Posey Application Instructions Instruction Manual

Twice-As-Tough® Cuffs 2700Q, 2700QL

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Application Instructions

DESCRIPTION OF PRODUCT: Padded limb restraints with double-security closure.

Indications for Use

• Patients assessed to be at risk of disrupting life-saving treatments (e.g., chronic tube pulling).

• Patients assessed to be at risk of line pulling, which may prevent monitoring of vital signs.

• Patients whose picking, pulling, scratching, or peeling exacerbates a skin condition, causes
self-injury, or compromises wound site integrity.

• Patients assessed as being in extreme danger of injury to themselves or to others.

Contraindications

• DO NOT use this device on a patient who is or becomes: suicidal, highly aggressive or
combative, self-destructive, or deemed to be an immediate risk to others, UNLESS the
patient is under constant supervision.

• NEVER use on a patient:

– With a dislocation or fracture on the restrained limb; or
– If an IV or wound site could be compromised by the device.

See the Posey Catalog for other options for such a patient.

2700Q/
2700QL

Adverse Reactions

• Severe emotional, psychological, or physical problems may occur if the applied device is
uncomfortable or if it severely limits movement. If the patient is likely to cause injury to
him/herself or others, get help from a qualified medical authority to find an alternative form
of intervention or method of restraint.

Application Instructions

• Before each use, check cuffs and straps for cracks, tears, and/or excessive
wear or stretch, cracked or broken buckles or locks, and/or that hook-and-loop adheres
securely, as these may allow patient to remove cuff. Discard if device is damaged.

• If you have any questions about patient safety, ask the appropriate medical authority for
alternatives.

The order of either application of the straps to the bed OR applying the cuff to the patient is to
be determined by the clinician/physician depending on the situation.

NOTE: ALWAYS secure both wrists to help prevent patient release.
APPLICATION OF CONNECTING STRAP ENDS TO THE BED OR
STRETCHER/GURNEY (Repeat steps 1 to 2 for each side):

1. Wrap the connecting strap at least once around a movable
part of the bed or stretcher/gurney, and out of the reach of the
patient (Fig. 1). Make sure that the connecting strap moves
with the patient when the bed height and/or the incline/decline
features are in use. If buckle does not fit an opening, use the
alternate method in Fig 2. Close the gray quick-release buckle
by sliding the male end into the female end (Fig. 3). The gray
QR buckle will only release when applying pressure on all three
buttons in Fig 3.

2. Once the buckle is in place and the strap is secured to the bed,
pull on the excess strap end to adjust to the desired length
between the cuff and the attachment point. Tie an overhand
knot with the excess strap directly below the QR buckle to limit
any unwanted adjustment. Secure the remaining strap end(s)
out of the reach of the patient.

APPLYING THE CUFFS (Repeat steps 1 to 4 for each side):

1. Wrap the neoprene piece around the ankle or wrist of the
patient. Attach the black hook-and-loop pieces together,
followed by the colored hook-and-loop pieces. The loop piece
should be sandwiched between the two pieces of hook (Fig. 4).
Be sure to overlap at least one inch (3cm).

2. Press the hook-and-loop closure together firmly and make
sure it adheres securely. Slide one finger (flat) between the
cuff and the inside of the patient’s ankle or wrist to ensure
proper fit.

3. Open the buckle and then twist the male end once before
inserting back in place with the female end (Fig. 5). Secure the male and female ends of
the cuff’s quick-release buckle, listen for “clicking” sound.

4. Adjust the connecting strap(s) length from the bed to allow desired freedom of movement
without compromising patient or caregiver safety. Ensure the remaining strap end(s) are
secured and out of the reach of the patient.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Fig. 5

TO LIMIT LOWER LIMB RANGE OF MOTION (Fig. 6):

1. Attach the cuff that is secured to the bottom right side of the

2. Criss-cross the straps and attach the cuff secured to the

3. Adjust connecting straps as necessary.

NEEDED (See Posey Catalog):

• If the patient pulls violently against the bed straps.

• To reduce the risk of the patient getting access to the line/wound/tube site.

• To prevent the patient from flailing or bucking up and down and causing self-injury.

MONITOR PER FACILITY POLICY. Check to ensure that:

• Bed attachment straps cannot slide in any direction. Tighten or loosen if the patient pulls

• Cuffs are attached in a way that the patient is not able to use his or her teeth to remove

• Cuffs are intact and not torn or damaged. DO NOT allow patients to ingest product material.

MONITORING

• Posey recommends constant direct supervision for patients deemed to be at risk of injury

• NEVER allow a patient to have access to any tool, utensil, or object that might be used to

• Be aware that a sudden mood swing may cause agitated or aggressive behavior. Contact the

• Check the patient regularly to ensure that:

BED SAFETY

• ALWAYS use Hospital Bed Safety Workgroup (HBSW) (https://www.fda.gov/MedicalDevices/

• Use side rail covers and gap protectors to help prevent the patient’s body from going under,

Rx ONLY

2700Q/
2700QL

Posey Twice-As-Tough Cuffs

REF

2700Q Universal QR, single strap cuff, regular size

REF

2700QL Universal QR, single strap cuff, large size

Patent Pending 29626361

Fig. 6

bed to the left ankle.

bottom left side of the bed to the right ankle.

ADDITIONAL OR DIFFERENT BODY OR LIMB RESTRAINTS MAY BE

on them or if the bed is adjusted.

the device.

to themselves or others. For times when direct supervision is not possible, monitor by line
of sight or by a video/audio device.

unlock or damage cuffs.

medical team AT ONCE if this occurs. No level of monitoring may avoid the risk of serious injury
to highly agitated or aggressive patients.

– Circulation is not impaired. Serious injury may occur if the cuffs restrict circulation.
– Cuffs are secure. Death or serious injury to the patient or others may occur if the

patient can remove the cuffs.

ProductsandMedicalProcedures/GeneralHospitalDevicesandSupplies/HospitalBeds/default.
htm) compliant side rails in the UP position and fill ALL gaps to reduce the risk of entrapment.

around, through, or between the side rails. Failure to do so may
result in serious injury or death if a patient becomes suspended or
entrapped. Posey offers a full range of side rail pads and/or gap
protectors to cover gaps.

ADDITIONAL SAFETY AND LAUNDERING

INSTRUCTIONS ON OTHER SIDE

Posey Products, LLC • 5635 Peck Road, Arcadia, CA 91006-0020 USA
Phone: [phone] • Fax: [phone] • www.posey.com

I9301 REV C 041718© 2018 Posey Products, LLC. All rights reserved.

Safety Information for the Use of Posey Torso and Limb Restraining Products

WARNING:

ALWAYS Monitor patients per facility policy.

Improper application or use of any restraint may result in serious injury or death.

RX ONLY. NOT FOR HOME USE.

order of a physician. For use in a licensed healthcare facility only.

Federal law (USA) restricts this device to sale by or on

STAFF TRAINING: Staff must have on going training and be able to demonstrate

competency to use this device in accord with: Posey instructions; your facility policies and
state and federal regulations (Federal Register, Part IV, 42 CFR Part 482.13(e)(5) and (f)(6); Posey
offers inservice training aids at no charge. Contact Posey online at www.posey.

com or call

toll-free at 1.800.447.6739 (press 5).

SELECTING THE RIGHT POSEY PRODUCT:

Refer to the Posey catalog to help select the

right device to meet individual patients’ needs.

BEFORE APPLYING ANY RESTRAINT:

• Make a complete assessment of the patient to ensure restraint use is appropriate.

• Identify the patient’s symptoms and, if possible, remove the cause. You may need to:
cater to individual needs and routines; increase rehabilitation and restorative nursing;
modify the environment; or increase supervision.

• Use a restraint only when all other options have failed. Use the least restrictive device,
for the shortest time, until you find a less restrictive alternative. Patients have the right to
be free from restraint.

• Obtain informed consent from the patient or guardian prior to use. Explain the reason for
restraint use to the patient and/or guardian to help ensure cooperation.

• A restraint must only be used in accord with the patient’s Individualized
Care Plan (ICP). The ICP is an assessment by an interdisciplinary team,
which may include, but is not limited to: PT, OT, Nursing, the Physician,
and Social Services. The ICP should include: restorative nursing; patient
release; and pressure sore prevention.

NOTE: Just as patient behavior is not 100% predictable, no product is 100% foolproof.

Patient safety requires regular reassessment and monitoring per facility policy. A product
that worked in the past may be inappropriate if the patient’s mental or physical health status
changes. NEVER apply any product that you feel is unsafe. Consult with the proper medical
authority if you have questions about patient safety.

ADDITIONAL WARNINGS:

1. ALWAYS monitor patient per facility policy. Be aware that
constant monitoring may be required for:

• Aggressive or agitated patients; and

• Patients deemed at risk of aspirating their vomit. This includes
patients in the supine position, or who are not able to sit up. If the patient vomits, he
or she could aspirate the vomit and suffocate.

• Be prepared to intervene at the first sign of danger. Such patients require frequent
review and evaluation of their physical and psychological status.

How to Tie the Posey Quick-Release Tie

1 2 3 4 5

1. Wrap the strap once around a movable part of the bed frame leaving at least an 8” (20 cm) tail. Fold the loose
end in half to create a loop and cross it over the other end.

2. Insert the folded strap where the straps cross over each other, as if tying a shoelace. Pull on the loop to tighten.

3. Fold the loose end in half to create a second loop.

4. Insert the second loop into the first loop.

5. Pull on the loop to tighten. Test to make sure strap is secure and will not slide in any direction.

6. Repeat on other side. Practice quick-release ties to ensure the knot releases with one pull on the loose end of
the strap.

2. NEVER alter or repair this product. ALWAYS Inspect before each use: Check for

broken stitches or parts; torn, cut or frayed material; or locks, buckles, or
hook and loop fasteners that do not hold securely. DO NOT use soiled or
damaged products. Doing so may result in serious injury or death. Dispose
of damaged products per facility policy for BIOHAZARDOUS material.

3. ALWAYS secure straps, to a movable part of the bed or chair frame, out of the
patient’s reach, using quick-release ties (see drawing below) or buckles. These

allow easy release in the event of an accident or fire. Test to make sure straps cannot
tighten, loosen, or slip and create excess slack. If this occurs, the patient may slide off
the chair or bed, increasing the risk of serious injury or suffocation. Restraint release is
an important part of facility fire and disaster drills. Straps can be cut with scissors in an
emergency.

4. NEVER use Posey products on toilets, or on any chair or furniture
that does not allow proper application as directed in the
Application Instructions. DO NOT use at home.

5. NEVER expose this product to open flame, fire, smoking materials,
or high heat sources. Some products may melt or ignite and burn. The

facility smoking/no smoking policy should be strictly enforced.

6. NEVER use a Posey product as a seat belt in a moving vehicle.

Posey products are not designed to withstand the force of a crash or
sudden stop.

LAUNDERING INSTRUCTIONS (if applicable):

• Fasten all buckles and locks to reduce risk of damage during wash and dry cycles. DO
NOT put buckles or locks through extractors. For maximum life, launder in a laundry bag.

• Before laundering, zip up and turn the product inside out to protect zipper.

• Hook and loop fasteners may collect lint after repeated use or laundering, reducing grip
strength. Fasten the “hook” to the “loop” before laundering to help prevent lint buildup.
As needed, use a stiff- bristle brush to remove lint from the “hook” side.

• These products, other than foam products, can be
machine washed under CDC* guidelines for material
soiled with blood or bodily fluid.

• For non-contaminated material, use lower temperature wash and dry cycles to extend
product life.

• For foam products:

Test Zippers or hook and loop fasteners before each use. DISCARD device if it does not
fasten securely.

STORAGE AND HANDLING:

• This device is designed for use in normal indoor environments.

• This device may be stored in ambient warehouse temperatures at normal humidity levels.
Avoid excess moisture or high humidity that may damage product materials.

*www.cdc.gov

AL WAYS use the proper size product. Products that are too small or large may compromise patient
comfort and could result in severe injury or death.

BINDING COLOR SIZE WEIGHT lb. (kg.) CHEST in. (cm)

White X-Small 60-115 (27-52) 25-32 (64-81)
Red Small 112-160 (51-73) 31-37 (79-94)
Green Medium 135-203 (61-92) 35-40 (89-102)
Yellow Large 160-225 (73-102) 38-44 (97-112)
Blue X-Large 180-247 (82-112) 42-48 (107-122)
Black XX-Large 220-275 (100-125) 46-55 (117-140)
Yellow/Black XXX-Large 265-305 (120-138) 54-60 (137-152)
Blue/Black XXXX-Large 295-340 (133-154) 58-64 (147-163)

Posey Belts are not color-coded, but are sized according to this table.
Flame-retardant fabric is available on request.
Patient weight and size are a general indicator only. Consider individual physical characteristics to choose the

right product for each patient. Refer to product label for specific sizing information.

Sizing Table for Posey Products

Posey Company • 5635 Peck Road, Arcadia, CA 91006-0020 USA • www.posey.com
Phone: [phone] or 1.626.443.3143 • Fax: [phone] or 1.626.443.5014

© 2013 Posey Company. All rights reserved.

I9200D REV A 051613