Arjo MAA2000-XS User manual

Arjo Sling
Arjo Slings User Guide
TM
MAX02360.INT
Issue 1
March. 2005

2
SECTION Page
No.
Introduction................................................. 3
Sling descriptions ........................................ 4-8
Residents gallery ......................................... 9-10
When using a sling always ensure 11-12
Maxislide...................................................... 13
Care of your Arjo slings ............................. 14
Identification of quick reference symbols. 15
Components of a sling ................................ 16
Sling Size Guide Tape ................................. 17
Lifting From a chair .................................. 18
Lifting from a bed ..................................... 19
Raising from the floor ............................... 20
At the toilet................................................ 21
2 Point Spreader Bar (Loop sling) ............ 22-25
Lifting from a chair ................................... 22
Lifting from a bed and using the soft
stretcher ..................................................... 23-24
Lifting from the floor ................................ 25
Patient specific Slings (Flites) .................... 26
Bariatric slings ............................................ 27
Standing and Raising slings- Loop and
Lock and Clip fixings.................................. 28-32
Boss Slings ................................................... 33-34
Walking jackets........................................... 35
Arjo Tailor Made slings.............................. 36
Sling Range and part numbers- Clip and
Loop & Bariatric......................................... 37-39
Warning and safety instructions................ 40
Contents

3
Using the correct sling for each patient is an
essential element of safe patient handling. In some
cases, medical and physical factors mean that a
patient's comfort and safety can only be assured by
the provision of a correctly fitted sling. Carers also
benefit from fitting the correct sling on a patient as
their work is made easier and there is less chance of
back injury.
Arjo has long experience of making slings with
people in mind.
A powered sling lifter offers the most secure
transfer method for many patient-handling
procedures. However, providing the optimum sling
for the patient and the purpose is vital in order to
ensure safety and comfort. A sling that is the wrong
size or a bad fit for its patient creates discomfort
and increases the risk of injury.
This guide has been produced to provide users of
Arjo slings with the help and information they need
to ensure safe and comfortable transfer of patients,
whether it's from a bed, the floor, a chair or the
toilet.
Introduction

4
Clip Slings
MAA2000-xx
Unpadded clip sling
The above has no padding in the leg area and
therefore is easier to apply to residents with
skeletal issues such as contractures and curvatures
of the spine. These slings are commonly used on
people who are in moulded wheelchairs.
MAA4000-xx
Padded sling
Padding adds a level of comfort to the leg area of the
slings. The Padding also helps to prevent the
material roping and creasing under legs.
MAA4060-xx
Mesh clip sling
The above is most commonly used for showering or
bathing. The mesh allows the water to pass through
the material therefore retaining less water when the
patient is being towel dried. This is a benefit when
the patient is hoisted back into their wheelchair or
onto a towel in bed. The porous material also allows
the skin to breath and can be left underneath the
patient.
MAA4031xx
Toilet clip sling
Used for toileting, dressing and undressing
patients. The padded arm supports provide the
comfort and support. Leg supports are padded for
comfort but again are narrower to allow clothing to
be removed. Careful patient assessment is
necessary before this sling is used.

5
Clip Slings
MAA4031xx
Extended leg padded clip sling
The leg pieces are extended by 100mm (4 inches) to
allow easier attachment of the leg clips. Used for
patients who have larger thighs and hips.
MAV4828/
Amputee clip sling with Velcro flap
Used on double amputee above or below knee. The
design allows easier application to the patient
rather than having to log role them in their chair or
bed. The sling is applied as with a normal sling and
the Velcro fastened to provide more support.
Right leg single amputee clip sling
Used for Left single leg amputee patients above,
below or total hip. The larger leg pieceprovides
more support to the stumps of the affected side.
Left leg single amputee clip sling
Used for Right single leg amputee patients above,
below or total hip. The larger leg piece provides
more support to the stumps of the affected side.
MAV4826 MAV4873

6
Clip Slings
Amputee clip sling
Used for Bilateral leg amputee patients with above
knee or total hip. The design requires the patient to
be log rolled onto the sling while on the bed or
rolled from side to side in a chair. The aperture does
not allow toileting.
Amputee clip sling with commode aperture
Used for Bilateral leg amputee patients with above
knee or total hip. The design requires the patient to
be log rolled onto the sling while on the bed or
rolled from side to side in a chair. The aperture
allows toileting of a patient who's lower clothing
has already been removed while on the bed.
MAA2090-xx MAV7121

7
Loop Slings
Unpadded loop sling
This sling has no padding in the leg area and is
easier to apply to patients with skeletal issues such
as contractures and curvatures of the spine. These
slings are commonly used on people who are in
moulded wheelchairs.
Padded loop sling
Padding adds a level of comfort to the leg area of
the slings. The Padding also helps to prevent the
material roping and creasing under legs.
Loop amputee sling
Used for Bilateral leg amputee patients with above
knee or total hip. The design requires the patient to
be log rolled onto the sling while on the bed or
rolled from side to side in a chair. The aperture does
not allow toileting
MAA1211-xx MAV1816
Loop toilet sling
Used for toileting dressing and undressing patients.
The padded arm supports provide the comfort and
support, which is lost when providing good access
to the patient's perineum area. Leg supports are
padded for extra comfort but again are narrower to
allow clothing to be removed.
MAV1848 MAV7123

8
Loop Slings
Right leg single amputee loop sling
Used for Left single leg amputee patients above,
below or total hip. The larger leg piece provides
more support to the buttocks and stump of the
affected side.
Left leg single amputee loop sling
Used for Right single leg amputee patients above,
below or total hip. The larger leg piece provides
more support to the buttocks and stump of the
affected side.
MAV1857 MAV1852

9
Residents Gallery
Residents in elderly care and other facilities are
very different, they have different diseases and
problems and different backgrounds yet they all
need to be offered a high quality of care.
Choices in care are made on the basis of
assessments of each resident, choices tailored to
their needs and desires as a "typical" resident does
not exist.
In order to plan care for residents there needs to be
a system of standardisation and classification. This
is the reason Arjo developed the Residents Gallery,
it is a classification of five typical residents based
on their degree of functional mobility. But it is more
than just a classification system; it offers colourful
images of five residents who you would actually
meet in real life health care settings. By envisaging
them it makes it possible to discuss choices in care
and rehabilitation in a realistic way.
We know them as Albert, Barbara, Carl, Doris and
Emma and they represent the five different mobility
levels (A-E).
ALBERT
CHARACTERISTICS
• Ambulatory, but may use a cane for support
• Independent, can clean and
dress himself
• Can tire quickly
• Stimulation of abilities is very
important
The resident is able to perform daily
activities by him- or herself without
assistance from another person, It is
possible that the resident needs
special aids or appliances. As a rule
there is no risk of physically overloading the carer.
Albert requires careful monitoring.
BARBARA
CHARACTERISTICS
• Uses walking frame or similar
• Can support herself to some
degree
• Dependant on carer who is
present in demanding situations
• Not physically demanding for
carer
• Stimulation of remaining
abilities (e.g. ambulation) is
very important
The resident is partly capable of performing daily
activities by him- or herself. However, the
assistance that is required is in general not
physically demanding for the carer/the nurse. The
assistance may consist of verbal support, feedback
or indications, but light physical assistance is also
possible. This assistance can be given in
combination with smaller aids (walking aids,
support or grips and handles) or adaptations in the
environment of the resident. Barbara's remaining
capacity should be stimulated.
CARL
CHARACTERISTICS
• Sits in wheelchair
• Is able to partially bear
weight on at least one leg
• Has some trunk stability
• Dependant on carer in most
situations
• Physically demanding for
carer
• Stimulation of remaining
abilities is very important
The resident is not capable of performing daily
activities by him- or herself, but is able to
contribute to the action or perform part of the action
by him- or herself The assistance would, if given
without special precautions, lead to the risk of
physically overloading the carer/the nurse. The
resulting load for the nurse would be in excess of
safe limits for manual handling or static loads. In
these cases it is necessary to use equipment that will
reduce the exposure of the nurse to safe levels. The
resulting load for the nurse would be in excess of
safe limits for manual handling or static loads.

10
In these cases it is necessary to use equipment that
will reduce the exposure of the nurse to safe levels.
At the same time these residents are able to actively
contribute to the movement and it is important for
the resident to maintain or improve this capacity as
much as possible. The assistance that is given in
these instances is, for example, transfer using an
active lifter. It is important to stimulate remaining
capacity and slow down deterioration of mobility.
DORIS
CHARACTERISTICS
• Sits in wheelchair
• No capacity to support
herself at all
• Cannot stand unsupported
and is not able to bear
weight, not even partially
• Dependent on carer in
most situations
• Physically demanding for
carer
• Stimulation of remaining
abilities is very important
The resident is not capable of performing daily
activities independently or to contribute to this
actively in any substantial or reliable way. The
assistance in this case will, without special
precautions, result in a risk of physically
overloading the nurse/carer. It is necessary to use
equipment that eliminates this risk of overloading.
The resident can, in this case, not contribute
substantially to this movement. In spite of this,
where- and whenever possible it remains important
to activate these residents. The assistance provided
in this case is for example the transfer with a
passive lifter. An extra point of attention in this case
is the prevention of the risks of immobility, (e.g.
give good skin care). It is important to slow down
deterioration of mobility.
EMMA
CHARACTERISTICS
• Passive resident
• Might be almost completely
bedridden
• Often stiff, contracted joints
• Totally dependent
• Physically demanding for carer
• Stimulation and activation is
not a primary goal
The resident is not capable of performing daily
activities independently or to contribute to these
activities actively. The assistance in this case will,
without special precautions, result in a risk of
physically overloading the nurse/carer. It is
necessary to use equipment that eliminates this risk
of overloading. In Emma's case it is not considered
important any more to stimulate her to contribute to
the movement and become active. Promoting or
stimulating mobility and activating the resident is
not a goal in the care plan anymore. Providing
optimum care and/or prevention of the
complications of immobility, e.g. good skin care,
are given priority. Transfers will in this case be
performed with for example a passive litter. The
aim is to avoid complications caused by long-term
confinement to bed and make her as comfortable as
possible.
Residents Gallery

11
The sling is smoothly fitted from the base of the
spine (coccyx) to the top of the head. (See fig 1 &
2) An indication of a badly fitted or wrongly sized
sling may be that the head support is 3 or 4" (76-
102mm) above (sling may be too large) or below
the top of the head (sling may be too small).
Arjo have now produced a sling-size guide tape to
act as a guide to fitting the correct size sling on a
patient. (See fig 3)
Instructions for using the sling-sizing
guide are as follows.
• Ensure that the tape is used the correct way
round. (Teal (seaweed green) colour - XXS at
the coccyx)
• Ideally the patient should be in a seated position
• Measure from the coccyx to the top of head. The
colour level with the top of the head indicates
the required size.
• If the size falls between two sizes always use the
smallest size
• Patient width and body proportions, should also
be considered and a professional judgement
made
• This sizing tool is only intended as a guide and
is an approximation. Other factors like the
patients physical disabilities, weight
distribution and general physique all need to be
taken into consideration.
• The tape can be used to make dimensional
records of patient for Tailor Made sling
Requirements. (See fig 4 )
When using a sling always ensure…
Fig. 1
Fig. 2
Fig. 3

12
Centre line stitching has also been introduced down
the back of Arjo slings to make it easier for carers
to see exactly where the patient should be
positioned in the sling. The centre line stitching
should be positioned along the patient's spine to
give the sling a perfectly centred fit.
Ensure the leg supports are placed smoothly under
the patient's thighs so that the attachment clips/
loops are between the patient's legs towards the
middle of the thighs. (See fig 5) Indications of a
badly fitted or wrongly sized sling may be the sling
clips/loops only just appearing between the patients
thigh, (sling may be too small) or the leg supports
of the sling digging into the back of the patient's
knees with the sling clips/loops several inches
above the front of the patients thighs (sling may be
too large).
During the lift, the patient will settle into the sling
as their weight is taken up. Ensure the sling
adequately supports the head and the patient's
buttocks are not slipping through the sling aperture.
(See fig 6) Should this happen stop the lift
immediately and retry with a smaller sling size.
When using a sling always ensure…
Fig. 4
Fig. 5

13
52% of accidents and injuries that are suffered by
nursing staff occur during manoeuvres in and
around the bed.
Nurses have always recognised that the principle of
sliding patients in bed reduces the effort, and have
traditionally used sheets and even plastic bags to
aid this movement.
The Maxislide is a unique, ergonomically designed
device having ultra-low friction properties, which
aid carers in moving or positioning patients whilst,
at the same time, encouraging good posture without
causing undue stress to either the patient or carer.
The Maxislide will also encourage patients to help
themselves wherever possible.
The Maxislide CD-ROM is available which can be
used as a user guide; its step-by-step instructions
take the user through the most commonly used
manoeuvres, showing at each stage how the
Maxislide should be used.
Maxislide
Maxislide CD

14
• The sling should be inspected before use. It is
essential that the slings, their stitching, their
straps, the trim and attachment clips are
carefully inspected. If the slings, trim or straps
are frayed or cut or the clips show any signs of
damage DO NOT USE. Consult the person
responsible for Patient/Resident care. The sling
should be withdrawn from use immediately and
replaced.
• If the sling label is missing or cannot be read the
sling should also be withdrawn from use.
• When laundering slings, they should not be
classified as linen, but as a medical accessory to
a patient transfer lifter and therefore classified
as a medical device.
• Slings should be cleaned and disinfected only in
strict accordance with the manufacturers
instructions. (Refer to sling instruction sheet
MAX. 81687- INT and MAX01510- INT,
supplied with every sling and covered briefly
below).
• DO NOT IRON.
• Slings may be air-dried.
• Before washing remove plastic stiffness from the
pockets in the sling and replace before use.
• Wash using normal detergents.
Chemical Decontamination: Sodium hypochlorite
(chlorine) 150-300 ppm (parts per million) or
milligrams per litre, Low temperature tumble dry
40ºC/104ºF (test house conditions).
We recommend that the sling is washed before
being used on the next patient, if suspected of being
contaminated or soiled.
•Note: If the slings are contaminated
or soiled then the following is a summary
of the washing and drying procedure.
•Note: Note: Always follow washing
guidelines indicated on the sling Washing
and Using instruction label, prior to
washing your sling. .
Care for your Slings

15
Identification of quick reference symbols
1. Stop and read Hoist Operating Instructions before using this sling
2. Maximum washing temperature °C
3. Do not iron
4. Do not tumble dry
5. Maximum weight to be lifted in kilograms - 190kg. Hoist lifting capacity may vary. Refer to hoist load
rating label
6. Sling only to be used on Arjo Sling Lifters
1. Stop and read operating instructions before using this sling
2. Maximum washing temperature (or 194ºF)
3. Do not Iron
4. Low temperature tumble dry
5. Maximum weight to be lifted in Kilograms (or 440lbs)
6. Date of Manufacture
7. Serial number of sling
8. Sling only to be used on these Arjo sling lifters
9. Space for ward/facility/patient name
1
24
5
6
3
1
2
3
4
5
6
7
8
9

16
Components of a Sling
Head piece
Stiffeners pocket
Stiffeners
Attachment clip
Shoulder strap
Leg strap
Leg piece with padding
Leg section
Body section
Head section

17
Please refer to the sling-sizing guide tape, which
can be used as a guide to which sling to use f
or which patient. See page 11for full instructions.
The measuring tape has centimetres and Inches on
it and is colour coded to represent to colour of the
sling needed for the patient.
Arjos standard sling range is now available in 8
sizes. Extra sizes have been added to lessen the gap
between each size and provide customers with
greater choice and better fit. (fig a)
Arjo standing and raising aid slings are available in
4 sizes (fig b).
All Arjo slings are tested to a maximum weight of
200kg or 440lbs.
This patient sling size guide is only an
approximation, other factors which must be
considered when selecting the appropriate sling
are:
• Patient's distribution of body weight, i.e. hips,
thighs, upper body.
• Patient's height, torso length.
• Patient's physical condition, i.e. amputee.
•Note: IF THE PATIENTS WEIGHT
FALLS INTO TWO SIZES OR THERE IS
ANY DOUBT ON CHOOSING THE
RIGHT SIZE SLINGS, ALWAYS GO FOR
A SMALLER SIZE.
Sling Size Guide
Sling tape size
Passive lifters sling range. Fig a
Active lifters sling range. Fig b
Sling size guide:
SIZE COLOUR WEIGHT RANGE
Extra Extra small Teal 0 - 25 Kg 0 - 55 lbs
Extra small Brown 25 - 35 Kg 55 - 77 lbs
Small Red 35 - 60 Kg 77 - 132 lbs
Medium Yellow 55 - 75 Kg 121 - 165 lbs
Large Green 70 - 120 Kg 154 - 264 lbs
Large Large Purple 100 - 140 Kg 240 - 270 lbs
Extra Large Blue 120 - 160 Kg 264 - 352 lbs
Extra Extra Large Terracotta 160 - 190 Kg 352 - 418 lbs

18
Using the Dynamic Positioning
System ((DPS) Clip Sling)
Ensure the spreader bar is securely attached to the
lifter before commencing with the lifting
procedure. ('Lock and Load' combi system jib
only).
Place the sling around the patient so that the base of
his/her spine is covered, and the head support area
is behind the head. Place each leg piece under the
thigh so that it emerges on the inside of the thigh.
(See fig. 1). You may wish to use the Maxislide to
help in this situation. For reference, see Maxislide
CD-Rom, Technique 24.
Ensure the positioning handle on the spreader bar is
facing away from the patient, and that the wide part
of the spreader bar is at, or just below shoulder
level. (See fig. 2).
Ensure that the Lifter is close enough to be able to
attach the shoulder clips of the sling to the spreader
bar. To accomplish this you may have to put the
patient's feet on, or over the chassis.
Once the Lifter is in position, first attach the leg
clips to the spreader bar; this will stop the patient
slipping down. Then attach the shoulder strap
attachment clips to the pegs on the spreader bar.
(See fig. 3)
If necessary, lower the spreader bar using the
handset control, being careful not to lower it onto
the patient, although if this should happen
inadvertently, there is a built in cut-out device
which will prevent any further downwards
movement. Do not continue to press the handset-
lowering button.
Raise the patient by operating the handset control,
move the lifter away from the chair then carefully
lift the positioning handle until the patient is
reclined in the sling - the head support will now
come into use. This is the most comfortable
position for transportation, as it reduces pressure on
the thighs. The angle of recline can be adjusted for
increased comfort, if the patient is restless, using
the positioning handle.
Before transportation, turn the patient to face the
attendant at approximately normal chair height.
This gives confidence and dignity and also
improves the Lifter mobility.
Fig. 1
P1146a,b
Fig. 2
P1392c
Fig. 3
P1392d, P1002a,b,c
•Note: If the handset button is
released during lifting or lowering,
powered motion will stop immediately.
Lifting from a chair

19
Position the patient onto the sling by rolling the
patient towards you then folding the sling in half
and placing it behind the patient's back (see fig. 1).
Position the sling carefully so that when rolled back
the patient will lie centrally on the sling (see fig. 2)
and check that the head support area of the sling
covers the patient's head. If the patient is unable to
be rolled, either because of their size or the fact that
they may be in pain, a Maxislide can be used to
slide the patient onto the sling. Refer to the
Maxislide CD-ROM for details of use.
Alternatively, the patient can be brought into a
sitting posture then position the sling as detailed in
the section "To Lift From A Chair".
Approach the bed with the open side of the spreader
bar towards the patient's head. (See fig. 3).
Using the adjustable width chassis, it is possible to
make adjustments to chassis leg widths to assist
manoeuvrability around obstructions, for example,
bed legs.
Position the Lifter so that the spreader bar is just
above
Using the positioning handle, tilt the spreader bar
until the shoulder attachment points can be
connected to the sling shoulder strap attachment
clips. (See fig. 4).
Press down on the positioning handle until
connection of the sling leg pieces is possible. (See
fig. 5) The leg pieces must be brought under the
thighs to connect up, this may involve supporting
one leg at a time to connect up. You may need to
lower the spreader bar a little more, using the
handset control.
Fig. 1
P1133b
Fig. 2
P1022a
•Note: When rolling the patient back
onto the sling, roll the patient slightly in
the opposite direction so that the folded
part of the sling can be brought out.
Fig. 3
P1393e
Fig. 4
P1395a, P1002 a,b,c
Fig. 5
P1395b
Lifting from a bed

20
Put the sling around the patient as before, either by
using the rolling, sitting or Maxislide method.
Put the sling around the patient as before, by using
the rolling or sitting up method or use the Maxislide
if the patient cannot be rolled or sat up, see
Maxislide CD-ROM Technique 27. Depending on
circumstances, space and/or position of patient etc.
approach the patient with the open part of the
chassis. Open the chassis legs if necessary, and lift
the patient's legs over the chassis as shown in fig 1.
The patient's head and shoulders could be raised on
pillows for comfort, if required, but this is not
essential when connecting up the sling to the
spreader bar.
With the open part of the spreader bar pointing
down towards the shoulders, attach the shoulder
strap attachment clips, as shown in fig 2 and inset.
The lifters brakes should be applied once the lifter
is in the correct position. This ensures the lifter does
not move and injure the patient.
Once connected, raise the hip and knee into
maximum flexion, and push down on the
positioning handle in order to connect the leg strap
attachment clips as shown in fig 3. This will have
the effect of raising the patient's head and shoulders
slightly.
When lifting from the floor, some attendants prefer
to connect the leg pieces first. This in particular
applies to the very large patient with large thighs. In
this case, raise the hip and knee into maximum
flexion, and attach the leg straps first, then tilt the
spreader bar towards the shoulders to enable the
shoulder straps to be connected.
When all the straps have been properly connected,
raise the patient from the floor in a semi-recumbent
position. Supporting the head can be comfortable
and reassuring for the patient. Once raised from the
floor, ensure the patient's legs are clear of the
chassis before continuing to lift. (See fig. 4). The
leg sections of the sling will tend to be fairly high
up the thigh, so straighten them out for added
comfort. The patient may be positioned in a chair,
or placed onto a bed. If the patient is prone to
extensor spasm, he/she may be lifted by the Arjo
passive lifter, but special attention should be paid to
supporting the legs during the early part of the lift.
Fig. 1
P1394a
Fig. 2
P1394b, P1002 a,b,c
Fig. 3
P1394c
Fig. 4
P1394d
Raising from the floor