Ambu Perfit ACE Military Cervical Collar: Field Manual & SOP

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Ambu Perfit ACE Military Cervical Collar: Field Manual & SOP

Category: First Aid

Difficulty Level: Tier 3: Field Competency Required

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Written by: Valerie Ellis Lavin

Quick Overview

The Ambu Perfit ACE Adjustable Cervical Collar is a military-grade spinal immobilization device used by combat medics, tactical paramedics, and search and rescue technicians to stabilize potential cervical spine injuries in pre-hospital, tactical, and mass casualty environments.

The Perfit ACE replaces four standard adult collar sizes through a 16-setting ratchet track adjustable across Neckless, Short, Regular, and Tall configurations. Its olive drab rigid shell restricts flexion, extension, lateral bending, and rotation of the cervical spine, while the charcoal black foam interior manages moisture and reduces pressure sore risk during prolonged wear. The flat-pack design conserves space in aid bags and vehicle medical compartments, making it a practical choice for austere and mounted patrol deployments. A large tracheal opening maintains access for carotid pulse checks, advanced airway procedures, and cricothyrotomy without collar removal.

Correct sizing is a clinical priority, not a preference. A collar sized too large causes hyperextension of the neck, while a collar sized too small may obstruct the airway or compress the jugular veins, impairing venous drainage from the brain. Sizing is measured by finger-widths from the top of the shoulder to the angle of the mandible, with the corresponding size indicator locked in using dual safety buttons. Fit is confirmed by verifying that one finger can be inserted between the collar and the neck after application.

The cervical collar is an adjunct to full spinal motion restriction protocol, not a standalone intervention. It must be used in conjunction with manual in-line stabilization, a rigid backboard or scoop stretcher, and head blocks. The collar is CT, MRI, and X-ray compatible, allowing it to remain in place during initial diagnostic imaging to prevent unnecessary movement during transfer.

Field Application Steps

1. ESTABLISH MANUAL IN-LINE STABILIZATION (MILS): Have a secondary responder maintain the casualty's head, neck, and spine in a neutral, aligned position. Do not release MILS at any point until the collar is fully secured and the casualty is immobilized on a backboard or equivalent device.

2. PREPARE THE COLLAR: Remove the Perfit ACE from its packaging and ensure the chin piece is flipped down to its flat storage position before sizing. Attempting to size with the chin piece up will produce an inaccurate measurement.

3. MEASURE THE CASUALTY: Place one hand flat on the casualty's shoulder at the base of the neck over the trapezius muscle. Extend your fingers and measure the vertical distance from the top of the shoulder to the bottom of the chin at the angle of the mandible, noting the number of finger-widths.

4. UNLOCK AND ADJUST THE RATCHET TRACK: Pull both dual safety lock buttons outward simultaneously to disengage the adjustment mechanism. Slide the upper portion of the collar until the bottom edge of the chin support aligns with the size indicator matching your finger-width measurement: 3 for Neckless, 4 for Short, 5 for Regular, or 6 for Tall.

5. LOCK THE SELECTED SIZE: Firmly push both safety lock buttons inward to lock the collar at the selected setting. Verify the lock by attempting to slide the mechanism. It must not move.

6. POSITION THE POSTERIOR SHELL: With MILS maintained, gently slide the posterior section of the collar behind the casualty's neck. Confirm it is centered and that no clothing or hair is trapped between the foam padding and the skin.

7. SEAT THE ANTERIOR SECTION: Bring the anterior section of the collar up and scoop it under the chin to properly seat the mandible support against the jaw.

8. SECURE THE VELCRO STRAP: While holding the anterior section firmly in place, wrap the hook-and-loop strap around the back of the neck. Feed it through the plastic opening on the opposite side, pull it snug, and fasten it securely.

9. LOCK THE CHIN PIECE: Flip the chin piece upward into its final locked position, confirming it is fully seated and supporting the casualty's mandible.

10. PERFORM CRITICAL FIT CHECK: Attempt to slide one finger between the collar and the neck. If you cannot insert one finger, loosen the collar immediately. The collar must restrict movement without impeding breathing or restricting venous return from the head.

11. RELEASE MILS AND REASSESS ABC: Release MILS only after the collar is fully secured and the casualty is immobilized on a backboard or equivalent device. Immediately reassess Airway, Breathing, and Circulation, and check for difficulty breathing or changes in voice quality that may indicate the collar is too tight.

12. CHECK PMS TIMES FOUR AND DOCUMENT: Assess Pulse, Motor, and Sensory function in all four extremities. Document all findings and continue monitoring for audible breathing difficulty, voice changes, increased agitation, visible neck swelling, or any loss of distal pulse, motor, or sensory function.

Equip Yourself: Ambu Perfit ACE Adjustable Cervical Collar – Military Edition (Box of 10)

Ensure you have the right gear before an emergency strikes.

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LEGAL DISCLAIMER & SAFETY WARNING:
The information provided in this Luminary Global Field Manual is strictly for educational and informational purposes. It is not a substitute for formal medical, tactical, or professional training. In the event of a medical emergency, immediately seek professional help or contact emergency services. Luminary Global assumes no liability for the misuse of equipment, improper application of techniques, or any injuries/damages resulting from the use of these guidelines. Always rely on your official agency training, local laws, and established protocols during a crisis.