ROHO THE ADAPTOR and DRY FLOATATION Special Application Cushing Devices Operations Manual Dec 2015

TABLE OF CONTENTS INTENDED USES & PRODUCT SPECIFICATIONS

2-3

CAUTIONS

4

ADJUSTMENT INSTRUCTIONS

5-6

COVER REMOVAL & REPLACEMENT

7

CLEANING & DISINFECTING YOUR PRODUCT

7

TROUBLESHOOTING

8

REPAIRS

8

RETURN POLICY

8

DISPOSAL

8

LIMITED WARRANTY

9

ESPAÑOL

2-3

FRANCAIS

4

DEUTSCH

5-6

ITALIANO

7

NEDERLANDS

7

DANSK

8

SVENSKA

8

NORSK

8

SUOMI

8

PORTUGUES

9

ROHO, Inc. has a policy of continual product improvement and reserves the right to amend specifications presented in this manual. ROHO® Cushioning Products are manufactured by ROHO, Inc., 100 North Florida Avenue, Belleville, Illinois 62221-5429, www.therohogroup.com. U.S.A.: 1-800-851-3449, Fax 1-888-551-3449 Outside the U.S.A.: 1-618-277-9150, Fax 1-618-277-6518 e-mail: [email protected] © 2007-2008 ROHO, Inc. The following are trademarks and registered trademarks of ROHO, Inc.: ROHO®, DRY FLOATATION®, MINI-MAX®, PACK-IT®, HEAL PAD®, THE ADAPTOR®, AIR SPRING®, Yellow Rope®, shape fitting technology®. Velcro® is a registered trademark of Velcro Industries B.V.

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INTENDED USES & PRODUCT SPECIFICATIONS: The cushioning devices are designed to conform to a user's shape to protect skin tissue and aid in the prevention of tissue breakdown. ROHO, Inc. recommends that a clinician such as a physician or therapist experienced in seating and positioning be consulted to determine if the ROHO® cushioning device is appropriate for the user's particular needs. All devices in this manual are made of neoprene. Inflation valves are nickel plated brass. The cover top and side materials are 100% flame resistant polyester. The bottom material is 100% polyester reinforced PVC. A cover is not included with all products. THE ADAPTOR®

The ADAPTOR is intended to enhance soft tissue protection, absorb shock, and protect against shear and friction on surface shapes such as sides of wheelchairs, head and foot rests, or anywhere uncontrolled movement may need protection. The ADAPTOR is not intended to be used as a supporting medium under the buttocks. The ADAPTOR sizing specifications: Cell Height 0.5 in. (1.5 cm)

Width 9.5 in. (24.0 cm)

Depth 13.0 in. (33.0 cm)

Weight 0.5 lbs. (0 .2 kg)

HEAL PAD®

The Heal Pad is intended to provide a therapeutic environment which aids in the healing of heel and elbow ischemic ulcers. Heal Pad sizing specifications: Cell Height 0.5 to 1.5 in. (1.5 to 4.0 cm)

Width 11.5 in. (29.0 cm)

Depth 12.5 in. (32.0 cm)

Average Weight 0.75 lbs. (0.3 kg)

MINI-MAX®

The MINI-MAX is intended for users who: • Need sitting and shearing pressures minimized • Are at low risk for skin breakdown • Require shock and impact absorbtion

• Are active • Need skin protection

MINI-MAX sizing specifications: Cell Height 1.25 in. (3.0 cm)

Smallest Width 15.0 in. (38.0 cm)

Smallest Depth 15.0 in. (38.0 cm)

Largest Width 18.0 in. (45.5 cm)

Largest Depth 18.0 in. (45.5 cm)

Average Weight 2.0 lbs. (1.0 kg)

PACK-IT®

The PACK-IT is intended for users who: • Require shock and impact absorbtion • Are active • Have short term needs such as athletic competition, bathing, traveling; or scapular, sacral or lumbar support PACK-IT sizing specifications: Cell Height 1.0 in. (2.5 cm)

Width 16.0 in. (40.5 cm)

Depth 9.5 in. (24.0 cm)

Weight 1.0 lb. (0.5 kg)

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PRODUCT SPECIFICATIONS: RECLINER CUSHION

The Recliner Cushion is specially made to the dimensions of the client's chair and is intended to provide back and seating surface protection. If you are using a wheelchair with a sling seat, ROHO, Inc. recommends the use of the ROHO Contour Base, the ROHO Solid Seat Insert, or a drop seat in conjunction with your Recliner Cushion for best positioning results. Recliner Cushion sizing specifications: Contact ROHO Customer Service for details.

SHOWER/COMMODE SEAT

The Shower/Commode Seat cushion is designed to fit a shower/commode chair and is intended for users who: • Are at moderate risk to high risk for skin breakdown • Are able to perform independent weight shift

• Have partial or no sensation

Shower/Commode Seat sizing specifications: Cell Height 2.5 in. (6.5 cm)

Smallest Width 15.0 in. (38.0 cm)

Smallest Depth 15.0 in. (38.0 cm)

Largest Width 16.0 in. (40.5 cm)

Largest Depth 18.0 in. (45.5 cm)

Average Weight 2.0 lbs. (1.0 kg)

TOILET SEAT

The Toilet Seat cushion is designed for standard size toilets and portable bedside commodes. It is intended to provide stability and aid in securely positioning the user while helping to protect from a potential risk of tissue breakdown. Toilet Seat sizing specifications: Cell Height 1.0 to 2.5 in. (2.5 to 6.0 cm)

Width 7.0 in. (18.0 cm)

Depth 15.0 in. (38.0 cm)

Weight 1.25 lbs. (0.6 kg)

LUMBAR SUPPORT

The Lumbar Support cushion is intended to help provide relief from back pain or fatigue. Lumbar Support sizing specifications: Cell Height 4.0 in. (10.0 cm)

Width 6.0 in. (15.0 cm)

Depth 15.0 in. (38.0 cm)

Weight 1.25 lbs. (0.6 kg)

SACRAL SUPPORT

The Sacral Support cushion is intended to help prevent sacral sores and encourage proper positioning. Sacral Support sizing specifications: Contact ROHO Customer Service for details.

Note: The average weights are based on median sized cushioning devices. Note: Refer to Customer Service for specific cushioning device sizes. 3

CAUTIONS THE ADAPTOR AND DRY FLOATATION CUSHIONING DEVICES: • CHECK INFLATION AT LEAST ONCE A DAY! • WEIGHT LIMIT: The cushioning device should be correctly sized to the user. No weight limit on neoprene ROHO products if the product has been correctly sized to the user. • CUSHIONING DEVICE ORIENTATION: Product must be used with the air cells facing the user. For products with a provided cover, if the cover is not used correctly or if the cover is the wrong size, it may reduce or eliminate the cushioning device's benefits and could increase risk to the skin and other soft tissue. • PUNCTURE: Keep your cushioning device away from sharp objects, which may puncture the air cells and cause it to deflate. • HEAT/FLAME: DO NOT expose your cushioning device to high heat, open flames or hot ashes. • DO NOT use on top another cushioning product. • OBSTRUCTIONS: DO NOT place any obstructions between the user and the cushioning device, as it will reduce product effectiveness. • HANDLING: DO NOT use any valve as a handle for carrying or pulling your cushioning device. Carry your cushioning device either by the yellow nylon carrying rope (when applicable), the cover’s carrying handle, or by holding the cushioning device's base. • SOLUTIONS: DO NOT allow oil-based lotions or lanolin to come in contact with your cushioning device, as they may degrade the material. • OZONE GENERATORS: Prolonged exposure to ozone will degrade materials used in your cushioning device and may affect the performance of your product and invalidate the product warranty. Avoid prolonged exposure of the cushioning device to direct sunlight or other sources of ultraviolet (UV) light. • PRODUCT USE: DO NOT use your cushioning device as a water flotation device (e.g., a Life Preserver).

DRY FLOATATION CUSHIONING DEVICES ONLY: • UNDER-INFLATION: DO NOT use an under-inflated cushioning device. Using a cushioning device that is underinflated reduces or eliminates the cushioning device’s benefits, increasing risk to the skin and other soft tissue. If your cushioning device does not appear to be holding air, check to make sure that all valve(s) are closed by turning the inflation valve(s) clockwise. If your cushioning device is still not holding air, contact your clinical caregiver, distributor, or ROHO, Inc. immediately. • OVER-INFLATION: DO NOT use an over-inflated cushioning device. An over-inflated cushioning device will not conform to the user's shape and will reduce or eliminate the cushioning device’s benefits increasing risk to the skin and other soft tissue. • PRESSURE: Changes in altitude may require adjustment to your cushioning device. Check your cushioning device when changing altitude of 1,000 feet (300 meters) or greater. • CLIMATE: If a cushioning device has been in temperatures less than 32°F (0°C) and exhibits unusual stiffness, allow the cushioning device to warm to 72°F (22°C), then open inflation valve. Roll up the cushioning device and then unroll it until the neoprene is soft and pliable again. Repeat proper adjustment instructions before using. • DO NOT use any pump, cover, or repair kit other than those provided by ROHO, Inc. Doing so may damage the cushioning device and void your product's warranty.

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ADJUSTMENT INSTRUCTIONS FOR: • THE ADAPTOR Each of the AIR SPRING® ADAPTOR's cells is independently sealed, allowing it to be cut to fit various shapes such as sides of wheelchairs, trays, head and foot rests, inside of helmets, or anywhere uncontrolled movement may need protection. The ADAPTOR should be cut with scissors to the shape of the surface to which it will be applied. Cut between the air cells when possible. Air cells that are cut will provide no cushioning. ROHO, Inc. suggests using hook and loop fastener strips for attachment.

ADJUSTMENT INSTRUCTIONS FOR: • HEAL PAD

STEP 1 Lay HEAL PAD flat, with the cells facing up.

STEP 2 Turn valve counterclockwise to open. Slide pump's rubber nozzle over the valve and inflate until cells are firm. low height cells which make a “V” area. The higher cells should contact the back of the leg/arm. STEP 5 The heel/elbow should barely engage the low height cells. If not, release air by turning valve counterclockwise until desired contact is achieved.

STEP 3 Pinch the pump's rubber nozzle and turn valve clockwise to close. Remove pump.

STEP 7 Enclose smaller pad section around the sole of the foot and fasten snaps on either side to form a closed-end around heel/elbow.

STEP 4 With pad in this overinflated condition, place the individual’s heel/elbow on the

STEP 8 Place foam tab over shin/ arm, loop Velcro® strap through metal ring, and adjust strap to desired firmness.

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STEP 6 Visually or with a finger, check to ensure that the heel/ elbow is not touching the base of the HEAL PAD.

NOTE: DO NOT use an improperly inflated cushioning device. Underinflation and over-inflation of the air cells reduce or eliminate the product's benefits and could increase risk to the skin and other soft tissue. The Heal Pad is most effective when there is 1/4 inch (.5 cm) to 1 inch (2.5 cm) of air between the user's heal/elbow and the base of the HEAL PAD.

ADJUSTMENT INSTRUCTIONS FOR: • MINI-MAX

• PACK-IT

• RECLINER CUSHION

• TOILET SEAT

• LUMBAR SUPPORT

• SACRAL SUPPORT

• SHOWER/COMMODE

STEP 1 Place cushioning device on surface, making sure the air cells face the user (Use directional labels as a guide). If applicable, secure the cushioning device to the surface using its straps and/or snaps.

STEP 2 If the user will sit on the cushioning device, the air valve should be in the user's front, left corner. Consult your prescriber about alternative positions of air valves. Turn valve counterclockwise to open.

STEP 3 Slide the pump’s rubber nozzle over the valve and inflate the cushioning device until it begins to arch.

STEP 4 Pinch the pump's nozzle and turn valve clockwise to close. Remove pump. If applicable, repeat steps 1-4 for remaining valves.

STEP 5 Have the user sit, making sure the cushioning device is properly placed. The user should be seated in their normal sitting position.

STEP 6 Slide your hand between the cushioning device’s surface and the user. Feel for their boniest prominence.

STEP 7 Turn valve counterclockwise to let out air, while keeping your hand under the person’s boniest prominence. Release air until you can barely move your finger tips – no more than 1 inch (2.5 cm). For MINI-MAX and PACK-IT, no less than 1/4 inch (.5 cm), and for Recliner Cushion, Lumbar Support, Sacral Support, Shower/Commode, and Toilet Seat, no less than 1/2" (1.5 cm). Turn valve clockwise to close.

NOTE: DO NOT use an improperly inflated cushioning device. Under-inflation and over-inflation of the cushioning device sections reduce or eliminate the cushioning device's benefits and could increase risk to the skin and other soft tissue. Follow the specifications in the adjustment instructions. 6

COVER REMOVAL & REPLACEMENT: While a cover is not required, a ROHO cover is included with every MINI-MAX, PACK-IT and Recliner Cushion to help keep the cushioning device in place. To cover your cushioning device: 1. Unfold the cover with the non-skid material facing upward and zipper facing you. 2. Insert your cushioning device into the cover with the air cells down. 3. Carefully, close the zipper and turn the cushioning device over so cells are facing up. Your cushioning device is now ready for use as long as it has been properly adjusted (see Adjustment Instructions in this manual). If properly fitted, the cushioning device will lay flat on the surface (non-skid material on the bottom) with all cells covered. To remove the cover: Unzip and gently remove the cover from the cushioning device.

CLEANING & DISINFECTING YOUR PRODUCT: Cleaning and disinfecting are two separate processes. Cleaning must precede disinfection. Product must be cleaned, disinfected, and checked for proper functioning between multiple patient use. To Clean the Cover: First remove the cover from the cushioning device. Machine wash in warm water (40°C) with mild detergent, gentle cycle, or wipe clean with neutral detergent and warm water. Tumble dry low. To Disinfect the Cover: Hand wash in warm water using 1/2 cup household liquid bleach per quart of water (125 ml bleach to 1 liter of water), then rinse thoroughly. The cover can also be machine washed in hot water (60°C) to disinfect. Air dry. Note: Follow safety guidelines on bleach container. To Clean the Cushioning device: Remove the cover, close valve(s) and place in large sink. Use a soft plastic bristle brush, sponge or washcloth to gently scrub all surfaces. ROHO, Inc. suggests using a dishwashing soap, laundry detergent, or other multi-purpose detergent used for general cleaning. For institutional cleaning, a general housekeeping disinfectant cleaner may be used. Rinse with fresh water. Pat dry with towel or air dry. To Disinfect the Cushioning device: Repeat cleaning instructions above using a germicidal that meets infection control needs (ROHO, Inc. suggests a disinfectant with tuberculocidal properties). A solution of 1/2 cup liquid household bleach per quart of warm water (125 ml bleach to 1 liter of warm water) can also be used. Keep the clean cushioning device wet with bleach solution for 10 minutes. Rinse and dry per cleaning instructions. Note: Most germicidal disinfectants are safe if used following the disinfectant manufacturer’s dilution directions. To Sterilize the Cushioning device: ROHO, Inc. highly discourages sterilization methods using temperatures greater than 200°F (93°C). High temperatures accelerate aging and may cause damage to the cushioning device. If institution protocol demands sterilization, open the valves and use the lowest temperature possible for the shortest time possible. Gas sterilization is preferable to steam autoclave, but neither is recommended. If steam autoclaving, make sure all valves are open. NOTE: DO NOT use oil-based lotions, lanolin, or phenolic-based disinfectants on your cushioning devices as they may compromise the integrity of the neoprene.

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TROUBLESHOOTING: Not Holding Air: First, make sure all valves are closed tightly by turning valves clockwise. If still not holding air, visibly check for holes. If no holes are visible, close the valve and immerse an inflated section in sink or tub of water and look for air bubbles. If ‘pin-hole,’ sized holes are found, see “Minor Repairs” below. If large holes or other leaks are found, see “Repair Program” below. Uncomfortable/Unstable: Make sure product is not over-inflated. (see Adjustment Instructions). Make sure air cells and the cover’s stretch top are facing user. Make sure cushioning device is not too big or too small for the surface. Allow the user to use the cushioning device for at least one hour to get use to the texture of the product’s surface and immersion into the air cells. Cushioning Device Slides: Make sure non-skid bottom of the cover is facing away from user. Use directional labels on cushioning device and cover. Ensure straps and/or snaps are securely fastened. REPAIRS: MINOR REPAIRS: If your product develops a leak, use the repair kit that came with your product and follow the repair kit instructions. (Not included with The ADAPTOR) REPAIR PROGRAM: If you require a repair, you may return the product for assessment. Before returning the product to ROHO, Inc., contact our Customer Service Department at 1-800-851-3449 toll free in the U.S.A. for a Return Authorization Number. A Return Authorization Number must be obtained from ROHO, Inc. and a completed Return Authorization Form must be included with your product when returned. The Return Authorization Form can be obtained from our website at www.therohogroup.com or by contacting Customer Service. Outside the U.S.A., contact the nearest ROHO International distributor. See our website for current list of ROHO International distributors (www.therohogroup.com). Be advised that a charge will be assessed for any service provided for product that does not qualify under the product’s warranty. Failure to submit a Return Authorization Form may result in the product being returned without evaluation or repair. RETURN POLICY: All returns require prior authorization from ROHO Inc. and are subject to a restocking charge. Before returning your product, contact our Customer Service Department at 1-800-851-3449 toll-free in the U.S.A. Outside of the U.S.A., contact your country’s ROHO International distributor or contact ROHO International at 1-618-277-9150 for your nearest distributor. See our website, www.therohogroup.com, for a current list of ROHO international distributors. DISPOSAL: When properly used and disposed, there are no known environmental hazards associated with the components of the products in this manual. Dispose of the product and/or components in accordance with the applicable regulations in your jurisdiction. DO NOT INCINERATE.

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LIMITED WARRANTY: What is covered? ROHO, Inc. covers any defects in materials or workmanship of the product. Any substitutions of supplied hardware will void the warranty. For how long? 24 months from the date the product was originally purchased with the exception of covers, which have a 6-month limited warranty. What we will do. Within a reasonable amount of time after you return the product to us, we will repair any defect in material and workmanship and ship it back to you, all free of charge. What we will not do. We will not repair free of charge a product if it has been misused, damaged by an accident, or damaged from " an act of Nature", e.g., flood, tornado, earthquake, fire. What the customer must do. Within the U.S.A., the customer must contact ROHO, Inc. to obtain a Return Authorization Number and a completed Return Authorization Form must be included with the product when returned. The Return Authorization Form can be obtained from our website at www. therohogroup.com or by contacting Customer Service at 1-800-851-3449 toll free. Outside the U.S.A., contact the nearest ROHO International distributor. See website for current list of ROHO International distributors (www.therohogroup.com). Failure to submit a Return Authorization Form may result in the product being returned without evaluation or repair. Questions? Call our Customer Service Department toll free from U.S.A. at 1-800-851-3449. Outside of U.S.A. call your ROHO International distributor or the ROHO Customer Service Department at 1-618-277-9150. Disclaimer. Any implied warranties, including the MERCHANTABILITY and FITNESS FOR A PARTICULAR PURPOSE are also limited to warranties stated above from the date of original purchase and any action for a breach of such warranties or any express warranties herein must be commenced within this time. ROHO, Inc. shall not be responsible for any incidental or consequential damages with respect to economic loss or injuries to property, whether as a result of a breach of express or implied warranties, or otherwise. ROHO, Inc. will not be responsible for the results of careless handling, unreasonable or improper use of this product. Your Rights and the Effect of this Warranty upon Them. This warranty restricts the duration of all implied warranties as noted above and limits or excludes recovery for incidental or consequential damages. Some jurisdictions do not allow limitations on how long implied warranties will last and some jurisdictions do not allow the exclusion or limitation of consequential or incidental damages, so those provisions may not apply to you. While this warranty gives you specific legal rights, you may also have other rights which vary from jurisdiction to jurisdiction. 9