Hi folks! Ever had a trauma patient with a fractured clavicle who screamed if you tried to place a cervical spine neck splint for transport? What did you do?
Sandbags? head blocks ? Kendrick extrications device? Vacuum mattress splint?
Ever heard of the Montana Horse Collar?
Thanks to Critical Care Paramedic, Ryan Ziegler for the images and this description he emailed me when I asked for help to write this post. Follow him on twitter @momedic9019
Minh, here you go….the presented Montana Horse Collar. Small background….. It was born sometime in the 80’s by a Montana EMT…at least, that’s what the folklore tells us. It was originally used to try and maintain c-spine alignment during a rapid extrication from a wrecked vehicle or other dangerous situation, and actually, it works quite well.
Best used with a fully conscious or unconscious patient you will see the most benefit. We know that normal people don’t care for standard cervical collars, this could be seen as a comfortable, warm reminder, to not move your neck. It sizes itself, and fits every patient, modify it for peds, and it doesn’t need to be removed for DL. The best part is it’s basically free.
It starts as a standard issue hospital blanket. Two people grasp opposite corners, one person then spins their corner until it’s wound tight, place center of blanket around back of neck, cross free ends over chest, and tie in the back, or, if still using a backboard, ensure it stays tight and patients weight will maintain tension. You can still use head blocks to secure if needed.
The pictures shown were done hastily, and don’t show absolute proper placement. The anterior view should have the blanket fully up under the chin, and up into the armpit. Securing it in the back, you’d want to avoid a large knot, it won’t go anywhere once the patient is laying on it.
My bio…… Ryan Ziegler, primary work is with the Pewaukee Fire Department, in Pewaukee Wisconsin where I practice as a Critical Care Paramedic and Firefighter. I’ve been there for 7, years, with an additional 7 years spent in an urban-prehospital ALS service. I also moonlight with Children’s Hospital of Wisconsin as a Communications Specialist for our Pediatric/Neonatal Critical Care transport service. I’ve got a true passion for all things medical, and especially, pre-hospital medicine.
Cheers!
Ryan Z.
Prehospital and Retrieval Medicine - THE PHARM dedicated to the memory of Dr John Hinds 
….There’s something that cannot be made with a hospital blanket??!!!Usually we use them as an alternative for tank extrications…but this is an other great solution if neck collar is unavailable or unsuitable…..
Great post Minh!!!….Thanks to Ryan Z.!!!!!!
….There’s something that cannot be made with an hospital blanket??!!!! Usually we use it as an alternative for tank extrications…but this is an other great solution if neck collar is unavailable or unsuitable…..
Great post Minh!!!….Thanks to Ryan Z.
MacGyver Medicine rules!!!!!!
There is a skills video in the Mosby paramedic teaching pack with similar useage, with a C collar…. thicker blanket and a bit of a tweek…. but where the blanket comes under the arms the medic can use this to support and turn the patient for extrication. Email if you wany more info… will try and find a link!
Love it! We were taught this during a wilderness EMS class and I loved it then and am loving seeing it again.
When Trauma Mama Mary Peczynski taught us this one, she called it a Philadelphia Horse Collar. But hell. Montana, Philly, what matters is that it works….