1. Kids vs. Adults: C-spine Immobilization
Jerome Pediatric Products & The Broselow-Luten Color Coding System

2. Broselow-Luten System
Patented pediatric measuring and dosage system
Originally developed by James Broselow, MD (Hickory, NC) and Bob Luten, MD (Jacksonville, FL)
Assigns each child 1 of 9 color codes
Based upon length or weight
Better Patient Care:
Eliminates dosage calculation errors
Simplifies treatment
Widely recognized by EMS and ED personnel

3. Cervical Spine System for Kids

4. NecLoc Kids®, Miami Jr®. & AirWay PAD®
Uniquely designed pediatric spinal immobilization and positioning devices for maintaining kids’ necks in proper anatomical c-spine & airway alignment

5. Jerome Pediatric Collars
Patented "Airway Back" design.
Flared occiput uniquely maintains airway and c-spine alignment.
Addresses anatomical growth transition from birth to adolescence (0 – 12 years).
Pick a picture.

6. Jerome Pediatric Collars
Miami Jr.
Hospital
Long term use
4 sizes: P0, P1, P2, P3
Color coded labeling
NecLoc Kids
Pre-hospital
Short term use
3 sizes: P1, P2, P3
Color coded labeling

7. Collar Sizing: Simple Sizing based on: Age  Broselow-Luten color code
0 – 6 mos
6 mos – 2 yrs
Simple Sizing based on:
 Broselow-Luten color code
Age
2 – 6 yrs
Poster and front face photo.
6 – 12 yrs

8. Pediatric Collar Design Kids vs. Adults
P1 Collar
(Ages 0-2 yrs.)
P2 Collar
(Ages 2-6 yrs.)
P3 Collar
(Ages 6-12 yrs.)
Adult
(Ages > 12 yrs.)

9. Kids vs. Adults Relative Head Size
Change in Relative Body Proportions from Fetus to Adult
(from Robbins et al: Growth, Yale University Press, New Haven, 1928.)

10. Adult / Child Differences:

11. Chin Height:
Negative
Chin Height

12. Kids vs. Adults Neck Length
P1 Collar
(Ages 0-2 yrs.)
P2 Collar
(Ages 2-6 yrs.)
P3 Collar
(Ages 6-12 yrs.)
Adult
(Ages > 12 yrs.)

13. Back of Head to Back:
Negative
Ratio

14. Occipital Angle:
30 °
45 °
60 °
75 °
90 °

15. Kids vs. Adults Occipital Angle
P1 Collar
(Ages 0-2 yrs.)
P2 Collar
(Ages 2-6 yrs.)
P3 Collar
(Ages 6-12 yrs.)
Adult
(Ages > 12 yrs.)

16. Kids vs. Adults Flexibility / Range of Motion

17. Kids vs. Adults Airway & Spinal Alignment

18. Kids vs. Adults Airway & Spinal Alignment

19. AirWay PAD Pediatric supine Alignment and positioning Device
Achieves neutral c-spine alignment
Opens airway
For Kids 0-12 years
Full-size Broselow Scale
Indicates appropriate Jerome collar size

20. AirWay PAD
KID = PAD

21. AirWay PAD MR Testing
11 yo No collar, No Pad
11 yo w/ AirWay PAD

22. AirWay PAD Simple as 1, 2, 3, 4! Open Pad Measure Child Choose Color
Fold Pad

23. AirWay PAD

24. AirWay PAD

25. AirWay PAD

26. AirWay PAD

27. AirWay PAD Guidelines: Ear in line with shoulder
Pad height should match occipital offset of collar

28. AirWay PAD

29. AirWay PAD
pad.exe

30. Papoose®

32. Infant Spinal Cord Injury:
How do we immobilize?
How do we establish proper airway alignment?

34. PROPER AIRWAY ALIGNMENT
Papoose
Marriage of two important ideas:
IMMOBILIZATION
and
PROPER AIRWAY ALIGNMENT

36. AirWay and Anatomy:

37. AirWay PAD MR Testing
11 yo No collar, No Pad
11 yo w/ AirWay PAD

39. Papoose
Immobilizes the youngest of our pediatric population: Broselow Gray (0 – 3 months).
CTLSO: Allows for immobilization of C-Spine and T-Spine injuries.
Occipital shape prevents plagiocephaly / brachiocephaly.

41. Papoose Allows for continued intimacy between caregiver and child.
Permits convenient diaper changing with minimal disruption in immobilization.
Temporary immobilization for IV placement, diagnostic imaging, suturing, etc.
Extrication & Transport