ADVANCED RESCUE REFRESHER TRAINING STANDARD V02.1 ANNEXES
2020-10-01_TSR_ARTR_V02.1
HEAD SUPPORT DURING RESCUE
1. PURPOSE The purpose of this annex is to explain the risks associated with using a rigid or semi rigid cervical collar (cervical collar), the mitigation steps to minimise the risks, explain how the use of a cervical collar in a rescue setting is not considered routine and to present some alternative methods to support the head and manage the airway of an unconscious injured person during extrication from an enclosed space. The current ERC, AHA and ANZCOR first aid guidelines recommend against the routine application of a cervical collar by a first aider. The context for these recommendations is in the case of a suspected spinal injury where traditionally it has been normal practice to apply a cervical collar to immobilise the spine and prevent further injury. 3. NON-ROUTINE USE OF A CERVICAL COLLAR DURING RESCUE The context for the recommendations in the first aid guidelines is routine use for spinal immobilization. The context for the use of a cervical collar during a rescue is to support the head and maintain the airway of an unconscious injured person. Extrication of an unconscious injured person from an enclosed space or moving an unconscious injured person in a wind turbine creates the possibility of causing further injuries to the injured person. Additionally, the head and limbs of an injured person are free to move and can impede the extrication or movement of an injured person. While the limbs are relatively easy and risk free to control the head presents unique challenges. Head injuries could result from unintended movement of the head striking an object and or the movement of the head could actively compress the airway, or the head could become an obstruction to the movement of an injured person through a restricted opening. The risk of further injuries and the risk of airway obstruction during extrication and movement of an unconscious injured person are significant and therefore, controlling head movement and maintaining the airway of an unconscious injured during these activities is of the upmost importance. Head support and airway maintenance can be achieved through manual in-line stabilization (MILS) where a rescuer actively supports the head with their hands, or through the use of a transfer board with headblocks. The application of MILS protocols requires that that rescuer is only doing that and cannot perform other practical rescue operations and therefore requires more than one rescuer. Due limited space the use of a transfer board with headblocks can be a hinderance or a complete obstruction to the extrication of an unconscious injured person from an enclosed space. In many cases technicians work in turbines in teams of two and therefore the possibility exists that if one of them is injured and unconscious and there is a need to move them before help arrives that the other technician may need to perform a rescue operation by themselves as a single rescuer. Due to this possibility it is very important that the rescuing technician is able to support the head of an
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