Posey Twice-as-Tough, Cuffs for Stretcher User Manual

tWicE-As-touGH cuFFs For strEtcHEr

Applicable Products:

REF

2750, 2755

ApplicAtion

instructions

DEscription oF proDuct:

2750

A full body restraint for total immobilization in a supine position. For stretcher application only.

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;

posEY tWicE-As-touGH
cuFFs For strEtcHEr

REF

2750 Wrist pair, regular

stretcher (blue neoprene)

REF

2755 Ankle pair, regular

stretcher (red neoprene)

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.

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 alternate intervention or method of restraint.

ApplicAtion instructions:

(Connecting Straps) (repeat steps 1-4 for each side)

• 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.

1.

Place the cuffs on the stretcher at the wrist or ankle position.

2.

Bring the ends of the strap down through the inside of the side

rails so they do not interfere with the movement of the side rails.
read the end of the strap over the top, around the frame, and
connect the blue or red hook and loop together.

3.

Pull the strap snug.

4.

Position the patient on the stretcher.

ApplYinG tHE cuFFs (repeat steps 1-2 for each limb):

1. Wrap the neoprene piece (the blue or

red side should be positioned against
the skin) around the wrist/ankle. Attach
the black hook and loop pieces together,
followed by the blue or red hook and
loop pieces. e fuzzy piece should be
sandwiched between the two pieces of

FiG. 1

hook (fig. 1). Be sure to overlap at least
one inch (3 cm).

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 wrist/ankle to ensure proper fit. e cuffs
must be snug enough to prevent escape, but not interfere with
circulation.

rx onlY

MONITOR PER FACILITY POLICY. Check to ensure that:

• Straps cannot slide in any direction, tighten or loosen if the
patient pulls on them, or if the stretcher is adjusted;

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

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

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

• Be aware that a sudden mood swing may cause agitated or
aggressive behavior. Contact the medical team AT ONCE if this
occurs. No level of monitoring may avoid the risk of serious injury
to highly agitated or aggressive patients.

• Check the patient regularly to ensure that:

•

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.

STRETCHER SAFETY

• ALWAYS use Hospital Bed Safety Workgroup
(HBSW) (http://www.fda.gov/cdrh/beds/
modguide.html) compliant side rails in the UP
position and fill ALL gaps to reduce the risk
of entrapment.

• Use side rail covers and gap protectors to help prevent the patient’s
body from going under, around, through or between the side rails. A
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



© 2009 Posey Company. All rights reserved.

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

EC REP

MDSS GmbH
Schiffgraben 41
D-30175 Hannover, Germany

I9232 092309

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

© 2012 Posey Company. All rights reserved.

EC REP

MDSS GmbH
Schiffgraben 41
D-30175 Hannover, Germany

I9200B REV B 092412