Halo Immobilization/Halo Vest

Halo Immobilization/Halo Vest 

Purpose: 

This device maintains alignment of the cervical spine after spinal surgery or spinal fractures, promoting early stabilization of the vertebral column, as ordered by the physician. 

Policy: 

The licensed nurse is responsible for overall care, including pin care, skin care, assessment of skin integrity, and documentation. 

Procedure: 

I. Explanation and Privacy: 

• Explain the procedure to the resident. 

• Ensure privacy during care. 

II. Pin Care: 

• Monitor for pain and discomfort around the pin sites, loosening of pins, complaints of “something moving.” 

• Clean the area of penetration daily per MD order. 

• Remove any crust or drainage. 

• Gently move the skin to ensure no adhesion to the pin or underlying tissue. 

• Dry sites thoroughly. 

• Note: Iodine-containing ointment is not recommended for daily use. 

III. Skin Care: 

• Release each shoulder belt one at a time. 

• Wash underneath the belt with a facecloth. 

• Do not use powders, soaps, or lotions under the vest. 

• Inspect the skin for any abnormalities in skin integrity. 

IV. Repositioning: 

• Turn the resident and the brace as a unit. 

• Avoid contact of the halo with metal objects (e.g., metal side rails) to prevent conduction into the bone. 

V. Shampooing Hair: 

• Determine the best position for shampooing, such as kneeling on a chair and leaning over the sink. 

• Dry hair with a handheld dryer or air dry. 

• Complete pin care after shampooing to remove soap residue. 

VI. Potential Issues Requiring Physician Notification: 

• Numbness under the vest. 

• Foul odor or drainage from the vest. 

• Break or crack in the vest. 

• Unexplained fever of 101°F or higher. 

• Loose pins. 

• Unrelieved pain after administration of pain medication or new pain. 

• Clanking noise.