How many patients a day come to you in a C-collar? If your ED is anything like mine, you measure it by the dozen. C-collars come in a multitude of shapes and sizes, ranging from stiff cheap plastic to velvet padded luxury. One of the deficits that all of these models share is that they obscure visualization of the neck. The Clear Collar by Clear Advantage Collar, Inc. attempts to fill this void. But does it give up too much in the process?
The Clear Collar is constructed of two pieces of clear rubber riveted to an overlying piece of opaque plastic. This single unit is placed behind the patient’s neck and wrapped around the chin, then secured by Velcro. What makes this collar unique is that all of the Clear Collar’s material, short of the Velcro strap, is see-through. The intent is that you can visualize trauma, JVD, tracheal deviation, etc... through the collar itself.
While its true that you can see your patient’s neck through the collar, its a bit like trying to see the road through a foggy windshield on a cold winter morning before the defroster kicks in. While significant trauma will stand out, I’m not sure that I’d recognize JVD through the somewhat hazy plastic. That said, even with imperfect visualization through the collar, it is still infinitely better than standard collars which offer zero visualization.
This visibility does not come without a downside, however. In order to allow full visibility of the patient’s neck under the Clear Collar, all padding has been eliminated. Anyone who has worn a C-collar for any period of time knows how uncomfortable they can be. Now add to this discomfort the soothing feeling of skin on plastic and you’ll see where I’m going with this. In any kind of warm environment the skin on plastic contact of the Clear Collar has you warm and clammy in minutes. While Clear Collar states that there is no increase in skin breakdown with their collar versus others, I’d be reluctant to admit an immobilized patient without replacing the Clear Collar with a padded C-collar.
Despite this detraction the Clear Collar does offer additional benefits. The rubber that makes up the internal portion of the collar is fairly pliable while the plastic outer shell adds enough stiffness to make the Clear-Collar comfortable yet sturdy. The anterior aspect of the collar has a reasonably sized opening allowing for tracheal visualization as well as enough room to perform a crichothyroidotomy. The posterior side of the collar has a very generous opening allowing direct viewing and palpation of the cervical spine (something lacking in most C-collars).
As of this writing Clear Collar offers four sizes ranging from pediatric to adult large. They also have plans to release an adjustable version this fall and a product for prolonged use called the Rehabilitation line due out summer 2011.
Overall the Clear Collar is a nice product that is well-suited for pre-hospital care. Its use by EMS providers allows the receiving facility to be able to reasonably visualize the neck of a patient without removing the C-collar and risking injury to an unstable cervical spine. That being said, I would take care to replace the Clear Collar with a softer C-collar in patients that will require cervical spine immobilization for prolonged periods of time.
Rating: 3/5 stethoscopes
Pros: Decent visualization of neck through collar, large posterior opening to palpate spine
Cons: Rubber not as comfortable as padded collars