APPLICATION INSTRUCTIONS (APPLICABLE WITH PATIENT SUPINE OR UPRIGHT)
1. Ensure the padding extends beyond the edge of the plastic and the Sternum Relief Knob is oriented vertically as shown in Figure 1.
2. Remove any pillows from behind the patient’s head. Position patient with arms to the side, shoulders down, and head centrally aligned.
3. Slide the Back Panel behind the patient’s neck and center it. Note up orientation marks on the panel. (Figure 2)
4. Slide Front of brace up the chest wall and scoop it up under the chin, aligning the front edge of the collar’s Chin Support with the front of the chin. (Figure 3)
5. Assess approximate neck height and adjust accordingly. Either on or off the patient, depress Height Adjustment Button and manually raise or lower the chin support relative to the sternum contact. (Figure 4 & 5)
6. When desired height is attained, release Height Adjustment Button to lock in place.
7. Verify that desired height is achieved on both sides of the brace. If not, depress Height Adjustment Button and correct. Make collar height micro adjustments as necessary.
8. While holding the Front securely, place the sides of the collar Front within the sides of the Back Panel. Apply the Hook Straps of the back panel to the Hook Landing Areas on the front. Tighten straps alternately, one at a time, to an equal length on both sides. (Figure 6)
9. If further height adjustment is required, depress Height Adjustment Button and manually move to position. Use the Height Indicator Marks to record patient’s collar height. (Figure 7)
10. When desired position is attained, engage the Patient Compliance Lockout located behind the Height Adjustment Button by moving the lever to the left. (Figure 8)
11. Hook Straps must be aligned symmetrically with respect to the Hook Landing Areas. When patient is properly fit, there should be equal amounts of excess straps overhanging the Hook Landing Area. These may be trimmed, and optional Repeatable Fit Tabs can be added to the strap ends. (Figure 9)
ADDITIONAL FIT NOTES
1. Optional Repeatable Fit Tabs can be used to finish off trimmed straps to the front of the Hook Landing Areas. These provide a contact point for the patient to don and doff the collar to a repeatable position. To use, thread the strap end through the tab and attach to the hook molded into the tab. (Figure 10) Patient can then grab the tabs and pull to the same position on the front of the Hook Landing Area. With practice, the patient can repeat without the use of a mirror or other aids. 7 8
2. The blue Sternum Relief Knob adds a degree of freedom for the patient so that activities such as eating or talking can be performed with greater comfort. The knob turns 90 degrees clockwise when looking at the collar from the front. (Figure 11)
FINAL FITTING CHECKLIST A properly applied Miami J Select will look like Figure 12.
• 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 straps are aligned straight, 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 “finger” gap between the tracheal opening and the neck. If the collar is fit too closely/tightly to the neck, size up to the next taller size.