Ossur MIAMI J Instruction Manual

MIAMI J

®

Instructions for use

EN

Sizing & Application Instructions

2

A specific anatomical indicator best characterizes each of
these collar sizes:

200S

Super Short/Kyphotic

Does your
patient have a
kyphotic (chin­on-chest) neck?

• Kyphotic

• Chin-on-chest

• Geriatric

• Osteoporitic

and/or
ankylosing
spondylitic

200L

Stout

Does your
patient have a
very large neck
circumference?

• Very large

circumference

• Obese

• “No-neck”

• Massive

shoulders

250

XS

Does your
patient have a
very short, thin
neck?

• Very short thin

neck

• Principally female

• More prevalent in

the Asian
population

• Rare

SPECIALITY SIZES: <30% of Population

1 2

3

3

SIMPLE SIZING

STANDARD SIZES: >70% of Population

500

Tall

Does your
patient have a
long tall neck?

• Long, tall neck

• “Swan neck”

• Young women

• Adolescents

400

Regular

Is your patient
female?

• Female

• Standard size for
mature women

• Thin, mature

men

300

Short

All other adults.

• Standard size for

adult men

• Short-necked
women

A specific anatomical indicator best characterizes each of
these collar sizes:

Proper sizing is critical to achieving
comfort and proper immobilization.

5

6

4

4

INTRODUCTION:

FRONT

BACK

Occipital

Support

Chin

Support

Tracheal

Opening

Sternal

Pad

Angulation

Buttons

Hook and Loop Strap

Useful Terminology

5

The Miami J® collar sizes are phenotype-driven. By identify-

ing your patient´s phenotype according to the Sizing Silhou­ettes & Simple Sizing Questions, you may quickly determine
the appropriate collar size.

Collar size is best determined by observing the vertical dis­tance between the highest point of the trapezius and the top
of the chin when the head is in the desired treatment align-

ment.

QUICK SIZE CHECK:

(Optional Alternative)

Use your fingers to measure the
vertical chin-to shoulder distance.

On the collar, this measurement

corresponds to the distance from
the top of the hook and loop
strap to the bottom edge of the
collar plastic.

SIZE IT UP!

The Miami J® Simple Sizing Questions

1

Identify phenotype based on
patient characteristics.

2

Easily select appropriate
collar size.

6

Is your patient a child (12 years or under?)

SIZING TIPS:

Refer to Miami Jr.® Sizing and Application Instructions.

• If you are deciding between two consecutive

sizes, try the smaller size first.

• Use the largest size that st comfortably and

maintains desired treatment position.

• To insure proper sizing, it is a good idea to t

operative patients prior to surgery.

For your smallest, most important
patients, Össur oers the Miami Jr.®

pediatric collar line. These collars are
specifically engineered to meet the
unique anatomical needs of children

during the growth transition from
birth to adolescence. Please contact

Össur for more information about
these distinctive collars.

- Collar size may be incorrectly identied in the

presence of post-operative dressings and

swelling.

• Miami J® Fronts and Backs are interchangeable;
However, this is rarely necessary.

- e.g., To accommodate a larger neck circumfer-

ence with use of the 200S (Super Short), the Back
of the 200L (Stout) size may be substituted.

7

Application Instructions (Supine)

At least two persons are needed for initial collar placement:
one to maintain the patien´s head and neck in proper align-

ment, the second to t the collar.

SCOOP IT UP!

1

Remove any pillows from

behind the patient’s

head. Position patient
with arms to the side,
shoulders down and head

centrally aligned.

2

Slide the Back Piece

behind the patient´s
neck and center it.

Ensure the blue
Sorbatex™ padding
extends beyond the
edge of the plastic.

8

Application Instructions (Supine)

SCOOP IT UP! (cont´d)

3

Flare the sides of the
Front out, slide it up the
chest wall and

scoop it

up

under the chin.

4

Sides of the collar Front

should be oriented up, o

the trapezius, and toward

the ears.

Place the Front of collar
inside the Back.

5

While holding the Front

securely, curl the ends
snugly against the
patient´s neck. Apply the
hook and loop strap
and secure the opposite
side of the collar

in the
same fashion. Tighten
straps alternately, one
at a time, to an equal
length on both sides.

9

Application Instructions (Supine)

SNUG IT UP! (cont´d)

Hook and loop straps must be
aligned symmetrically and oriented
“blue-on-blue” to the Front

adhesive sections. When the
patient is properly fit, there should
be equal amounts of excess hook

and loop overhanging the Front
blue adhesive sections. These may

be trimmed.

6

Whenever

possible, t

the collar to a sitting
or standing patient.

Collar application must be secure to ensure proper t, main­tain alignment, and to prevent the chin from slipping inside.
If the patient can slip his/her chin inside the collar, it is clear
indication that it is not snug enough. It is nearly impossible

to t a properly sized collar too tight.

UPRIGHT APPLICATION:

To t the collar to a sitting or standing patient, follow the in­structions for supine application except apply the Front rst
with the Assist Strap.

Attach the Assist
Strap

Inside of

Collar Front

Hook and loop

Pile

10

UPRIGHT APPLICATION: (cont´d)

A unique feature of the Miami J® Collar is the optional Assist
Strap. This elasticized strap may be attached to the Front of

the collar.

The main purpose of this strap is to free the
hands of the person applying the collar, and it does not
need to be tight.

Assist Strap:

Bring the Assist Strap
around the back of the

neck and attach the white

portion loosely to the blue
hook and loop section on
the opposite side of the
collar.

“What is that extra strap for?”

• It assists the patient in applying the collar independently,

at home.

• It may be useful during routine skin care and hygiene. If /

when you logroll the patient to cleanse the back of the

neck and check for occipital pressure, the Assist Strap

allows the Front of the collar to remain in place and

maintain critical flexion control.

• For the predominantly supine Trauma or ICU patient, the

Assist Strap is unnecessary.

11

Angulation Buttons:

FINAL ADJUSTMENTS:

For a patient with a heart-shape
face, set the Chin Support
Buttons to top position.

For a square face, set the Chin
Support Buttons to bottom
position.

The Angulation Buttons may be used to fine-tune the fit of
the collar for better anatomical conformity, pressure distri-

bution and comfort. Minor adjustments in angulation of the
Chin and Occipital Support can signicantly reduce pressure

areaas at these critical contact points.

- Slide up to relieve chin tip pressure or discomfort.

- Slide down to relieve jaw/mandibular pressure or discomort.

Chin Support Positioning Guidelines:

It is easier to adjust
the Angulation

Buttons if you rst

remove the collar.

UNLOCK POSITION

LOCK

12

Occiput Support Positioning Guidelines:

FINAL ADJUSTMENTS (cont´d):

Please keep sternal pad with patient´s
belongings in case collar is prescribed
for long-term or at-home use.

Sternal Pad:

For a predominately supine patient keep Occipital
Support Buttons set to top position. this will direct
the top edge of the collar shell into the bed.

- Slide up to relieve occipital pressure or discomfort.

- Slide down to enhance extension control.

Other Modifications:

Upon physician recommendation, collar corners and
edges may be modified or trimmed to relieve discomfort
or pressure. Excess hook and loop strap may also be
trimmed as necessary.

The Miami J® includes a

removable sternal pad to
dstribute ambulatory pres­sure. It may be removed if
patient anatomy dictates, for
comfort during sleep and/or

during meals to ease chew­ing and swallowing.

13

FINAL CHECKLIST:

A properly applied Miami J® will look like the above illustra­tions:

Collar extends from mandible to just below sternal notch.
Chin is centered comfortably in Chin Support. Chin

should

not extend over edge of Sorbatex™ pad, nor fall

inside collar.

Collar hook and loop straps oriented blue-on-blue, both
tabs the same length.
Sides of Back should overlap sides of Front.
Front of collar angled up toward ears. Lower plastic edge

should not be resting on patient´s clavicles nor digging
into trapezius.

No plastic touching skin. Sorbatex™ pads extend beyond

all plastic edges.

No slack or gaps in any of the straps.

Tracheal opening and posterior vent are midline.

Collar sits away from the neck. There should be a “nger”
gap between the tracheal opening and the neck. If the col-

lar is fit too closely/tightly to the neck, size up to the next
taller size.

14

An improperly applied Miami J® will look like the top two
illustrations on the following page:

TROUBLESHOOTING:

Problem Solution

Lower edge of collar

digging into clavicle or
trapezius.

Re-

t anterior half of the

collar and direct sides up

toward the ears.

Align hook and loop
straps “blue-on-blue”

Collar t too closely / tightly

against the neck.

Size “up” to the next taller

size.

Assist Strap is in the way. Remove it.

Pressure or redness on

chin or occiput.

Remove pillows from be­hind patient´s head.

Check that Angulation

Buttons are properly set
and that routine skin care is
being performed.

Chin slips in collar. Snug it up!

Running out of hook and

loop

when securing the

collar.

Check size. Either the cir­cumference is too large or
the collar is too short.

Patient complaining of
chewing and swallowing

problems.

Remove Sternal Pad during

meals.

Other problems, questions,

or concerns?

Contact Össur Customer
Service, 1 800-257-84 40,
www.ossur.com

15

ADDITIONAL NOTES:

These instructions do not supercede hospital protocol and/
or direct orders of patent´s physician.

Just Right

Too Large

Too Small

Miami J® collars are for adolescent and adult patients. For
children 12 and under consult Miami Jr.® Sizing and Applica-

tion Instructions.

For instructions on proper care and cleaning of the Miami J®
collar, please consult the Miami J® Patient Care Handbook or
Routine Skin Care Instructions.

Össur Head Oce

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Tel + 354 515 1300
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P.O. Box 120
5690 AC Son en Breugel
The Netherlands
Tel: [phone]
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Kundenservice Deutschland
Augustinusstrasse 11A

50226 Frechen

Deutschland

Tel: [phone]
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[e-mail]

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Parque Európolis
Calle Edimburgo N°14
28232 Las Rozas – Madrid Spain
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P.O. Box 67
751 03 Uppsala, Sweden
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Manchester M22 5TG, UK
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www.ossur.com ©Copyright Össur 2010 IFU0268 Rev.2

MIAMI J

®

Instructions for use

EN

Sizing & Application Instructions