A PHOTOGRAPHICVACUUM GUIDE IMMOBILISATION TO THE VACUUM IMMOBILISATION MATTRESS MATTRESS 1

INSTRUCTION MANUAL

READ BEFORE USE

EDITION 1 : 8 SeptemberRAPP 2006 Australia Pty Ltd RAPP Australia Pty Ltd A PHOTOGRAPHIC GUIDE TO THE VACUUM IMMOBILISATION MATTRESS PAGE 2 2

This manual has been produced by RAPP Australia Pty Ltd for training purposes only and is not for sale.

First published 8 September 2006 in Australia by: RAPP Australia Pty Ltd 151 Patullos Rd Lara Victoria Australia 3212

Copyright © RAPP Australia Pty Ltd 8 September 2006

For any issues relating to this publication, contact: The Manager RAPP Australia Pty Ltd 151 Patullos Rd Lara Victoria Australia 3212

Email: [email protected]

This publication is copyright. Apart from reproduction permitted under the Copyright Act, no part of this publication may be produced by any means (whether electronic, micro copying, photocopying, mechanical or otherwise) without direct permission from RAPP Australia Pty Ltd.

EDITION 1 : 8 September 2006 RAPP Australia Pty Ltd A PHOTOGRAPHIC GUIDE TO THE VACUUM IMMOBILISATION MATTRESS 3

This manual is a basic guide to using the NEANN VIM (Vacuum Immobilisation Mattress)

If this manual conflicts with your Organisations protocols, you should follow those protocols in preference to the guidelines stated in this manual.

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TABLE OF CONTENTS

INTRODUCTION ……………………………………..…...…….. 5

FIELD USE OF THE VIM …………...……………...………….. 8 Edition 1 February 2004 RAPP Australia Pty Ltd VIM COMPONENTS ………………….………………...... 12

FULL BODY IMMOBILISATION ………….……………………. 16

ACCESSORIES FOR THE VIM …….…………………………. 26

CLEANING ………………………………………..……………... 28

SPECIFICATIONS ………………………………………………. 30

ORDER FORM …………………………………...……………... 32

TRAINING EVALUATION FORM …….………………………… 34

RAPP CONTACT DETAILS …………………………….………. 36

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INTRODUCTION

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INTRODUCTION

The management of the trauma patient requires a range of skills including scene management, safe work practices, hazard control, patient assessment and treatment.

This booklet — used in conjunction with a proper ‘Prehospital Trauma Management’ course and the manual ‘A Photographic Guide To Prehospital Spinal Care” freely downloadable at www.neann.com/psc.pdf, is designed to introduce the VIM in the patient’s overall care.

TERMINOLOGY

Prehospital personnel including , First-Aiders, Rescue Officers and other persons performing activities in the prehospital setting, will for standardisation, all be referred to as ‘Officers’ in this manual.

TRAINING

Officers should realise that there is no substitute for training and experience in trauma management. Each person must be thoroughly trained in all areas of prehospital trauma care.

The ideal situation is to have all members of the team qualified to manage all the steps presented in this manual. If unqualified members are present at a scene, they must perform under strict supervision of a qualified team member.

Frequent exercises need to be held to ensure that training levels are maintained. Practice will lead to high levels of competence and safety.

RAPP Australia Pty Ltd recommends that initial training of Officers in the use of the VIM is to include: 1. Review of this manual (supplied with each VIM) under direct supervision of an appropriately trained supervisor. 2. Practical hands-on applications of procedures presented in this manual in a training environment under direct supervision of an appropriately trained supervisor before use on actual patients.

RAPP Australia Pty Ltd recommends that ongoing training of Officers is to include: 1. Three monthly practical review in the use of the VIM in its intended environment,. 2. Twelve monthly theoretical & practical review .

Persons using the VIM without proper initial & ongoing training may place the patient and other Officers at risk of .

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EQUIPMENT

Officers must be familiar with the VIM, the way it operates, and it’s limitations. Every Officer should be competent to check and maintain the VIM in the field.

USING THE MANUAL

This manual is designed to be used in conjunction with a proper trauma management course, and must not be used in isolation.

COURSE BOOKLET

This booklet is written for Officers who have previous first-aid knowledge. It is designed for Officers with a minimum Level Two - Workplace First Aid Course.

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FIELD USE

OF THE

VACUUM

IMMOBILISATION

MATTRESS

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The NEANN Vacuum Immobilisation Mattress (VIM) is primarily a full spine / body immobilisation transportation device for multi-trauma patients with suspected spinal , but is also excellent as a transportation splinting device for patients with pelvic, NOF or extremity fractures, and for the intubated patient to prevent airway movement.

INDICATORS OF USE - SPINAL INJURIES The VIM is indicated for use as a full spine / body immobilisation device where:9-11

1. Signs & symptoms of potential or actual spinal cord / column injury exist

OR

2. Mechanism of Injury exists without signs & symptoms of spinal cord / column injury AND the patient has one or more of the following: : a. Unconscious or Altered Conscious State b. Alcohol / Drug Consumption c. Distracting Injury or Event d. Modifying Factors (including language barrier, extremes of age, intellectually disabled, bone disorders)

LIMITATIONS OF USE

Vacuum Mattresses made of PVC give only limited durability against glass, metal and other sharp objects found in the prehospital environment. Whilst the VIM provides greatly increased durability over PVC materials, if punctured, a mattress will not maintain it’s immobilisation ability. To significantly extend the long term life of the VIM, it is best to leave the VIM on the whenever possible, and to take the patient to the VIM, rather than VIM to the patient.

A Vacuum Mattress is of most benefit where the patient will require immobilisation for greater than one hour, or where the patient cannot lay flat on a Long Spine Board or .

Whilst a Vacuum Mattress gives excellent lateral body immobilisation, and greater than that of a Long Spine Board or Scoop Stretcher, a Mattress does not provide the same longitudinal immobilisation that is found with a Long Spine Board or a Scoop Stretcher. It is therefore strongly recommended that if the patient suffering a potential or actual spinal cord injury is to be carried any distance in a Vacuum Mattress, the Vacuum Mattress should be carried on a Long Spine Board or Scoop Stretcher.

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APPLICATION

Before applying the VIM, Officers should undertake the following steps of patient assessment (as appropriate).

1. The First Officer undertakes a full assessment of the patient before application of the VIM. This includes:

• Check safety, scene, and situation.

2. A Second Officer brings c-spine into neutral in-line position (unless contraindicated) and performs manual head stabilisation until Step 14 (page 22).

3. The First Officer continues the assessment by:

• Perform Primary Survey: i. Response ii. Airway iii. Breathing iv. Compressions V. Major Bleeds

• Perform Basic Care: i. Rest, ii Reassure iii. Oxygen iv. Position v. Pulse Oximeter w. ECG Monitor

• Perform A Vital Signs Survey: i. Conscious Status Assessment ii. Perfusion Status Assessment iii. Respiratory Status Assessment

• Perform A Secondary Survey: i. Motor/Sensory x 4 ii. Head iii. Spine iv. Chest v. Abdomen vi. Pelvis vii. Legs viii. Arms

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• Check AMPLE: i. Allergies ii Medications iii. Past medical history iv. Last oral intake v. Events leading up to injury

• Apply Other Spinal Equipment i. ii Cervical Extrication Device (if indicated) iii. Long Spine Board or Scoop Stretcher

• Apply the VIM 1. Lift the patient on the VIM using Long Board or Scoop Stretcher 2. Immobilise the patient to the VIM.

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COMPONENTS

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VIM

The VIM is the first of the new generation Vacuum Mattresses, utilising the latest materials, technology and manufacturing processes to provide improved durability and immobilisation.

Components of the VIM include:

Materials

The external cover of the VIM is made of a heavy duty, specialised and uniquely manufactured pure reinforced double coated Silik Elastomer™. This material provides a significant improvement over PVC, the standard material used by other Vacuum Mattresses. Improvements of Silik Elastomer™ include: • 10-15 times more expansive • Significantly improved abrasion, puncture and tear resistance • 100% airtight in comparison to the slow leaking PVC materials

The internal beads are of a newly developed material, offering significant improvements over the standard Styrofoam used in other Vacuum Mattresses including: • Higher density material preventing collapsing of beads • Significantly improved X-ray translucency

The new patented inner lining system provides a 21 multi-chamber configuration preventing the beads from moving around and clumping in comparison to other Vacuum Mattresses on the market.

Carry Bag

The VIM comes with a simple carry bag that allows for storage in the current Mercedes Ambulance vehicle, meeting the 20G standard.

VIM Carry Bag

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IMMOBILISATION STRAPS

The VIM comes with a range of straps which meets the latest requirements in spine immobilisation and include:

Blue Shoulder Black Arm Straps Straps

Green Pelvic Straps

Yellow Upper Leg Straps

Red Ankle Yellow Lower Straps Leg Straps

Straps are colour co-ordinated to assist in the application process using the following order: Green, Yellow, Red, Blue, Black.

Strap Attachment

Straps are attached with a Tri-Glide adapter to allow easy removal and replacement of straps when contaminated. It is recommended that a second set of straps be purchased for rapid changeover for cleaning purposes, and to allow for the rapid return of the VIM to service.

Tri-Glide Strap Attachment

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CARRY HANDLES

The VIM comes with 4 carry handles down each side for moving the VIM.

The handles should not however be used for carrying spinal injury patients. In these cases, the VIM should be Carry Handles carried on a Long Spine Board or Scoop Stretcher.

FOREHEAD STRAP

A uniquely designed forehead strap is supplied with VIM.

Forehead Strap

AIR VALVE

The Air Valve on the VIM is found on the underneath of the bag. Turn clockwise to close and seal the VIM to keep it rigid. Turn anticlockwise to allow air to enter the VIM.

Air Valve Battery Powered Suction Unit Attachment

VACUUM PUMPS

The VIM has 2 pumps available, either a hand or foot pump. An attachment is also provided to allow it to be connected to a battery powered suction unit including the Laerdal LSU or the Hospital’s suction equipment.

Hand Pump

Battery Powered Suction Unit & Attachment Foot Pump

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FULL BODY

IMMOBILISATION

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FULL BODY IMMOBILISATION

The following section is a detailed photographic guide to Full Body / Spine Immobilisation using the VIM. These techniques offered are based on current research and x-ray studies and offer the most up to date teaching.1-5

There is increasing questioning by some of the need to immobilise the full spine, with suggestions that immobilisation does not prevent further cord injury, but may actually cause such injuries.6 Whilst a Medline literature search failed to find any studies supporting the theory that correctly applied immobilisation causes secondary cord injury, a number of studies have shown that failure to identify and immobilise patients with unstable fractures do acquire secondary cord deterioration.7 Recent studies looking at prehospital spinal cord injuries & field clearance failed to establish any secondary cord injury on any patients correctly immobilised during transport.8-9

A number of studies in the literature do present complications when POOR STANDARDS of immobilisation are performed. Issues include occipital, lumber and sacral pain development when padding is inadequate or absent,10-14 increased respiratory compromise with incorrect chest strapping,15-16 pressure sore development due to inadequate padding2-4 and spinal miss-alignment again due to inappropriate padding.2, 14, 17 When proper consideration is given, such complications are significantly reduced or avoided.1-5

Training Requirements: 2 x Staff 1 x Patient 1 x Cervical Collar 1 x Scoop Stretcher 1 x VIM and Pump 1 x Stretcher Canvas 1 x Towel 1 x Combine Pad 1 x Hand / Wrist Airsplint 1 x Head Strap

Procedure

Step 1

Place the VIM on the Ambulance Stretcher.

Undo straps on VIM and lay all straps to the side.

Ensure no carry handles are caught under the VIM.

Ensure beads are spread evenly and appropriately. Place VIM on Ambulance Stretcher

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Step 2

Place a Stretcher Canvas or sheet down the full length of the VIM.

This will ease removing the patient off the VIM, and helps prevents sweating and heat loss when lying on the VIM.

Place Canvas Sheet on the VIM

Step 3

A Hand / Wrist Airsplint fully opened should be placed under the lumber spine of the patient to fill the gaps formed by the anatomical curvature of the spine, as the VIM does not always fill this gap.12 It should be placed with the bottom of the airsplint level with the green pelvic strap.

The hand / wrist airsplint should only be inflated once the air has been evacuated from the VIM (Step 16).

Position Hand/Wrist Airsplint

Step 4

Place the patient onto the VIM using a Long Spine Board or Scoop Stretcher.

Position the patient ensuring that the top of the patient’s shoulders are level with the shoulder line marking. Once the shoulders are correctly positioned, remove the Long Spine Board or Scoop Stretcher.

Position patient’s shoulders level with shoulder marking

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Combine Pad Step 5

In adults, place adequate padding under the head section of the VIM to maintain the head in the neutral in-line position. Firm padding using a Folded Towel or similar (NOT A PILLOW) is generally required under the head section of the VIM in an adult to prevent hyperextension of the cervical spine.14, 17 A small number of adults will however require no padding.

A 20 x 20 cm Combine Pad can be placed between the patient’s head and the VIM to improve the long term comfort Place towel under VIMs 12 head section for the patient and to help prevent headaches developing.

Manual Head Stabilisation

In a suspected spinal injury, one person should also continue holding the head to maintain head alignment until the head is immobilised to the VIM (Step 14). A Cervical Collar alone has been shown in numerous studies to be ineffective in maintaining adequate cervical spine immobilisation.21-24

Tightening The Straps

Straps should be tightened with a ‘feed and pull’ method to prevent twisting of the patient. If a bystander is available, pushing laterally inwards on the sides of the VIM will also greatly assist in tightening the straps.

Step 6

Place the Green Pelvic Strap across the pelvic bone or iliac crest and tighten. Ensure that the strap goes over the bone rather than the soft abdomen otherwise abdominal organ damage may occur.

This strap will help prevent lateral movement of the spine.

Apply Green Pelvic Strap

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Step 7

Place the Yellow Upper Leg Strap across the upper legs and tighten. If the legs are able to move laterally, spinal column movement, including the cervical spine can still occur.25

Apply Yellow Upper Leg Strap

Step 8

Place the Yellow Lower Leg Strap across the lower legs and tighten. Again, if the legs are able to move laterally, spinal column movement, including the cervical spine can still occur.25

Apply Yellow Lower Leg Strap

Step 9

Using the Red Foot Strap, apply a ‘Figure Of Eight’ around the patient’s ankles and tighten. This strap will prevent downward sliding of the patient on the VIM that may occur if the foot end of the VIM is tilted downwards, or when the Ambulance accelerates. This strap will also help prevent lateral movement of the legs. Apply Red Foot Strap

Step 10

Apply both Blue Shoulder Straps across the chest in a crossing application and tighten. Following application of the straps, there should be just enough slack to allow one hand to be placed between the chest and the strap. Over tightening may compromise respiratory effort.15-16

Apply Blue Chest Straps These two blue straps will prevent upward sliding of the patient’s body when the VIM is tilted head down, or when the brakes of the vehicle are applied during transport. They will also help prevent lateral movement of the torso if the VIM needs to be tilted sideways (vomiting patient).26

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Step 11

Apply the Black Arm Strap, encompassing the arms to prevent the upper arms of the patient from moving around; to help prevent lateral movement;9 and to help prevent the upper arms from moving above shoulder height. Raising the arms above the shoulder level as required for such manoeuvres as the Canadian Log-Roll Apply Black Arm Strap is in general CONTRA-INDICATED in spinal injuries, as studies have shown this to cause sagging of the thoracic and lumber spine.26-27

Step 12

Recheck all the torso straps before immobilising the patient’s head to the VIM.

Step 13

Once the patient’s body is secured properly to the VIM, ONLY THEN is the patient’s head secured to the VIM. Ensure the correct amount of firm padding remains is under the head section of the VIM (step 5) to maintain the patient’s spine in the neutral in-line position (generally around 2 - 7 cm in most adults).

Apply Forehead Strap Wrap the head section of the VIM around the patient’s temporal region. Continue to hold this section firmly against head until air is evacuated (Step 14).

Apply the 25mm Forehead Strap. Tighten strap ensuring foam pad is centered on the patient’s forehead. Place thumbs on the center of forehead, and pull both ends with equal pressure. Velcro into place.

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A PHOTOGRAPHIC GUIDE TO THE VACUUM IMMOBILISATION MATTRESS PAGE 22 22

Step 14

Once all the strapping is applied, attach the hand pump, foot pump or battery powered suction pump, and evacuate all the air out of the VIM until it feels solid.

Ensure patient’s upper arms are against the VIM during air evacuation to prevent build up of a beads under the armpits (as this may cause discomfort).

To ensure beads remain close to the body to improve Evacuate air from VIM until solid immobilisation, three bystanders can be used to push the beads in against the patient’s body down the full length of the VIM.

Step 15

Re-adjust straps following evacuation of the air out of the VIM as the straps will loosen off.

Step 16

If a gap develops under the lumber spine when the air is evacuated out of the VIM, inflate the Hand / Wrist Airsplint to fill this void so as to improve long term comfort.12

Inflate the Air Splint

Step 17

Secure the VIM to the stretcher ready for Ambulance transport. The VIM allows for the current 20G stretcher restraints to be effectively used.

Apply Stretcher Harness

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Bibliography

1. Mazolewski Annals Of Vol 23:6 June 1994 The Effectiveness Of Strapping Techniques In Spinal Immobilisation

2. Walton R, DeSalvo JF, Ernst AA, Shahane A. Acad Emerg Med 1995 Aug;2(8):725- Padded vs unpadded spine board for cervical spine immobilization.

3. Hauswald M, Hsu M, Stockoff C. Prehosp Emerg Care 2000 Jul-Sep;4(3):250-2 Maximizing comfort and minimizing ischemia: a comparison of four methods of spinal immobilization.

4. Cordell WH, Hollingsworth JC, Olinger ML, Stroman SJ, Nelson DR. Ann Emerg Med 1995 Jul;26(1):31-6 Pain and tissue-interface pressures during spine-board immobilization.

5. Hann A Response Volume 33 N0. 2 Long Spine Board: Does It Cause Discomfort

6. Hauswald M, Ong G, Tandberg D, Omar Z. Acad Emerg Med. 1998 Mar;5(3):203-4. Out-of-hospital spinal immobilization: its effect on neurologic injury.

7. Menzies Foundation Towards the prevention of spinal cord injuries

8. Stroh G, Braude D. Ann Emerg Med 2001 Jun;37(6):609-15 Can an out-of-hospital cervical spine clearance protocol identify all patients with injuries? An argument for selective immobilization.

9. Hankins DG, Rivera-Rivera EJ, Ornato JP, Swor RA, Blackwell T, Domeier Prehosp Emerg Care 2001 Jan-Mar;5(1):88-93 Spinal immobilization in the field: clinical clearance criteria and implementation.

10. Cross DA, Baskerville J. Prehosp Emerg Care 2001 Jul-Sep;5(3):270-4 Comparison of perceived pain with different immobilization techniques.

11. Chan D, Goldberg RM, Mason J, Chan L. J Emerg Med 1996 May-Jun;14(3):293-8 Backboard versus mattress splint immobilization: a comparison of symptoms generated.

12. Chan D, Goldberg R, Tascone A, Harmon S, Chan L Ann Emerg Med 1994 Jan;23(1):48-51 The effect of spinal immobilization on healthy volunteers.

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13. Hamilton RS, Pons PT. J Emerg Med 1996 Sep-Oct;14(5):553-9 The efficacy and comfort of full-body vacuum splints for cervical-spine immobilization.

14. Lerner EB, Billittier AJ 4th, Moscati RM. Prehosp Emerg Care 1998 Apr-Jun;2(2):112-6 The effects of neutral positioning with and without padding on spinal immobilization of healthy subjects.

15. Bauer MD Kowalski Annals Of Emergency Medicine Vol 17 September 1988 Effect Of Spinal Immobilisation Devices On Pulmonary Function

16. Schafermeyer RW, Ribbeck BM, Gaskins J, Thomason S, Harlan M, Attkisson A. Ann Emerg Med 1991 Sep;20(9):1017-9 Respiratory effects of spinal immobilization in children.

17. Shriger Annals Of Emergency Medicine Vol 20:878-881 August 1991 Spinal Immobilisation On A Flat Backboard: Does It Result In Neutral Position Of The Cervical Spine

18. Heurta MD Griffith MD Joyce MD Annals Of Emergency Medicine Vol 16:10 October 1987 Cervical Spine Stabilisation in Paediatric Patients: Evaluation Of Current Techniques

19. Stein MD EM And ACN Vol 10 December 1988 Flat Boards May Pose Dangers Transporting Children

20. Bones And Organs Of Movement Vol 12 April 1990 Standard Back Boards May Be Hazardous For Children With C-Spine Injuries

21. Cline MD Scheidel MD Journal Of Trauma Vol 25:649-653 A Comparison Of Methods Of Cervical Immobilisation Used In Patient Extrication And Transport

22. Cline MD McCabe MD Journal Of Emergency Medicine Comparison Of Rigid Cervical Immobilisation Collars

23. Podolsky MD Baraff MD Simon MD Journal Of Trauma Vol 23 No 6 1983 Efficacy Of Cervical Spine Methods

24. Graziano MD Cline MD Annals Of Emergency Medicine Vol 16:10 October 1987 Radiographical Comparison Of Prehospital Cervical Spine Methods

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25. Butman American College Of Surgeons/Emergency Training Institute Prehospital Trauma Life Support Text 1990

26. Suter DO Gerard DO Sartori DO Prehospital And Disaster Medicine Vol 7 No 2 April - June 1992 Thoraco-Lumber Spinal Instability During Variation Of The Log-Roll Manoeuvre

27. Seaman Emergency May 1992 Log-Roll Technique

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IMMOBILISATION ACCESSORIES

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ACCESSORIES FOR THE VIM

To assist with Full Body Immobilisation, additional equipment to the VIM is required. It is also helpful if all this additional equipment is prepared and stored in a kit near the VIM, so that the accessory items can be easily carried to the patient and no time is wasted searching for the equipment. The following equipment & spinal immobilisation accessories listed below, should be considered:

VIM Carry Bag VIM CARRY BAG

Containing the following items:

∗ VIM ∗ Forehead Strap ∗ Foot Pump

SPINAL IMMOBILISATION CARRY BAG

Containing the following items:

∗ Full Set Of Cervical Collars ∗ 1 x Towel ∗ 1 x Combine Pad (20 x 20 cm) ∗ 1 x Stretcher Canvas or Sheet ∗ 1 x Hand / Wrist Airsplint with Hand Pump

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CLEANING

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CLEANING THE VIM

All fabrics used in the VIM are designed to comply with the Australian Standards on Laundry Practice (AS 4146-1994) for the removal and killing of HIV, Hepatitis B and Vegetative Organisms.

A cleaning program that complies with the Australian Standards is available directly from RAPP Australia Pty Ltd for cleaning blood, vomit and other substances off the VIM. For those wishing to undertake in-house cleaning (at you own risk, including risk to warranty), some basic guidelines are listed below:

• The cleaner in keeping with normal practices should put on personal protection barrier equipment such as gloves, safety glasses, face masks, etc..

• Small areas of contamination:

Blood - Soak by placing a wet sponge on stain immediately after contact. If available, an antibacterial solution (Milton's or similar) should be added to the water. Repeat as necessary, then gently clean off residual stains with light spray of Nifty. Allow to dry thoroughly before re-use.

Vomit - Gently sponge with hot water immediately after contact. If available, an antibacterial solution (Milton's or similar) should be added to the water. Repeat as necessary, then gently clean off residual stains with light spray of Nifty. Allow to dry thoroughly before re-use.

• Larger areas of contamination:

Blood - Soak by placing effected panels in cold water. An antibacterial solution (Milton's or similar) should be added to the water. Let effected part soak for 20 minutes. Using Nifty, gently sponge of residual stains. Allow to dry thoroughly before re-use .

Vomit - Soak by placing in hot water. An antibacterial solution (Milton's or similar) should be added to the water. Using Nifty, gently sponge of residual stains. Allow to dry thoroughly before re-use.

In very heavy saturation, soak the VIM in cold water with an antibacterial solution (Milton's or similar) for 2 hours, rinse and then emerse again and bring up to a temperature of 90 degrees Celsius and maintain for 10 minutes. Using Nifty, gently sponge of residual stains. Dry thoroughly before re-use.

Ensure Valve is always closed before cleaning to prevent water entering the VIM.

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SPECIFICATIONS

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SPECIFICATIONS

DIMENSIONS

Dimension of the VIM opened: Adult 6 Ft Adult 7 Ft Paediatric Length 190 cm 214 cm 125 cm Thickness 5 cm 6 cm 3 cm Width 84 cm 92 cm 56 cm Weight 6 kg 8.5 kg 2.6 kg

Dimension of the VIM stored: Adult 6 Ft Adult 7 Ft Paediatric Length - - 48 cm Height 84 cm 92 cm 41 cm Width 40 cm 45 cm 13 cm Weight 6.3 kg 8.8 kg 2.8 kg

SAFE WORKING LOAD

The safe working load of the Adult VIM is 160 kg and 38 kg for the Paediatric VIM.

PARTS SUPPLIED

Part …… Carry Bag Part …… VIM - Adult 6 ft Part …… VIM - Adult 7 ft Part …… VIM - Paediatric Part …… Hand Pump Part …… Foot Pump Part …… Set Of Straps Part …… CD Powerpoint Training Presentation Part …… Printed Training Manual

Spare parts are available on request by contacting RAPP Australia Pty Ltd

WARRANTY

RAPP Australia Pty Ltd warrants to the purchaser that the VIM is free from defects in material and workmanship for a period of 3 years from the date of purchase by the original user. During this period, RAPP Australia Pty Ltd will upon receipt of the product found to be defective due to materials or workmanship from the purchaser and notification in writing of the defect at its option repair or replace any parts found to be defective or the entire product. All postage, shipping and handling charges shall be the sole responsibility of the purchaser.

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ORDER FORM

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VACUUM IMMOBILISATION MATTRESS ORDER FORM

Name ……………………………………………… Title ………………………..

Organisation ……………………………………...………………………………….

Address ………………………………………………. ……………………………..

……………………………………………………………………………...

Phone Number ……………………………… Fax …………………………….

Quantity Item Part Number Cost Carry Bag VIM - Adult 6 Ft VIM - Adult 7 Ft VIM - Paediatric Hand Pump Foot Pump Set Of Straps Forehead Straps Powerpoint Training Presentation CD Printed Manual TOTAL

Quote Only (Valid 30 Days Only) For Purchase

Fax this form to the RAPP Australia Pty Ltd on (03) 5282 4892

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TRAINING

EVALUATION

FORM

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TRAINING EVALUATION FORM

Organisation: ……………………………………………………………………………….

Officer’s Name Undertaking Training: …………………………………………………….

INITIAL TRAINING Date Completed Supervisor

Powerpoint Presentation Reviewed

Instruction Manual Reviewed

5 x VIM Training Applications

THREE MONTHLY REVIEW Date Completed Supervisor

1 x VIM Training Application

TWELVE MONTHLY REVIEW Date Completed Supervisor

Powerpoint Presentation Reviewed

Instruction Manual reviewed

1 x VIM Training Application

THIS PAGE CAN BE PHOTOCOPIED WITHOUT BREACH OF COPYRIGHT

EDITION 1 : 8 September 2006 RAPP Australia Pty Ltd A PHOTOGRAPHIC GUIDE TO THE VACUUM IMMOBILISATION MATTRESS 36

For further information, please contact

RAPP Australia Pty Ltd

151 Patullos Rd Lara Victoria 3212

Phone: (03) 5282 4920 Fax: (03) 5282 4892

Email: [email protected]

Web Page: www.neann.com

For the latest information on the VIM and an on-line training manual, please go to

www.neann.com/vim.htm

EDITION 1 : 8 September 2006 RAPP Australia Pty Ltd