ARJOHUNTLEIGH CARMINA and CARMINA BASIC Instruction for Use Aug 2014

WARNING To avoid injury, always read this Instructions for Use and accompanying documents before using the product. Mandatory to read the Instructions for Use

Design Policy and Copyright ® or ™ are trademarks belonging to the ArjoHuntleigh group of companies. © ArjoHuntleigh AB 2013. As our policy is one of continuous improvement, we reserve the right to modify designs without prior notice.The content of this publication may not be copied either whole or in part without the consent of ArjoHuntleigh AB.

Contents Foreword ... 4 Intended Use ... 5 Safety Instructions ... 6 Preparations ... 7 Parts Designation ... 8 Product Description/Functions ... 10 Adjustable Back Rest ... 11 Tiltable Seat ... 11 Push Poles (only Carmina shower and commode chair) ... 12 Armrests ... 12 Footrest (only Carmina shower and commode chair) ... 13 Anti-Swivelling Guides (only Carmina Basic shower and commode chair) ... 13 Castors ... 14 Storage and Product Transportation (only Carmina shower and commode chair) ... 14 Entering the Chair ... 15 User Category ... 15 Independent Patients ... 15 Independent Patients (Carmina Basic shower and commode chair) ... 16 Dependent Patients ... 17 Dependent Patients (Carmina Basic shower and commode chair) ... 19 Transport the Patient ... 20 Shower the Patient ... 21 Toileting over a Conventional Toilet ... 22 At the toilet ... 22 Toileting by the Bedside using a Commode Container ... 23 Cleaning and Disinfection Instructions ... 24 Care and Preventive Maintenance ... 26 Troubleshooting ... 29 Technical Specifications ... 30 Labels ... 32 Parts and Accessories ... 34 ArjoHuntleigh Addresses ... Last page

3

Foreword Service and Support

Thank you for purchasing ArjoHuntleigh Equipment Your Carmina shower and commode chair for bariatrics is part of a series of quality products designed especially for hospitals, nursing homes and other health care use.

A service routine has to be done to your Carmina shower and commode chair to make sure the safety and operating procedures of your product. See section Care and Preventive Maintenance on page 26. If you require further information, please contact ArjoHuntleigh for comprehensive support and service programs to maximize the long-term safety, reliability and value of the product.

We are dedicated to serving your needs and providing the best products available along with training that will bring your staff maximum benefit from every ArjoHuntleigh product.

Contact ArjoHuntleigh for replacement parts. Contact information appears on the last page of this IFU.

Please contact us if you have any questions about the operation or maintenance of your ArjoHuntleigh equipment.

Definitions in this IFU

Please read this Instructions for Use thoroughly! Please read this Instructions for Use (IFU) in its entirety before using your Carmina shower and commode chair for bariatrics. Information in this IFU is crucial to the proper operation and maintenance of the equipment, will help protect your product, and make sure that the equipment performs to your satisfaction. Some of the information in this IFU is important for your safety and must be read and understood to help prevent possible injury.

WARNING Means: Safety warning. Failure to understand and obey this warning may result in injury to you or to others. CAUTION Means: Failure to follow these instructions may cause damage to all or parts of the system or equipment. NOTE

Unauthorized modifications on any ArjoHuntleigh equipment may affect its safety. ArjoHuntleigh will not be held responsible for any accidents, incidents or lack of performance that occur as a result of any unauthorized modification to its products.

Means: This is important information for the correct use of this system or equipment.

Means: The name and address of the manufacturer.

4

Intended Use Installation & Service Requirements

This equipment must be used in accordance with these safety instructions. Anyone using this equipment must also have read and understood the instructions in this Instructions for Use (IFU). If there is anything you do not completely understand, ask your ArjoHuntleigh representative.

The expected life of this equipment, unless otherwise stated, is ten (10) years, subject to preventive maintenance being carried out in accordance with the instructions for Care and Preventive Maintenance on page 26. NOTE Modifications made to the equipment without expressed consent of ArjoHuntleigh will invalidate the supplier's product liability.

Intended use Carmina The Carmina shower and commode chair is intended for hygiene care of hospital or nursing home adult bariatric residents. It shall be used during showering and toileting and to MOVE PATIENTS to and from shower and toileting. Residents shall be supervised by trained nursing staff and use shall be in accordance with the Operating and Product Care Instructions. All other uses must be avoided. Intended use Carmina Basic The Carmina shower and commode chair is intended for hygiene care of hospital or nursing home adult bariatric residents. It is designed for STATIONARY USE only during showering and toileting of residents. Residents shall be supervised by trained nursing staff and use shall be in accordance with the instructions outlined in the Operating and Product Care Instructions. All other uses must be avoided.

Resident Assessment We recommend that facilities establish regular assessment routines. Caregivers should assess each resident according to the following criteria prior to use: •

The resident needs to be able to sit in an upright position, normally defined as active or semi-active. • The resident’s weight shall not exceed 320 kg / 705 lbs. • The resident shall understand and respond to instructions. • The resident's length must be in the range of 148 and 190 cm (58 1/4” - 74 3/4”). If a resident does not meet these criteria, Carmina must not be used.

5

Safety Instructions WARNING Transport of patients is not allowed in Carmina basic because moving a chair without footrest can cause that patient's feet may be pinched or wheels to roll over patient's feet and cause injury.

WARNING Do not overload the Carmina. If you do, the chair may break and the patient may be seriously injured.

6

Preparations Site Preparations

To safely lower a patient using a passive lift together with the Carmina shower and commode chair the units must be placed according to the illustrations (top view) below.

To avoid the possibility of injury always make sure that: • the equipment is used by appropriately trained staff.

Front transfer

the patient's hands are resting in the lap during transportation. the Carmina shower and commode chair is moved with care, especially in narrow passages and over uneven surfaces.

•

the directions of driving during transportation is according to the illustration below.

ex. Maxi Move

100 mm (4”)

•

Side transfer

ex. Tenor

100 mm(4”)

•

0 50 mm(2”) 0 50 mm (2”)

Directions of the Carmina shower and commode chair The directions right, left, front and rear in this manual are given as below. • •

•

• •

rear

the castors and brakes work freely. the castors of the bed or other device are locked when transferring a patient to/from the Carmina shower and commode chair. if there is a drain cover in the area where the chair is manoeuvred, the drain cover must be smooth and set level with the floor. the slope of the floor does not exceed the ratio 1:50. transportation of patients is carried out only on hard floors.

right

front

NOTE If you have any questions, please contact your local ArjoHuntleigh representative for support and service. The contact numbers appear on the last page of this IFU.

7

left

Parts Designation 1

Push bar

2

Commode container with holder

3

Adjustable back rest

4

Tiltable seat

5

Push poles* 5a. Locking/release mechanism for push poles

6

Arm rests

7

Foot rest* 7a. Safety release mechanism for lowering of footrest 7b. Pedals for footrest manoeuvring

8

Castors

9

Anti-swivelling guide (only on Carmina Basic)

10 Strap to secure the footrest during storage/transport of the chair* * Parts of the product NOT included on Carmina Basic.

8

Carmina 6

3

1

7a 5 4

10

5a 7b

8 7

Carmina basic

2

9

9

Product Description/Functions Fig. 1

Push Bar In order to get the correct position for the carer to push (manoeuvre) the chair. A full-length push bar is integrated (located) at the rear of the chair with enough room for multiple gripping positions from more than one caregiver. (See Fig. 1 and 2)

Fig. 2

Commode Container with Holder The container can be applied by raising the seat upwards and lowering the commode container into position. Alternatively, it can also be placed in position from the back under the seat. Fig. 3

(See Fig. 3 and 4)

WARNING To make sure that the genitals of the patient not get pinched between the seat and container, make sure that: • the container is correctly placed (i.e. fully pushed in to the holder). Fig. 4

• the patient sits centred over the opening in the seat. The holder is articulated to move freely over the toilet. NOTE Place the commode container with the sockets of the handle vertical to the seat. (See Fig. 4)

10

Fig. 5

Adjustable Back Rest Adjustable into four different positions to provide additional support for different size patients. Place in a suitable position before placing the patient. The larger the patient, the further back the back rest should be placed. The angle of the back rest adjusts itself for the patient. (See Fig. 5)

WARNING Do not let the patient use the back rest for support during transfer to/from the chair. The back rest is movable and the patient may fall if using the back rest as a support.

Tiltable Seat Fig. 6

The seat has a comfortable design and can be folded up for cleaning/disinfection and access to the commode container. To fold up, grip the seat and pull up. The seat can then be kept in position by placing it in the support grooves. (See Fig. 6)

WARNING Do not put seat on frame without making sure it is properly placed on the frame. Patient may fall if seat is not properly placed.

11

Push Poles (only Carmina shower and commode chair) Fig. 7 A

When placed at the front of the chair, the push poles enable easier manoeuvring for nursing staff, especially through doorways and to/from toilet. In this position they can also be used by the patient for support when sitting down/standing up. The push poles can be swung away when not in use, ensuring complete access to the patient for general nursing procedures. The push poles can also be placed in the back position for easier side transfers.

B

Procedure for locking of the poles (3 steps) 1 Remove the pin. (See Fig. 7A) 2

Swing the push pole into its front position. (See Fig. 7A)

3

Put the pin in the hole until it is fully inserted. (See Fig. 7B).

WARNING Never use push poles in front position without locking them. If not locked, they can move away unexpectedly when used for support and cause patient to fall.

WARNING Avoid having the patient’s hands anywhere else but on the armrest when swiveling the push poles. If hands get between the frame and moving parts they may be pinched and injured. Fig. 8

Armrests Provide support to the patient’s arms when sitting in the chair. Can be folded up to allow caregiver access for hygiene or for easier patient side transfers.

WARNING Never pull the armrests. If the patient do so, the plastic cover can snap off and the patient may fall. Removing and assembling of the plastic covers should only be done during cleaning and never when the patient is in the chair. (See Fig. 8)

12

Footrest (only Carmina shower and commode chair) When flat to the floor: •

Fig. 9

Possible for the patient to stand on when entering/exiting the chair.

• Acts as a brake when resting on the floor. An elevated footrest position provides a comfortable sitting position, lift access, and enables safe transportation to shower room/toilet.

A

Elevating the footrest • Press the pedal towards the floor. (See Fig. 9A) The footrest will lock into position. To lower the footrest (2 steps) 1 Press the pedal all the way to the floor. With the pedal in this position, pull the knob of the safety release mechanism (See Fig. 9B), which will release the locked position of the footrest.

B

2

Gently bring the pedal up to the starting position.

WARNING Never lower the footrest with anyone's feet under it. Feet may be pinched between footrest and floor.

WARNING Never use the footrest as a step when it is in the elevated position. If doing so, the chair and patient will fall over and seriously injure him/herself.

Anti-Swivelling Guides (only Carmina Basic shower and commode chair)

Fig. 10 A

B

When smaller corrections have to be done in positioning of the chair, apply the guides to eliminate the risk of getting the patient’s feet jammed between the castor and the frame. • Apply guide (See Fig. 10A) • Release guide (See Fig. 10B) Apply the guides before the patient is in the chair.

WARNING Never move the chair with patient in it without applying the anti-swivelling guides. Moving the chair without guides engaged can cause wheels to roll over patient's feet and cause injury.

13

Castors

Fig. 11 A

B

The Carmina shower and commode chair is equipped with four individual braked castors. •

Apply the castor brakes. (See Fig. 11A)

•

Release the castor brakes. (See Fig. 11B)

Storage and Product Transportation (only Carmina shower and commode chair) Fig. 12

(5 steps) In order to provide easier access through doorways when the patient is not in the chair, the footrest can be folded away. 1

Apply the castor brakes. (See Fig. 12)

Fig. 13

2

Elevate the footrest. (See Fig. 13)

Fig. 14

3

Lift the footrest all the way up. (See Fig. 14)

Fig. 15

4

Fasten the safety strap. (See Fig. 15)

Fig. 16

5

Attach both pedals to the plastic hooks. (See Fig. 16)

14

Entering the Chair User Category Fig. 1

Independent patients: • •

Mobile patient, walking Pivot transfer, from bed/wheelchair

Dependent patients: • • Fig. 2

With mobile lifter (i.e. Tenor, MaxiMove) With ceiling lift

Independent Patients From a standing position (8 steps) 1 Make sure that the footrest is flush to the floor 2

Apply brakes. (See Fig. 1)

3

Make sure push poles are swung out and locked into the front position.

4

Make sure that the armrests are in down position for support when seated.

5

Let the patient hold onto the push poles for support. (See Fig. 2)

6

WARNING

Fig. 3

Never use the footrest as a step when it is in the elevated position. If doing so, the chair and patient will fall over and seriously injure him/ herself. Let patient sit down and position. (See Fig. 3)

Fig. 4

7

Raise the footrest to the elevated position to enable transportation of the patient

8

Transport the patient to the shower or toilet. (See Fig. 4)

15

Fig. 5

Side transfer from wheelchair/bed For the patient to be able to move from a wheelchair/bed without lifting aids, the individual must be strong enough to move him/ herself sideways and/or be able to stand up. Pivot transfer (6 steps) 1 Lock the push pole (the one which is furthest away from the patient) into the front position. (See Fig. 5) 2

Raise the armrest and swing back the push pole, located closest to the patient (if applicable).

3

Apply the castor brakes. (See Fig. 6)

4

Make sure that the patient’s feet are on the floor or on the lowered footrest. (See Fig. 7)

5

Stand the patient up.

6

Pivot and let the patient sit down with help of the push poles. (See Fig. 8)

Fig. 6

Fig. 7

Independent Patients (Carmina Basic shower and commode chair) From a standing position (3 steps) 1 Apply brakes and the anti-swivelling guides. 2

Make sure armrests are in down position for support when seated.

3

Let patient sit down and position him/herself comfortably.

Fig. 8

16

Dependent Patients

Fig. 9

From the bed to the Carmina shower and commode chair using a ceiling lift (6 steps) (See Fig. 9) Follow the separate operating instructions for the ceiling lift.

Fig. 10

1

Prepare the chair by lifting up the footrest using the pedal.

2

Place the Carmina shower and commode chair under the ceiling lift with the patient in the sling.

3

Apply the castor brakes.

4

Lower the sling with the patient until he/she reaches the seat of the chair.

5

Unhook the sling.

6

Transfer the patient to the shower or toilet.

From a passive lift to the Carmina shower and commode chair (front transfer) (12 steps) (See Fig. 10) Follow the separate operating instructions regarding the passive lift (Tenor). 1

Make sure that the push poles are placed in the back position (away from the patient area).

2

Make sure that the armrests are in the raised position.

3

Raise the footrest to the up position to enable the legs of the lift to go underneath. The legs should be in their most closed position.

4

Place the lift with the patient as close as possible to the Carmina shower and commode chair.

5

Move the chair, not the lift, when inserting the legs of the lift through the front of the chair under the footrest. Make sure the patient is directly over the seat of the Carmina shower and commode chair.

6

Apply the brakes on the Carmina shower and commode chair.

7

Lower the lift until the patient reaches the seat.

8

Unhook the sling. Continue with the steps on the next page.

17

9

Remove the passive lift.

10 Lower armrests. Make sure that the patient can stabilize him/herself. 11 Place push poles in the front position and make sure they are locked. 12 Transport the patient to the shower or toilet.

Fig. 11

From a passive lift to the Carmina shower and commode chair (side transfer) (12 steps) (See Fig. 11) Follow the separate operating instructions regarding the passive lift (Maxi Move). 1

Make sure that the push poles are placed to the back position (away from the patient area).

2

Make sure that the armrests are in the raised position.

3

Place the lift with the patient as close as possible to the Carmina shower and commode chair.

4

Raise the footrest to the up position to enable the legs of the lift to go underneath. The legs should be in their most open position.

5

Move the chair over the legs of the lift, without moving the lift, through the side of the chair. Make sure the patient is directly over the seat of the Carmina shower and commode chair.

6

Apply the castor brakes.

7

Lower the lift until the patient is fully supported by the seat of the chair.

8

Unhook the sling.

9

Remove the passive lift.

10 Lower armrests. Make sure that the patient can stabilize him/herself. 11 Place push poles to front position and make sure they are locked. 12 Transport the patient to the shower or toilet.

18

Dependent Patients (Carmina Basic shower and commode chair) Fig. 12

From the bed to the Carmina Basic shower and commode chair using a ceiling lift (4 steps) (See Fig. 12) Follow the separate operating instructions regarding the ceiling lift.

Fig. 13

1

Place the Carmina Basic shower and commode chair under the ceiling lift with the patient in the sling.

2

Apply castor brakes and the anti-swivelling guides.

3

Lower the sling with the patient until the patient is fully supported by the seat of the chair.

4

Unhook the sling.

From a passive lift to the Carmina Basic shower and commode chair (front transfer) (7 steps) (See Fig. 13) Follow the separate operating instructions regarding the actual lift (Tenor). 1

Make sure that the armrests are in the raised position.

2

Move the chair, not the lift, when inserting the legs of the lift through the front of the chair. Make sure the patient is directly over the seat of the Carmina Basic shower and commode chair.

3

Apply castor brakes and the anti-swivelling guides on the Carmina Basic shower and commode chair.

4

Lower the lift until the patient is fully supported by the seat.

5

Unhook the sling.

6

Remove the passive lift.

7

Lower armrests. Make sure that the patient can stabilize him/herself.

19

Transport the Patient WARNING Transport of patients is not allowed in Carmina Basic shower and commode chair because moving a chair without footrest can cause that patient's feet may be pinched or wheels to roll over patient's feet and cause injury. The Carmina shower and commode chair is pushed from the rear by multiple nursing staff members, using the full width push bar and with the patients feet on the raised footrest. (See Fig. 1)

WARNING Never leave the patient unattended. There is a risk of injury if the patient wants to leave the chair using the footrest as a step as it is in elevated position.

WARNING When transporting the patient in Carmina shower and commode chair, the patient's hands shall be resting in the lap. This is to avoid the patient's hands to get pinched against doorposts.

Fig. 1

20