corresponding ratcheting member 70, 72 attached on either side of the lower section 54 of the occipital support, although other engagement members may be utilized and may be otherwise disposed on the collar. The serrated straps preferably move freely in one direction through their corresponding ratcheting members, but are restricted from moving in an opposite direction unless first released, as described herein above. Although the mandible support and occipital support are shown as separate members connected by a pair of engagement members, the mandible and occipital supports may, alternately be formed as a unitary member having an opening adjustable by a single engagement member. The use of engagement members 62, 64 allows the mandible support and occipital support to move relative to each other, thereby selectively and incrementally adjusting the circumference of second opening 74. Adjustment of opening 74 allows support member 18 to be selectively sized about the neck, chin and base of the head of the patient, so as to engage and support the head of a variety of patients. Lower section 54 of the occipital support is contoured to conform to the nape of a patient's neck and is therefore, preferably configured in a generally "U" shape, including a curved, back section 56 and a pair of side extensions 58 and 60. Alternately, as shown in the embodiments of Figs. 4 and 9, the occipital support may be designed so that the pair of side extensions 58 and 60 extend from the upper section 52, without the use of a back section 56. In either case, upper section 52 preferably extends upwardly from lower section 54 at a rearward angle, and is configured to engage the rear portion of a patient's head, thereby cradling the back of the head.

Figs. 7b and 7c shows the upper section 52 of the occipital support 40 cradling the rear of the patient's head. The upper section 52 extends upwardly and preferably at a slight angle from lower section 54. This allows the upper section 52 to engage the rounded, back portion of the patient's head, thereby supporting and cradling the rear of the patient's head and minimizing any rotational or flex of the head. The upper section extends above the nape of the patient's neck and may, additionally extend above the occipital portion of the patient's head, if desired. By extending from the lower section, in a direction above a plane defined by the lower section of the patient's head, the collar may also be utilized to apply gentle traction to patient. In the present embodiment, the upper section 52 is approximately 2-4 inches in height, as measured from lower section 54, although other heights are contemplated. The height of upper section 52 should be large enough so as to support the user's head to allow for gentle traction to be applied, without causing undue strain or flex of the patients head.

Upper section 52 may additionally include an adjustment mechanism 75 (Fig. 9)in order to adjust the width of upper section 52. Adjustment mechanism 75 operates in the same manner as adjustment mechanism 53, as described herein above. In the present embodiment, upper section 52 is approximately 3 inches in height, "1", and has a generally inverted "U" shape, defining an opening 61 between the upper and lower occipital sections. Opening 61 is preferably sized in order to provide access to the rear of the patient's head, while also allowing circulation of air through the back of the collar, the opening being approximately 12 square inches in the present embodiment. Alternately, upper section 52 may be continuous with lower section 54 and, therefore, not include an opening therebetween.

With continued reference to Fig. 2 in conjunction with Figs. 3 and 4, lower section 54 may additionally include a support connection member 76 extending from back section 56. for adjustably connecting occipital support 40 to posterior portion 16 of base member 12. Connection member 76 allows support member 18 to move relative to base member 12. thereby adjusting both the vertical distance or spacing between the support and base members, as well as the height of collar 10, "h", depending upon the size of the patient's neck, as measured from the top of the patient's shoulders to the bottom plane of the patient's chin. The vertical adjustment of the support member 18, along with the support provided by the mandible and occipital supports, provides a custom fit for the patient, and allows gentle traction to be applied by collar 10, if desired, as described in greater detail herein below. The height of collar 10 preferably adjusts from approximately 2 inches to approximately 6 inches, although collars with other heights are contemplated, for example those designed for use with infants. Connection member 76 preferably includes a serrated strap 78 extending from approximately the center of lower section 54 and releasably secured within a corresponding ratcheting member 79 attached to the posterior portion 16. Alternately, other connection members may be utilized, or a pair of connection members 76a, 76b may be utilized on either side of lower section 54, as shown in Figs. 6 and 9. The use of connection member 76 also allows the occipital support 40 to move in the direction indicated by arrow "E", Fig. 3. Movement in the direction of arrow "E" allows the occipital support to be angled forward, toward the head of the patient, which may be desirable for some applications. If the connection members are disposed on either side of lower section 54, as shown in Fig. 9, then a pivot point may be inserted above either connection member, the pivot point being normally locked, and the actuable by depressing a button 81, 83 which operates to release the pivot point so that the occipital support may be actuated in the direction of arrow "E" to increase or decrease the angle θ, between the mandible and anterior portion of collar 10 (Fig. 10). Mandible support 38 may, likewise include a pair of connection members 80 and 82 which helps sustain the mandible support while connecting the mandible support 38 to the anterior portion 14 of base member 12 for incremental adjustment of the height of collar 10. as described above. Connection members 80 and 82 may preferably comprise a pair of serrated straps 84, 86 extending from the sides of the mandible support, the straps being releasably secured within corresponding ratcheting members 88, 90 attached on either side of anterior portion 14 and including a pivot point, as described above with respect to the occipital support. As shown in Fig. 6b, a single connection member 83 may also be utilized for the mandible support. Connection members 76 and 80 and 82, may be utilized alone, or in combination, for example, adjustment may be effectuated by use of connection member 76 alone, as shown in Fig. 10.

In use. the collar is stored in its nested, or smallest configuration, with support member 18 lying adjacent base member 12, and connection members 76, 80 and 82 being fully released. The medic preferably places the patient in the neutral, "eyes forward" position, while a second medic releases at least one set of side engagement members 28, 62 and places the collar around the neck of the patient. The medic then adjusts base member 12 about the neck of the patient by squeezing the base member so as to move the anterior portion 14 relative to the posterior portion 16. The movement of the anterior and posterior portions causes strap 30 to move within and be secured by ratcheting member 34 in order to reduce the size of opening 20 to the proper .fit for the patient. Likewise, the medic also adjusts the support member 18 about the patient by squeezing the support member so as to move the mandible and occipital supports relative to each other. Movement of the mandible and occipital supports causes strap 66 to move within and be secured by ratcheting member 70. thereby reducing the size of opening 74. The engagement members operate to secure the size of the openings 20 and 74 which effectively reduces the overall circumference of collar 10.

Once the engagement members 28 and 62 have been adjusted and secured, the medic then raises support member 18 vertically, above the base member, to increase the height of collar 10, preferably by grasping the occipital support 40 and pulling upward, in the direction of arrow "L". Pulling upward on the occipital support will, cause corresponding movement of the mandible support in the direction of arrow "L", the support member 18 moving together as one unit. Movement of support member 18 as a single unit provides even distribution of both support to the patient and the force necessary for gentle traction to the patient. The support member is adjusted to the proper height for the particular patient, in order to restrict rotational movement, lateral movement, and both flex and extension of the patient's neck and spinal area, and is preferably adjusted to a height which will provide "gentle" traction to the patient, thereby allowing the medic to remove manual traction, before continuing the extrication process. If gentle traction is not desired, the medic simply adjusts the collar as described in order to provide a comfortable, custom fit to the patient, but does not raise the support member to a height capable of providing traction. As described above, serrated straps 78, 84 and 86 are preferably designed to move freely in the direction of arrow "L", through ratcheting members 79, 88 and 90, respectively, but are preferably prevented from moving in the direction of arrow "K", without first releasing the ratcheting members, as is known in the art. If adjustment mechanisms 53, 75 are included, the width of the mandible and occipital supports may also be adjusted at this point. If desired, the mandible and/or occipital supports may also be moved individually, by separately releasing and adjusting connection members 76, 80 and 82, respectively. Individual adjustment may be desired, for example, when the medic is unable to move the patient into the neutral position, thereby requiring the collar to be placed on the patient "as is". In such a situation it may be necessary to adjust the mandible support downward to fit on the patient if the patient, for example, displays discomfort while attempting to pull the head gently and firmly away from the trunk of the body. It may also be desired, for a particular patient, to angle the occipital support forward, toward the head of the patient, by adjusting the occipital support relative to the base member 12 in the direction of arrow "E". Turning now to Figs. 11-13, another embodiment of a cervical extrication collar 110 according to the present invention, is illustrated. The collar 110 is substantially as previously described, including an adjustable base member 112 and an adjustable support member 118. with both the circumference and the height of collar 110 being adjustable, to fit the anatomy of the particular patient. Adjustment of collar 110 is, however, achieved by use of engagement members 123a, b disposed on either side of collar 110. Engagement members 123a. b each include a rotatable knob 127a,b, respectively, the rotatable knobs being threadingly engaged within a corresponding base knob 129a, b. Engagement members 123a, b replace engagement members 28, 29, 62, 64 as well as connection members 76, 80 and 82, of Figs. 2-4. Knobs 127a, b are preferably externally disposed on collar 110 and are preferably received through slots 131 and 133, disposed in anterior portion 114, as well as slots 135 and 137 disposed in posterior portion 116, and are also disposed through slots 139, 141, disposed along extensions 146, 148 of the mandible support 140. Base knobs 129a, b are preferably internally disposed on collar 110 and are preferably likewise received through slots 131/133, 135/137 and 139/141, respectively. Base knobs 129a, b may be secured through the occipital support in order to be stationary, and each preferably include an extension 149a, b (Fig. 13) having an internally grooved recess (not shown) for matingly receiving threaded post 153a, b, extending from adjustment knob 127a, b. A compression spring 157a, b is preferably disposed about each extension 149a, b and is contacted by knob 127a, b, respectively. Compression springs 157a, b are preferably disposed through slots 131/133 and 139/141, respectively, but contact extensions 159a, b of posterior portion 116, and are therefore not disposed through slots 135/137.

Turning either knob 127a, b clockwise, in the direction of arrow "F", tightens the connection of the knob, while turning either knob counter-clockwise in the direction of arrow "G" loosens the connection of the knob. By utilizing compression springs 157a, b, turning knobs 127a, b clockwise begins to compress the springs 157a, b thereby causing friction to develop between extension 159a, b and extensions 158, 160, respectively. At this point the friction will hold extensions 159a, b, and 158, 160 in the desired positions, thus temporarily retaining the occipital support 140 as well as the posterior portion 116. In this position the mandible support and anterior portion 114 remain freely adjustable and positionable. By continuing to turn either knob 127a, b clockwise, the knobs begin to contact the extensions of the anterior portion, which in turn contacts extensions 146, 148 of the mandible support, thereby securing the anterior portion and mandible support as well. Knobs 127a, b may be adjusted individually or together, and a single or multiple knobs may be utilized, as known to one of skill in the art.

Collar 110 is placed on a patient as previously described with respect to the embodiment of Figs. 2-4, so as to effectuate a comfortable, custom fit of the collar on the patient, which preferably provides support as well as gentle traction once adjusted to the patient. Slots 131, 133, 135 and 137 are preferably angled upwardly to provide both selective adjustment of opening 120 as well as adjustment of the height of the overall collar by moving the base member relative to the support member. By loosening knob 127, slots 131 and 133 may be moved in the direction of arrow "H" while slots 135 and 137 may be moved in the direction of arrow "I", in order to adjust the opening 120 of base member while simultaneously adjusting the height "h" of the collar. The slots may be open at one end, as illustrated by slot 131 so as to facilitate disengagement of the collar, or alternately may be captured, as illustrated by slot 135. Mandible support 138, likewise includes slots 139, 141, disposed along extensions 146, 148. By loosening knob 127, slots 139, 141 may be moved in the direction of arrow "J" to adjust the circumference of opening 174, as previously described with respect to the embodiment of Figs. 2-4. The collar is thereby adjusted to provide both support and gentle traction to the patient.

It will be understood that various modifications may be made to the embodiments disclosed herein. For example, various types of engagement and connection members may be utilized to adjust the height and circumference of the cervical collar, the cervical collar may be utilized in a long term capacity, other than for just extrication, and the collar may be utilized with or without providing gentle traction. In addition, all measurements are approximate and may be varied by one of skill in the art, for example if a newborn extrication collar is desired. Therefore, the above description should not be construed as limiting, but merely as exemplifications of a preferred embodiment. Those skilled in the art will envision other modifications within the scope spirit of the invention.

Claims

What is claimed is: CLAIMS

1. A cervical collar comprising: a base member shaped to fit over and be supported by a patient's shoulders; a support member shaped to support a patient's head; means for adjustably securing said base and support members in fixed relation to one another; and means extending upwardly from said support member for engaging the rear portion of a patient's head, above the nape of the patient's neck.

2. The cervical collar according to claim 1, wherein a first opening defined by said base member is independently adjustable from a second opening defined by said support member.

3. The cervical collar according to claim 1, wherein said support member includes a mandible support shaped to engage to the patient's lower jaw, and an occipital support including a lower section conformed to the nape of the patient's neck and an upper section extending from said lower section, wherein said means for extending upwardly from said support member is said upper section.

4. The cervical collar according to claim 1, wherein said cervical collar is configured and arranged to apply and maintain gentle traction to a patient.

5. The cervical collar according to claim 1, wherein the means for adjustably securing said base member and said support member comprises at least one adjustable connection member.

6. The cervical collar according to claim 5, wherein the adjustable connection member connects the occipital support to a portion of the base member.

7. The cervical collar according to claim 5, wherein the adjustable connection member is configured to allow angular movement of the occipital support relative to the base member.

8. The cervical collar according to claim 5, wherein the adjustable connection member is configured to allow angular movement of the mandible support relative to the base member.

9. The cervical collar according to claim 3, wherein the mandible support is connected to the occipital support by at least one engagement member.

10. The cervical collar according to claim 9, wherein the at least one engagement member is an incrementally adjustable engagement member.

1 1. The cervical collar according to claim 10, wherein the incrementally adjustable engagement member includes a serrated strap releasably secured within a corresponding ratcheting member.

12. The cervical collar according to claim 3, wherein said mandible support includes a ledge formed therein for supporting the lower jaw of the patient.

13. The cervical collar according to claim 1, wherein the base member includes an anterior portion connected to a posterior portion by at least one engagement member.

14. The cervical collar according to claim 13, wherein the at least one engagement member is an incrementally adjustable engagement member.

15. The cervical collar according to claim 14, wherein the incrementally adjustable engagement member includes a serrated strap releasably secured within a corresponding ratcheting member.

16. The cervical collar according to claim 3, wherein the mandible support includes an incremental adjustment mechanism for adjusting the width of the mandible support.

17. The cervical collar according to claim 3, wherein the occipital support includes an incremental adjustment mechanism for adjusting the width of the occipital support.

18. A cervical collar comprising: a base member shaped to fit over and be supported by a patient's shoulders; and a support member shaped to support a patient's head, said support member including a mandible support shaped to engage to the patient's lower jaw, and an occipital support including a lower section conformed to the nape of the patient's neck and an upper section extending from the lower section and shaped to engage the rear of the patient's head; wherein a first opening defined by said base member is independently adjustable from a second opening defined by said support member.

19. The cervical collar according to claim 18, wherein said upper section extends above a plane defined by the base of the patient's head.

20. A method of utilizing a cervical collar comprising the steps of: placing a base member over the shoulders of a patient; placing a support member about the neck of the patient, the support member including an occipital support having an upper section extending therefrom; adjusting the circumference of a first opening defined by the base member; fastening the base member so as to secure the first opening; positioning the support member relative to the base member so as to apply traction to the patient; adjusting the circumference of a second opening defined by the support member; and fastening the support member so as to secure the second opening.

AMENDED CLAIMS

[received by the International Bureau on 14 August 1998 (14.08.98); original claims 1, 3, 7, 8 and 12 amended; orignal claims 2, 4-6, 9-11, 13-15 and 19-20 cancelled; new claims 21-29 added; remaining claims unchanged (4 pages)]

1. A cervical collar comprising: a base member shaped to fit over and be supported by a patient's shoulders; a rigid mandible support member shaped to cradle a patient's jaw, and having_.a generally U-shaped configuration defined by a curved front section and rearwardly extending side extensions; means for adjustably securing said base and support member in fixed relation to one another; and an occipital support member extending upwardly from the mandible support.member and engaging the rear portion of a patient's head, and the nape of the patient's neck.

Deleted.

3. The cervical collar according to claim 1, wherein said mandible support is shaped to engage the patient's lower jaw, and said occipital support has a lower section conformed to the nape of the patient's neck and an upper section extending upwardly from and above said lower section with the upper section also above said mandible support.

4. Deleted.

5. Deleted.

6. Deleted

7. The cervical collar according to claim 3, having an adjustable connection member configured to allow angular movement of the occipital support relative to the base member.

8. The cervical collar according to claim 3, having an adjustable connection member configured to allow angular movement of the mandible support relative to the base member.

9. Deleted.

10. Deleted.

11. Deleted.

12. The cervical collar according to claim 3, wherein said mandible member includes a ledge formed therein for supporting the lower jaw of the patient.

13. Deleted.

14. Deleted.

15. Deleted.

18. A cervical collar comprising: a base member shaped to fit over and be supported by a patient's shoulders; and; a support member shaped to support a patient's head, said support member including a mandible support shaped to engage to the patient's lower jaw, and an occipital support including a lower section conformed to the nape of the patient's neck laterally aligned with said mandible support and an upper section extending from the lower section above said mandible support and shaped to engage the rear of the patient's head; wherein a first opening defined by said base member is adjustable independently of a second opening defined by said support member.

19. Deleted. 20. Deleted.

21. A cervical collar as set forth in claim 1 wherein the base member defines a generally oval adjustable opening with the base member shaped to cover and engage a patient's shoulders and clavicles; an occipital support interconnected to the mandible support, and wherein said means for adjusting comprises a support extending between the base member and the rear of the occipital support and a pair of supports extending from the base member to either side of the mandible support.

22. A cervical collar as set forth in claim 21 wherein said base member is formed of separate anterior and posterior portions interengaged by releasable means in fixed relation to one another in at least one direction.

23. A cervical collar as set forth in claim 22 wherein said releasable means secure said posterior and anterior portions for movement only in a direction toward one another.

24. A cervical collar comprising a base member shaped to fit over and be supported by a patient's shoulders, a rigid mandible support member shaped to cradle a patient's jaw positioned over said base member, a rigid occipital support having a lower section substantially coplanar with the mandible support member and an upper section extending upwardly from and supported by the occipital lower section, with the upper section extending substantially above the mandible support to a position adapted to engage the back of a patient's head above the nape of the patient's neck, means for adjustably interengaging the mandible support and occipital support, and means for adjustably interengaging said base member and occipital support.

25. A cervical collar as set forth in claim 24 wherein said lower section of said occipital support is contoured to conform with the nape of the patient's neck.

26. A cervical collar as set forth in claim 24 wherein said upper section of said occipital support extends angularly away from the mandible support and is defined by a generally inverted U-shaped member having its legs integral with opposite sides of the lower section of the occipital support and the bight of the inverted U-shape curved to conform with the back of a patient's head and providing access thereto between the legs of the inverted U-shaped member.

27. A cervical collar as set forth in claim 24 having means for adjusting the size of the U- shaped member.

28. A cervical collar as set forth in claim 24 wherein said mandible support member has a generally U-shaped configuration defined by a curved front section and rearwardly extending side extensions shaped to cradle a patient's jaw, and means for interengaging said base member and said mandible support at the side extensions thereof.

29. A cervical collar comprising a base member shaped to fit over and be supported by a patient's shoulders, a rigid mandible support member shaped to cradle a patient's jaw positioned over said base member, a rigid occipital support shaped to engage the back of a patient's head above the nape of the neck, means for interengaging the mandible support and occipital support and, means at the posterior and sides only of the collar for adjustably securing the mandible support and occipital support in substantially fixed relation to the base member while allowing limited jaw movement of a patient.