DESCRIPTION OF PRODUCT: Synthetic, locking restraintfor wrist and ankle with integral swivels and pre-attachedpropylene straps with locks.

CAUTION: FEDERAL LAW(USA) RESTRICTS THISDEVICE TO SALE OR USEBY OR ON ORDER OF APHYSICIAN.

Applicable Products:Cat. No. 2214, 2215, 2216

INDICATIONS: (Ref: 23)

A patient in a supine position whocannot sit up requires extra vigilance.Should the patient vomit, he/she couldaspirate his/her vomitus and suffocate.Monitor constantly and be prepared tointervene at the first sign of danger.(Ref: 48)

ADVERSE REACTIONS:Severe emotional, psychological, andphysical problems may occur if apatient’s movement is severely limited.The patient may become agitated if thedevice is uncomfortable or severelylimits movement. Request assistancefrom a qualified medical authority to tryto find a less restrictive alternativeproduct or intervention. (Ref: 46)

I9281 101102

ADDITIONAL SAFETY INSTRUCTIONS ON

OTHER SIDE

If this device is applied too tightly,circulation will be impaired; If tooloose, the patient may be able to sliphis/her limb from the device. Checkcirculation frequently and monitor forskin discoloration. (Ref: 57)

- When a patient’s picking, pulling,scratching or peeling exacerbates askin condition, causes self-injury, ordisrupts wound site integrity. (Ref: 26)

- Patients who continually disrupt life-saving treatment (e.g., chronic tube-pulling which breaks the integrity of anIV line or self-extubation). (Ref: 24)

- When a patient’s pulling linesprevents the healthcare professionalfrom adequately monitoring the vitalsigns of the patient. (Ref: 25)

RECOMMENDED CLEANING:

Synthetic Leather: Sanitization (theremoval of a least 99.998 % oforganisms) can be achieved byentirely submerging product in 70 %Isopropyl Alcohol for 10 minutes.Ensure that the product is completelydry before applying to a patient.Disinfection can be achieved byapplying any OSHA approvedIntermediate level Disinfectant per themanufacturers guidelines. It isimportant to remember that productstreated with disinfectants should berinsed with water to remove anyresidual chemicals that may be left onthe product.

APPLICATION INSTRUCTION SHEETPOSEY® SYNTHETIC LOCKING CUFFS

Posey Co.5635 Peck RoadArcadia, CA 91006 USATel: 1-800-44-POSEYFax: 1-626-443-5014www.posey.com

We welcome your suggestions for improvingour products or service:

- These products are to be used onpatients assessed as being in extremedanger of injury to themselves or toothers. (Ref: 32B)

- Do not use limb restraints onpatients with dislocations, fractures oropen wounds on the affected limb.(Ref: 38C)

CONTRAINDICATIONS: (Ref: 38)Contraindications include, but are notlimited to the following conditions:

- Do not use limb restraints if the I.V.site could be compromised. (Ref: 38D)

- Aggressive, combative, agitated, orsuicidal patients should not be put intoa restrictive product unless they willreceive constant monitoring. (Ref: 17)

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Check both cuffs and straps forexcessive wear. Discard product ifeither the synthetic cuffs or thepropylene straps are cracked, worn,torn. Injury to the patient or to othersmay result if this product is used whendamaged or excessively worn. (Ref:103)

Do not attach the limb holder in a waythat the patient may use his/her teeth toremove the device or inflict self-injury.Additional body restraint (fifth point)may be required to prevent the patientfrom moving the line/wound/tube site towithin access of his/her hands. Refer toPosey Psychiatric and EmergencyDept. Product Book, Part No. M1031.)Always secure strap at a framejuncture which will not allow the strapsto slide in any direction, changing theposition of the product. (Ref: 47D)

Application Instructions:

Product 2214 is sized for the wrist and can be identified byboth the black thread on the cuff and the word "Wrist"stamped on the cuff.Product 2215 is sized for ankles and/or large wrists, andcan be identified by both the white thread on the cuff andthe word "Ankle" stamped on the cuff.

1. Wrap the cuff around the patient’s wrist/ankle and bringthe metal post through the appropriate adjustment hole.You should be able to insert one finger between thedevice and the patient’s limb.

2. Close the lock by securing to the metal post. Make surethat the lock “clicks” shut. If the lock is not completelyclosed it can suddenly pop open. Pull firmly on the lockto ensure that it is locked to the metal post.

Note: Restraint cuffs should be snug enough to ensure thata patient cannot remove their extremity from the restraint,but should not be so snug as to compromise circulation.

3. Wrap connecting strap around a juncture of the moveableportion of the bed frame. Ensure that strap is wrappedaround the frame at least once prior to passing the endof the strap through the metal lock.

4. Pass the end of the propylene strap through the metallock and push the lock closed. Pull firmly on the strap toverify that the lock is secure.

Note: If more than one-inch (1) protrudes through the lock,ensure that the lock and strap are out of the patients reach.Reposition if necessary. Excess strap protruding from thelock may allow the patient to grab the strap and exertsignificant pressure on the lock. This could damage the lock.

5. To open, insert key into lock and turn counter-clockwise.In an emergency, propylene straps may be cut to freethe patient.

Be sure to make Posey Universal keys readily available toall staff members at all times. In the event of an emergencyit is difficult to cut the straps on this Posey product.Extreme Caution must be used when using any type ofpadding with these cuffs. If the patient violently pullsagainst the padding it may compress, allow the patient tofree their extremity.

Posey Synthetic Locking Cuffs (Clean Cuffs)Cat. No. 2214 - Locking WristCat. No. 2215 - Locking AnkleCat. No. 2216 - Posey Crisis Bag with one set of 2214 WristCuffs and 2215 Ankle Cuffs.Cat. No. 1074 - Universal Posey Key

#1 Posey restraintsare labeled: Caution:Federal law (USA)restricts this device

to sale by or on order of a physician.All staff should receive proper inser-vice training so products are applied inaccordance with the manufacturer'sinstructions, state and federal regula-tions and the facility's policies and pro-cedures. Posters, Videos and Inservicematerials are available free from PoseyCompany.

#2 Restrictive prod-ucts should only beused within the care-fully defined and docu-

mented parameters of the patient’sIndividualized Care Plan (ICP) whichaddresses (but is not limited to) restora-tive nursing, patient release, and pressuresore prevention. The ICP is created afteran assessment by an interdisciplinaryteam which may represent (but is notlimited to) PT, OT, Nursing, thePhysician, and Social Services.

#3 NEVER use aPosey product as aseat belt in a mov-ing vehicle. Poseyproducts are not de-

signed to withstand the force of a crash.

#4 DO NOT exposeany Posey Product toopen fire, flame, orcontact with smok-ing materials.

Components such as fabric, webbing,thread, etc. are susceptible to ignitionand burning. The facility’ssmoking/no smoking policy should bevigorously enforced. Flame retardantfabric is available on request.

#5 Never crisscrossthe straps of a PoseyVest/Jacket in backof the patient unless

there is a positioning slot in the rearof the product. Any restraint appliedincorrectly and/or worn backwardsmay cause strangulation or injury.

#6 Secure straps of restrictive productsout of the patient’s reach at a junctureof the movable part of the bed frame atwaist level so the device will not tightenor loosen when any section of the bedis raised or lowered. Make sure thestrap will not slide in any direction,changing position of the device.

#7 After applying arestraint or self-release product;

always put all side rails in the UPposition.

Side rail covers, or gap protectors, espe-cially with split side rails, may be re-quired to keep the patient on top of themattress, and avoid entrapment zones.

If the patient’s bodyweight becomes sus-pended off the mat-tress by goingunder, around, over,through or betweenthe side rails, chestcompression andsuffocation couldresult.

Restraints with pelvic pieces may benecessary to reduce sliding down orpulling the restraint over their head.

#8 Hips should beheld securely againstthe back of the chairwhenever any typeof restrictive productis used. The strapsshould be at 45

degrees over the hips and securedunder the seat out of the patient’sreach. Make sure straps are secured at ajuncture of the frame and will not slide inany direction, changing position of thedevice. Use extreme caution with allcushions. If dislodged, patient injurycould occur. (see #9).

#9 Monitor to makesure the patient is notable to slide down, orfall off a chair seat.

If their body weight becomes suspend-ed off the chair seat, chest compres-sion and suffocation could result.

Restraints with pelvic pieces may be nec-essary to reduce sliding down orpulling the restraint over their head.

#10 Straps must always be snug, butnot interfere with breathing. Youshould be able to slide your open hand(flat) between the device and the patient.Make sure straps do not slide in anydirection, changing position of device.

#11 Always use quick-releasing ties(see drawings) or buckles to securestraps – they allow easy release in theevent of accident or fire. Restraintrelease should be an integral part ofthe facility's fire/disaster evacuationdrills. Straps can be cut with scissorsin an emergency.

#12 Patients inrestrictive productsrequire appropriatemonitoring per yourfacility’s policy.

Aggressive, agitated, restless patientsand/or those in danger of aspiratingtheir vomit require constant monitoringand a systematic review and evaluationof both physical and psychological status.

#13 Inspect before usefor broken stitches orparts; torn, cut or frayedstraps or fabric; or hookand loop fastener or

locks that do not hold securely.These products could fail, resulting ininjury or death. Destroy and discardthem. Straps must be long enough tosecure out of the patient's reach. DONOT alter products.

#14 Do not use Poseyproducts on toilets, oron any type of furniturewhich does not allowapplication as directed

in the product application sheet.Posey limb and torso restraints shouldNOT be used at home without constantsupervision of a licensed healthcareprovider, physician’s order and anIndividualized Care Plan.

WARNING Monitor patients appropriatelyper your facility’s policy!

Inappropriate and/or incorrect usage of any restrictive product may result in seriousinjury or death. The Posey Company recommends the following steps before anyrestrictive product is used:• Identify the patient’s symptoms.• Determine and remove, if possible, the cause of the symptoms. This may include

catering to individual needs and customary routines; increased rehabilitationand restorative nursing; modifying the environment; and increased supervision.

• If the cause cannot be determined and removed, attempt alternative treatmentsunder proper medical supervision.

• A restraint should be used only when practicable alternatives have failed. Theleast restrictive device that will protect the patient and others should be selectedand used for the shortest time while less restrictive alternatives are sought. It iscritical that the appropriate restraint is selected.

• Follow the directions on the Application Sheet accompanying each product.

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

How to Tie the Posey Quick Release Tie

45˚➔

➔

Just as patient behavior is not 100%predictable, no product is 100% fool-proof under all circumstances. Arestraint is not a substitute for goodnursing care. Patient safety requiresregular reassessment and appropriatemonitoring per your facility’s policy.A product that worked successfully inthe past may prove inappropriate asthe patient’s mental and physicalhealth status changes. Never applyany product you feel is unsafe andconsult with the proper medicalauthority if you feel a product isinappropriate for the patient.

J.T. Posey Company 5635 Peck Road•Arcadia, CA 91006-0020 USA•Tel. 800-447-6739 or 626-443-3143•Fax 800-767-3933 or 626-443-5014•www.posey.comI9200 020604© 1993 J.T. Posey Company. All rights reserved.

1. Wrap the attachment straponce around the movablepart of the bed frame leavingat least an 8" tail. Fold theloose end in half to create aloop and cross it over theother end. Make sure strapsare secured at a juncture ofthe frame and will not slide in any direction, changingposition of device.

2. Insert the folded strapwhere the straps cross overeach other, as if tying a shoeor making a tourniquet knot.Pull on the loop to tighten.

3. Fold the loose end in half tocreate a second loop.

4. Insert the second loop intothe first loop.

5. Pull on the loop to tighten.

Sizing Table for Posey ProductsAlways use the proper size product. Products that are too small or

large compromise patient comfort and safety and should not be used.

Binding Color Size Weight (lb./kg) Chest (in./cm)

White X-Small 60-90/27-41 28-34/71-86Red Small 80-120/36-54 32-39/81-99Green Medium 110-155/50-70 37-45/94-114Yellow Large 145-190/66-86 43-49/109-124Blue X-Large 180-230/82-104 47-52/119-132Black XX-Large 220-275/110-125 50-56/127-142Yel/Blk XXX-Large 265-305/120-139 54-60/137-152Blu/Blk XXXX-Large 295-340/134-155 58-64/147-163

Posey belts are not color-coded, but are also sized according to this table.Flame-retardant fabric is available on request.

Weight and size measurements give a general indication of the proper size. Individualphysical characteristics should be taken into account before the medical authoritydetermines the correct size. Refer to label on product for specific sizing indications.