Head immobilization device

A head immobilization device, or head immobilizer, is disclosed. The head immobilizer includes an adjustable stable structure obtained by a middle wall standing vertically above the patient's head. The middle wall in an operative condition restricts hinges from up and down movement in a first perpendicular plane, and sideways movement in a second perpendicular plane, while still allowing vertical side walls to be folded flat against the temple areas of a patient's head. This structure permits the head immobilizer to secure a large variety of head sizes. Attachment flanges for the side walls are secured to the board at an angle of approximately 90.degree. to the middle wall. This attachment locks the structure from movement in a third perpendicular plane. The patient's head is prevented from moving forward by a restraining band joining the two side walls across the patient's forehead.

BACKGROUND OF THE INVENTION
 1. Field of the Invention
 The present invention relates to head immobilization devices. More
 specifically, the present invention relates to a head immobilization
 device for restraining a patient's head during transport on a spine board.
 2. Description of Related Art
 Head immobilization devices are used by emergency medical technicians to
 secure an injured patient's head from movement, especially rotational
 movements of the head.
 Numerous devices have been proposed in the past to perform the function of
 immobilizing or stabilizing the human head and/or neck for emergency
 purposes. Such devices are extremely important, particularly in emergency
 situations, in the handling of possible fractures of the cervical spine.
 In the case of industrial injuries, automobile accidents, and battlefield
 injuries, it is usually necessary to remove the patient from the injury
 scene, often under conditions of stress or time pressure, for transport to
 medical facilities. This removal is almost always accomplished by
 personnel who are not medical doctors, although they may have had varying
 amounts of education and training in the handling of injured persons.
 In such handling and moving, there is a high risk of aggravation of
 injuries to the cervical spine if the patient's head and/or neck are not
 properly immobilized or stabilized.
 Many prior art patents disclose devices comprising a rigid board member
 having straps attached thereto for attachment to a patient to immobilize
 the head and neck. These devices provide a rigid structure for completely
 preventing lateral motion and rotation of the patient's head. But they are
 often expensive, bulky, and complicated to use. They are also frequently
 impractical to maintain, store, and clean between uses.
 Head immobilization devices are usually single use or disposable devices,
 which do not require sterilization after a use. It is desirable that such
 disposable immobilizers be sturdy but also inexpensive.
 The storage capacity of emergency medical vehicles or ambulances is
 limited. These vehicles are able to carry more equipment when the
 equipment can be stowed in a flat or folded condition. Desirable head
 immobilization devices can be stored in a flat condition and unfolded to
 an operative condition.
 U.S. Pat. No. 4,182,322 discloses a head-restraining and safety support
 apparatus having a head-rest section at one end. Included is a durable,
 lightweight, three-section cushion that can be used for safety purposes to
 cover and restrain effectively the head of an accident victim while being
 placed on a body splint/litter apparatus in preparation for transport to a
 medical facility. Two flexible attaching members are connected to the rear
 edges of the opposing side cushion sections. The attaching members can be
 fastened to the head section of the body/splint litter apparatus by any
 convenient fastener such as hooks, snaps, or ties but preferably by the
 use of Velcro.RTM. brand fastening means. A main forehead strap protects
 and restrains the head from forward motion and a chin strap provides
 additional restraint and support, both straps being secured by any
 convenient means at one end of each to the front edge of one side of the
 cushion member, and fastenable by any convenient means to the outer
 surface of the opposite cushion section.
 U.S. Pat. No. 4,571,757 discloses a device for restraining the head of an
 injured person carried on a cervical support board, the device having a
 pair of L-shaped side frames each defining a base portion and a brace
 portion. The brace portion is sized approximately 6 to 8 inches long (in
 the direction of the base portion). Hook-loop fasteners, e.g.,
 Velcro.RTM., are fixed to the base portion of the side frames and to the
 support board where the injured person's head is located. The brace
 portion of the side frame is adapted then to be snugged against the side
 of the person's head, extending from close to the neck upward beyond the
 ears, with the base portion then being secured onto the support in this
 position. Straps are then trained over the person's head, at the forehead
 and/or chin, and secured again by hook-loop fasteners to the brace
 portions of the side frames. Openings in the guide portions of the side
 frames expose the person's ears for visual and tactual access. Padding on
 the brace portion surrounds the access opening to cushion the snugging
 action against the person's head.
 U.S. Pat. No. 4,589,407 discloses a spine immobilizer adapted for rendering
 an accident victim's head and upper body immobile. The spine immobilizer
 in a preferred form is made of a sheet of corrugated cardboard including a
 multilayer spine panel to resist longitudinal bending, laterally extending
 head panels bendable into position adjacent to the sides of the person's
 head, laterally extending body panels bendable into conformity with the
 person's upper body, and straps and fastening assemblies for securing the
 body panels in position. The immobilizer includes box sections providing
 increased resistance to longitudinal bending, one formed by laterally
 extending stiffener panels having free ends that can be arranged in
 overlying relation, and others formed by the strap arrangement. Features
 include laterally adjustable carrying handles and slot and strap
 configurations that reduce tearing of the cardboard.
 U.S. Pat. No. 4,718,412 discloses a disposable, lightweight, readily
 stored, low cost cervical spine board made of wax-coated or plastic-coated
 reinforced double walled corrugated board. The device has precut score
 lines therein for folding the device around the sides of the head and
 around the sides of the body. Head and neck tabs and body wings are
 secured by duct tape or other suitable two-inch tape, which optionally can
 be preattached to the device.
 U.S. Pat. No. 4,928,711 discloses a head immobilizer of the type that can
 be attached to a rigid backboard support, with the head immobilizer
 including a base and a pair of laterally extending side support panels.
 Each of these side support panels further comprises an inner panel and an
 outer panel, with the inner panel conformable appropriately to the shape
 necessary for snugly supporting the head to be immobilized. The inner
 panel also includes an opening that effectively divides a portion of that
 inner panel into a pair of spaced inner support members extending
 laterally from the base. The outer panel has inner and outer edges and is
 hingedly attached adjacent to its inner edge to the inner panel such that
 it is foldable relative to the inner panel to provide a substantially
 rigid brace for securing the inner panel in a desired immobilizing
 position. The outer panel also includes a cutout portion for providing
 substantial access to the opening of the inner panel when the inner panel
 is braced in a desired immobilizing position. The outer panel can be
 secured in a bracing position relative to the inner panel, and the outer
 panel includes an attachment panel hingedly attached adjacent its outer
 edge for securing the outer panel in bracing position adjacent the base.
 U.S. Pat. No. 4,964,418 discloses a collapsible immobilization device
 comprising two pieces of treated fiberboard. The pieces are placed one on
 top of the other and joined together at the center of each. The upper
 member consists of different sections formed by and attached to each other
 by fold lines. The fold lines allow these sections to be rotated
 independent of each other with the fold lines acting as a hinge. When
 certain sections are folded against a patient's head, they form a cradling
 area. When the rigid shoulder sections are mated to the base member by
 means of hook-loop fasteners, e.g., Velcro.RTM., the device becomes rigid,
 thus restraining the patient's head and neck area. Adhesive tape on the
 bottom of the base member allows for the device to be secured to a surface
 that further supports the patient's cervical area.
 U.S. Pat. No. 5,211,185 discloses a head immobilization device comprising a
 foundation portion and a restraining portion. The foundation portion
 comprises a foundational panel and an adhesive first spine board engaging
 element situated on the lower surface of the foundation panel. The
 restraining portion comprises a base panel, two side panels extending
 laterally from the outer sides of the base panel, and at least one band of
 material for affixing the side panels to each other in suitable
 conformance with the patient's head.
 U.S. Pat. No. 5,360,393 discloses a dual adhesive strap for securing a
 patient's head in a head immobilizer. The strap is designed to lie across
 and adhere to the patient's forehead and have each of its ends adhere to a
 spine board. The strap has a bottom side comprising a central region which
 comprises skin contact adhesive flanked by two regions which comprise
 board contact adhesive. The board contact adhesive is stronger than the
 skin contact adhesive, such that the strap stays adhered under various
 environmental conditions and the skin of the patient's forehead is not
 injured by the skin contact adhesive. The strap and the adhesive regions
 are preferably large enough to accommodate many sizes of heads, spine
 boards, and head immobilizers. It is preferred that a removable backing
 covers the adhesive side of the strap.
 SUMMARY OF THE INVENTION
 The present invention is directed to a head immobilization device, or "head
 immobilizer."
 More particularly, the present invention is directed to a head immobilizer
 for use in combination with a spine board, said immobilizer having a
 substantially rectangular middle wall and substantially rectangular side
 walls hingedly attached to opposite sides thereof and comprising:
 an adjustable stable structure obtained by said middle wall standing
 vertically above a patient's head, said middle wall in an operative
 condition restricts hinges from up and down movement in a first
 perpendicular plane and sideways movement in a second perpendicular plane,
 said side walls being folded flat against temple areas of said patient's
 head; and
 attachment flanges for said side walls for securing to a backboard in an
 operative condition at an angle of approximately 90.degree. to said middle
 wall.
 The head immobilizer includes an adjustable stable structure obtained by a
 middle wall standing vertically above the patient's head. The middle wall
 in an operative condition restricts hinges from up and down movement in a
 first perpendicular plane and sideways movement in a second perpendicular
 plane while still allowing vertical side walls to be folded flat against
 the temple areas of a patient's head. This structure permits the head
 immobilizer to secure a large variety of head sizes. Attachment flanges
 for the side walls are secured to the board at an angle of approximately
 90.degree. to the middle wall. This attachment locks the structure from
 movement in a third perpendicular plane. The patient's head is prevented
 from moving forward by a restraining band joining the two side walls
 across the patient's head.
 In a preferred embodiment, the present invention is directed to a blank for
 forming a head immobilizer, said blank having an obverse side and a
 reverse side and comprising:
 a middle wall having first and second substantially parallel end edges and
 first and second substantially parallel side edges;
 a first side wall connected to said first side edge of said middle wall by
 a first line hinge, and a second side wall connected to said second side
 edge of said middle wall by a second line hinge, each of said first and
 second side walls having a first side edge joined to said respective side
 edge of said middle wall, a second side edge parallel to said first side
 edge, and corresponding first and second opposite parallel end edges; and
 an attachment flange coupled by line hinges to each of said first end edges
 of each side wall and said middle wall, each of said attachment flanges
 having an adhesive element affixed thereto.
 In another preferred embodiment, the present invention is directed to a
 head immobilizer formed from a blank, said head immobilizer comprising:
 a middle wall having substantially parallel top and bottom edges and first
 and second substantially parallel side edges;
 a first side wall contiguous with said first side edge of said middle wall
 and a second side wall contiguous with said second side edge of said
 middle wall, each of said first and second side walls having a first side
 edge joined by a first line hinge to a respective side edge of said middle
 wall, a second side edge parallel to said first side edge, and opposite
 parallel top and bottom edges;
 an attachment flange joined by a second line hinge to each of said bottom
 edges of each side wall and said middle wall, each attachment flange
 extending perpendicular to the wall to which it is joined and having
 affixed thereto means for attaching said head immobilizer to a spine
 board; wherein each of said side walls is rotatable inward about said
 first side hinges to form an interior angle ranging from greater than
 90.degree. to less than 90.degree. with said middle wall, whereby said
 side walls can be adjusted to conform to the width of a patient's head at
 the temples.
 It is an object of the present invention to provide a rigid structure for
 prevention of lateral head motion and rotation of the head by use of a
 small device, i.e., smaller than the type described, for example, in U.S.
 Pat. No. 4,964,418, that can easily be stored attached to a spine board
 without any part of the device extending out over the edges of the board
 and thereby causing problems during storage and handling.
 It is another object of the present invention to provide a head immobilizer
 wherein the amount of material and manufacturing cost required for its
 construction are minimized.
 It is still another object of the present invention to provide a head
 immobilizer wherein stabilization is provided by resting against the flat
 surfaces of the temples just above and in front of the ears of the patient
 and wherein there is no interference with an extrication collar placed
 around the patient's neck and jaw.
 It is still another object of the present invention to provide a device
 that can be easily applied to a patient with minimal movement of the
 patient.
 It is still another object of the present invention to provide a device
 that can be used to secure a patient's head after the patient has been
 placed upon an apparatus that will be used to support the patient's
 cervical area.
 It is still another object of the present invention to provide a device
 that is adjustable permitting it to be used for differing head sizes.
 It is still another object of the present invention to provide a device
 that can be secured to a litter, stretcher, table or other substantially
 flat surface that will assist in the support of the patient's cervical
 area without that surface or apparatus being specially prepared to accept
 the device.
 It is still another object of the present invention to provide a device
 that can be supplied and stored in a substantially collapsed or folded
 condition, whereby only a small storage space is required.
 It is still another object of the present invention to provide a device
 that substantially conforms to the width of a patient's head at the
 temples, thereby providing greater immobilizing characteristics.
 It is still another object of the present invention to provide a device
 that is inexpensive and can be disposed of after a single use.
 It is still another object of the present invention to provide a device
 that can be made from lightweight materials in order to have enhanced
 portability.
 It is still another object of the present invention to provide a device
 that can be used in combination with a cervical neck brace.
 For a better understanding of the present invention, together with other
 and further objects thereof, reference is made to the following
 description taken in connection with the accompanying drawings in which
 preferred embodiments of the present invention are illustrated, the scope
 of the invention being pointed out and contained in the appended claims.

DESCRIPTION OF THE PREFERRED EMBODIMENT(S)
 The invention is a sturdy head immobilizer that is inexpensive and folds
 from a substantially flat, inoperative condition, i.e., a blank, into a
 three-dimensional, boxlike operative condition.
 The head immobilizer of the present invention can be made from cardboard;
 plastics, e.g., sheet plastics, injection molded plastics, or rigid foams;
 wood; metal; cloth; composite materials; other inexpensive sheet
 materials; or a combination of any or all to provide a disposable product.
 Generally, it will be desirable to avoid the use of metal parts so as to
 allow X-rays to be taken of the patient through the device itself while it
 is still restraining the person's head. Use of cardboard, especially
 double-walled, corrugated cardboard, is preferred because it is relatively
 inexpensive and readily available. If desired, it can be coated with wax,
 plastic resins, or the like in order to render it waterproof and resistant
 to absorption and/or staining by blood or other body fluids.
 FIG. 1 illustrates a perspective view of a preferred embodiment of the head
 immobilizer in its folded, operative condition attached to a spine board
 11. The head immobilizer includes an adjustable stable structure obtained
 by a middle wall 1 standing vertically with respect to the spine board 11
 and above the patient's head (not shown). The middle wall 1 in the
 operative condition restricts line hinges 7 from up and down movement in a
 first perpendicular plane and sideways movement in a second perpendicular
 plane, while still allowing vertical side walls 2 to be folded flat
 against the temple areas of a patient's head. Attachment flanges 6 for the
 side walls 2 are secured to the spine board 11 at an angle of
 approximately 90.degree. to the middle wall 1. This attachment locks the
 structure from movement in a third perpendicular plane. The patient's head
 is prevented from moving forward by restraining band 10 joining the two
 side walls 2 across the patient's forehead.
 FIGS. 2a and 2b illustrate top views of the device positioned around the
 head of a large adult and a small child, respectively. The structure of
 the head immobilizer permits a wide variety of head sizes to be
 accommodated. The head immobilizer of the present invention in its
 operative condition provides a stable structure by securing the vertical
 middle wall 1 and two side walls 2 to the spine board 11. The free corners
 of the boxlike structure are desirably held together by the restraining
 band 10 across the patient's forehead. This restraining band 10 prevents
 both lateral head motion as well as rotation of the head.
 FIGS. 3 and 4 illustrate, respectively, a plan view of the obverse surface
 of an embodiment of the invention in its flat, or inoperative, condition
 and a plan view of the reverse surface of the embodiment in its flat, or
 inoperative, condition, i.e., the two opposite sides of the blank of the
 present invention. The walls and flanges of the head immobilizer are flat
 sheets formed from, for example, corrugated cardboard, sheet plastic,
 injection molded plastic, or a comparable material. The head immobilizer
 in the flat condition can be stored in a minimum of space. Alternatively,
 the head immobilizer, in its flat condition, can be preattached to the
 spine board 11 at the correct position for folding into the operative
 condition when needed.
 The cutout opening 12 is formed in a substantial U-shape in a preferred
 embodiment of the invention. Those skilled in the art will understand that
 there is nothing particularly critical in the shape of the cutout opening
 12, which could as well be rectangular or have other archlike
 configurations. Thus the term "substantial U-shape" is intended to include
 within its scope these alternative designs. Opening 12 is cut out from the
 middle wall panel 1 and, when folded downward and inward, forms the head
 support extension panel 3. Attachment flange 5 forms a T-shaped flat panel
 structure with the head support extension panel 3 and is attached to the
 middle wall 1 on both sides of the cutout opening 12 by means of line
 hinges 8. The line hinges 8 are stamped as score lines in the sheet
 material or molded as film hinges. The side wall panels 2 are attached to
 each side edge of the middle wall panel 1 by means of line hinges 7. The
 line hinges 7 are also stamped as score lines in the sheet material or
 molded as film hinges. Attachment flanges 6 for the side walls 2 are
 attached to the lower edges of side walls 2 by means of line hinges 14.
 The line hinges 14 are stamped as score lines in the sheet material or
 molded as film hinges.
 The width of the middle wall 1 is preferably of a dimension such that the
 angle between the middle wall 1 and each side wall 2 can range from being
 greater than 90.degree. when the device is used for immobilizing a large
 adult head to less than 90.degree. when used on the head of a small child.
 The width of the side walls 2 must be of a dimension sufficient to allow
 the edges of side walls 2 to reach the temples just above the ears of a
 large adult head. It is known to be advantageous for head immobilizers to
 be configured in such a way that the ears of the patient are at least
 partially exposed and accessible to medical personnel to aid in providing
 emergency diagnosis and care. Thus the width of side walls 2 will
 typically be narrow enough so that they terminate above the ears of the
 patient. Alternatively, if wider side walls 2 are to be used, it will
 normally be advantageous to provide notches, openings, or apertures in
 side walls 2 for location adjacent the patient's ears. In this way
 exposure of the patient's ear can be provided to permit the patient to
 hear and to permit an attendant to observe and touch for diagnostic
 purposes and/or for administering drugs or medication. Specifically, the
 ear opening can provide important diagnostic information of the extent of
 injury by the type and amount of any fluid drainage. For example, bleeding
 from the ears may be indicative of a possible skull fracture.
 A foam pad 4 is preferably attached to the head support extension panel 3
 on the obverse surface of the device in its flat, or inoperative,
 condition, as shown in FIG. 3. The foam pad 4 and the head support
 extension panel 3 to which it is attached will stay flat against the spine
 board when the middle wall 1 is raised into the operative condition as
 shown in FIGS. 2a and 2b. Attachment means 9 are fixed to the outer edge
 of at least one of the side walls 2. In the preferred embodiment shown in
 FIG. 3, attachment means 9 are fixed to both side walls 2. For example,
 Velcro.RTM. brand or similar hook straps are affixed to the outer surface
 of at least one side wall 2 to provide suitable attachment means 9 when
 the restraining band 10 has complementary loop straps attached to its
 inside surface. It is understood that other conventional strap attachment
 means 9, such as cam buckles or pressure-sensitive adhesive pads, can be
 used.
 FIG. 4 shows adhesive elements 15 and 17 attached to the reverse surfaces
 of the attachment flanges 6 and 5, respectively. A suitable and preferred
 form of adhesive element is double-sided adhesive tape covered by a
 backing film material. The backing film material desirably extends beyond
 the adhesive elements 15 and 17 to form extension straps 16 and 18, which
 can be grasped without lifting the attachment flanges 6 and 5 from the
 surface of the spine board 11. These extension straps 16 and 18 of the
 backing film material can be folded back over the full length of the
 attachment flanges 6 and 5 for removing the backing film with a straight
 pull. Alternatively, the extension straps 16 and 18 can be folded at
 45.degree. angles as shown in FIG. 4 for removing the tape backing by
 pulling along the edge of the attachment flanges 6 and 5.
 The head immobilizer can be folded into its operative condition by pushing
 on the foam pad 4 through the cutout opening 12. This configuration, as
 shown in FIG. 3, causes the head support extension panel 3 and the
 attachment flange 5 to pivot around the line hinges 8 into a 90.degree.
 angle with the middle wall 1. The attachment flanges 6 are similarly
 folded outward at the line hinges 14 and the side walls 2 are folded
 inward in the direction of the foam pad 4. The folded structure is then
 positioned around the patient's head and the side walls 2 are aligned with
 the patient's temples just above the ears. When the device is properly
 aligned, the weight of the patient's head rests on the foam pad 4 and
 thereby holds the middle wall 1 in position, while the operator presses
 down on the middle wall 1 and pulls extension strap 18 along the flange 5
 to remove the backing material from the adhesive element 17. The
 attachment flange 5 is pressed firmly against the spine board 11 to secure
 its bonding to the spine board 11. The side walls 2 are then turned in
 against the patient's head while pulling the extension straps 16 to expose
 the adhesive elements 15, and the bonding is secured by pressing firmly on
 the attachment flanges 6.
 In an alternative embodiment of the invention, not shown, attachment
 flanges 6 are folded inward at the line hinges 14, rather than outward as
 described above. Those skilled in the art will understand that in this
 embodiment, adhesive elements 15 and extension straps 16 will be located
 on the obverse side of attachment flanges 6, rather than the reverse side
 as shown in FIG. 4.
 FIG. 1 illustrates the preferred embodiment of the invention in detail. The
 vertical middle wall 1 has a cutout opening 12 for access to the head of
 the patient. The middle wall 1 is attached to the spine board 11 by means
 of a 90.degree. attachment flange 5 adhesively or otherwise affixed to the
 spine board 11. Head support extension panel 3 rests against the spine
 board 11 on the other side of the cutout opening 12 and has a foam pad 4
 attached to its upper surface for support of the patient's head. Line
 hinges 8 are provided between the middle wall 1 and attachment flange 5 on
 both sides of the cutout opening 12. Side walls 2 are attached to each
 side of the middle wall 1 by means of line hinges 7, and both side walls 2
 are attached to the spine board 11 by means of the 90.degree. attachment
 flanges 6 adhesively or otherwise affixed to the surface of the spine
 board 11 following positioning of the side walls 2 against the patient's
 temples. The restraining band 10 is placed across the patient's forehead
 and is adjustably attached to the outer portions of both side walls 2.
 All the walls and flanges of the structure are made from rigid synthetic
 material, cardboard, or comparable material. The line hinges are formed by
 stamping grooves into the sheet material of the walls, gluing, or affixing
 the walls together with an overlapping film. Alternatively, the walls and
 flanges can be made by injection molding a film.
 The restraining band 10 is adjustably secured to the side walls 2 on at
 least one side. Securing can be accomplished by affixing means such as
 Velcro.RTM. brand or similar hook and loop tape or other conventional
 means. An attachment means 9 comprising a strip of Velcro.RTM. brand hook
 material is shown glued to the side wall 2 in this embodiment, and the
 restraining band 10 has Velcro.RTM. brand loop material on its inside
 surface.
 The restraining band 10 can be modified significantly within the scope of
 the invention. For example, the restraining band 10 can be tape which
 adheres to the side walls 2 or passes through slots (not shown) in the
 side walls 2 to form a loop, the end of which can be adhered to itself or
 the inner surface of the side walls 2. Alternatively, one end of the
 restraining band 10 can be permanently affixed to one of the two side
 walls 2. The use of at least one restraining band 10 with the invention is
 desirable in order to secure a patient's head for transport. The invention
 can be used to secure a patient's head in emergency situations without the
 use of a restraining band 10. Also, the use of a plurality of restraining
 bands 10 (not shown) can also be used.
 FIG. 2a shows a top view of an embodiment of the invention as it is used
 and positioned around the head of a large adult. The side walls 2 are
 positioned against the patient's temples above the ears as the patient
 lies on the spine board 11. The side walls 2 desirably form an interior
 angle greater than 90.degree. with the middle wall 1 and form a stable
 structure when the attachment flanges 5 and 6 are affixed to the spine
 board 11. The restraining band 10 is placed across the forehead of the
 patient and attached to both side walls 2. An extrication collar 13 does
 not interfere with the side walls 2 of the head immobilizer.
 FIG. 2b shows a top view of an embodiment of the invention as it is used
 and positioned around the head of a small child. The side walls 2 are
 positioned against the patient's temples above the ears as the patient
 lies on the spine board 11. This configuration is accomplished by turning
 the side walls inward to form an interior angle of less than 90.degree.
 with the middle wall 1 and not placing the patient's head as far inward
 toward the middle wall 1 as in the embodiment shown in FIG. 2a. The
 restraining band 10 is pulled across the patient's forehead, and both ends
 thereof are attached to the attachment means 9 on the side walls 2. An
 extrication collar 13 does not interfere with the side walls 2 of the head
 immobilizer.
 An alternative embodiment includes preaffixing the head immobilizer to the
 spine board 11. The operator aligns the device in its flat inoperative
 condition perpendicular to the center line of the board in a position
 where the patient's head is to be placed. The adhesive backing is removed
 from attachment flange 5 of the middle wall 1, and the bonding to the
 spine board 11 is accomplished by pressing firmly on the attachment flange
 5. The spine board 11 may be stored in this embodiment with the head
 immobilizer attached, ready for use.
 This alternative embodiment does not interfere with storage of the spine
 board 11 or placement of the spine board 11 under a patient. The head
 immobilizer is brought into the operative condition by grasping the upper
 edges of the middle wall 1 and both side walls 2 and folding them inward
 toward the patient's head and at an angle of 90.degree. to the spine
 board. This configuration causes all three attachment flanges 6 and 5 to
 fold at the line hinges 8 and 14.
 When placing the patient on the board, the operator ensures that the
 patient's head is in the correct position for use of the head immobilizer
 before immobilizing the torso on the spine board 11. Head immobilization
 is then performed by turning the side walls 2 against the patient's
 temples and securing the attachment flanges 6 to the spine board 11. The
 restraining band 10 is placed snugly across the patient's forehead and
 attached to the ends of the side walls 2.
 The invention provides an adjustable stable structure through a method of
 using the head immobilizers. The method involves placing the head
 immobilizer in the operative position with the middle wall 1 standing
 vertically with respect to the spine board 11 and above the top of the
 patient's head, which keeps the line hinges 7 from movement in two
 perpendicular planes, up-down and sideways. This step still allows the
 vertical side walls 2 to be turned against the flat temple areas of the
 patient over a wide variety of head sizes. Once the attachment flanges 6
 for the side walls 2 are secured to the spine board 11 at an angle of
 approximately 90.degree. to the middle wall 1, the structure is locked
 from movement in the third perpendicular plane. The restraining band 10
 across the forehead of the patient to the side walls 2 keeps the patient's
 head from moving forward.
 The preferred embodiment of the invention is a substantially flat structure
 that obtains its desirable characteristics when folded into the operative
 condition. However, this folding from a flat condition is not required for
 proper functioning of the invention. Also, the attachment flanges 5 and 6
 for attachment of the head immobilizer to the spine board 11 can be molded
 to an angle under 90.degree. or can be made from adhesive tape overlapping
 the lower edges of the vertical walls 1 and 2.
 The head support extension panel 3, the foam pad 4, and the cutout opening
 12 can also be significantly modified in structure, or even absent from
 the structure, and the head immobilizer of the present invention can still
 function.
 The benefits of the present invention over the type of head immobilizer
 described in U.S. Pat. No. 4,964,418, as well as other types known in the
 art, are numerous. For example, the head immobilizer of the present
 invention provides a rigid structure for prevention of lateral head motion
 and rotation of the head. Further, the head immobilizer of the present
 invention is a small structure that can easily be stored attached to the
 spine board without any part of the device extending over the edges of the
 board. Also, much less material is used to manufacture the head
 immobilizer of the present invention than is typically used in the
 production of prior art devices, and the design of the present invention
 permits minimization of manufacturing cost. Additionally, the head
 immobilizer of the present invention provides stabilization by resting
 against the flat surfaces of the temples just above the ears of the
 patient and does not interfere with an extrication collar placed around a
 patient's neck and jaw.
 From the foregoing, it will be obvious to those skilled in the art that
 various modifications in the above-described device can be made without
 departing from the spirit and scope of the invention. Accordingly, the
 invention may be embodied in other specific forms without departing from
 the spirit or essential characteristics thereof. Present embodiments,
 therefore, are to be considered in all respects as illustrative and not
 restrictive, the scope of the invention being indicated from the appended
 claims rather than by the foregoing description, and all changes that come
 within the meaning and range of equivalency of the claims are therefore
 intended to be embraced therein.