HEAD & NECK REPOSITIONING AND IMMOBILIZATION WITH THE CNR, CUSTOM NECK ROLL

Jeffrey Vincent Kostich, President
Smithers Medical Products, Inc.
North Canton, Ohio

ALPHA CRADLE® BRAND PATIENT REPOSITIONING SYSTEM HF1, LHF, IHI, IHI-R, CNR
Smithers Medical Products, Inc. is proud to introduce a new product that has been designed to work in conjunction with thermoplastics for optimum head and neck immobilization, the CNR, custom neck roll. Our new CNR makes a custom neck support that cradles the patient’s anatomy while a thermoplastic mask holds the head in position. There are also several other forms that accommodate the head in several positions including the lateral position.
The key to successful head forms lies in the correct management of two areas during the fabrication process. The first is to remember that the foam will lift the head out of the form as the foam itself begins to rise. Wait until the foam feels spongy and then using soft, yet firm pressure, press the head deep into the form. This will allow the foam to cover the patient’s ears, giving an excellent repositioning tool when placing the head back into the form. The second area is the successful management of patient movement during the fabrication process. It is vital with the head forms that the patient does not move at all. This includes talking. The slightest movement during the fabrication process will result in cell walls being crushed and the form not fitting as tight as it otherwise would have fit. For some odd reason, I have noted that people always want to see if the patient can move their head while the form is in the process of hardening. This is a self-defeating maneuver by the medical professional. Of course they can move. And now that they have moved, they have pushed foam away from them that would have kept them still. It is also imperative that the patient remains inside of the form until it has hardened and cooled completely back to room temperature. The time needed to correctly fabricate this form is 10-15 minutes, depending on the atmospheric conditions in the room (temperature, humidity).

ACMMII
The ACMMII offers the unique ability to create a head and neck form that cannot be duplicated with the ALPHA CRADLE® brand shells. This head and neck form actually creates a skull cap over the patient’s head that when placed on the patient, gives them the appearance resembling the Egyptian sphinx! The bag of foam is extended approximately 10” above the patient’s head, and then lifted and placed flat along the patient’s head with a divider. The top of the bag should fit along the patient’s eyebrows, without extending beyond this point. The base of the bag extends to the patient’s shoulders, where the dividers hold the foam firmly in place. When this form is completed, it has effect of immobilizing the patient’s head in relationship to their shoulders, while eliminating all movement. The patient removes the form and replaces it sitting up as they would a motorcycle helmet (see ACMMII Instruction Manual for more information).
The ACMMII allows for very tight fitting precise head forms to be made. However, it is imperative that the patient remains completely motionless throughout the fabrication process. It is also vital that they lay in the mold until all of the form has cooled to room temperature. This process should take approximately 15 minutes.