F O L L OW - U PTime: Location:

Authorized Representative: Scanlan Group B.V., Postbus 75664,1118 ZS Schiphol Triport, The Netherlands.

1MJRP © 04-05 Jerome

If your child experiences sudden neck or back pain,numbness or tingling, contact your doctor.

Doctor's Name/Number:

If you have any problems or questions about the useand care of the brace, please contact your child’sdoctor or orthotic professional.

Orthotist Name/Number:

These instructions do not supercede hospital protocoland/or direct orders of child's physician.

Additional instructions

The Miami Jr.® collar is specifically designed forkids: our smallest, most important patients. Thesecollars are engineered to meet the unique anatomicalneeds of children during the growth transition frombirth to adolescence. For infants (0 - 3 mos.)Jerome offers the Papoose infant spinal immobilizer.For adolescents (over 12 years of age) and adults,Jerome offers the Miami J® collar.Please contact Jerome formore information aboutthese distinctive collars.

s i z i n g & A p p l i c at i o nI n s t r u c t i o n s

P at i e n t h a n d b o o k

A Latex-Free Product

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Your child's doctor hasdetermined that wearing aMiami Jr.® collar will aidin rehabilitation bymaintaining your child'sneck in the proper positionwhile healing. You willneed to help your childunderstand that, althoughnot being able to turn orshake his or her head"yes" or "no" may seemunusual, limiting neckmotion is an important partof his or her treatment.

I N T R O D U C T I O N

This pamphlet will explainthe things you and yourchild’s caregivers shoulddo to help your childproperly use and care forthe Miami Jr.® or thePapoose® in the hospitalor at home.

You can help your child'shealing process byfollowing the nurse anddoctor's instructions andthe guidelines in thispamphlet.

ChinSupport

FRONT

Angulation Buttons

Sternal Pad

Occipital Support

TrachealOpening

Velcro Strap

BACK

AssistStrap

S i m p l e S i z i n g f o r k i d s

The Papoose® is sized to fitBroselow Gray infants (birth tothree months).

Choosing the proper size MiamiJr.® Collar is easy. Simply selectcollar size based upon:

Broselow-Luten color-codeor Age.

S IZ ING T I PS :

• If you are deciding between twoconsecutive sizes, try the smallersize first.• Use the largest size that fitscomfortably and maintains desiredtreatment positioning.

Sizing andapplying theMiami Jr.®Collar is assimple as:

54

At least two people are needed for initial collar place-ment: one to maintain the child's head, neck and airway inproper alignment and the second to fit the collar.

c - s p i n e p r e c a u t i o n s

Carefully log roll thechild to the side andplace the AirWay

PAD or a bolster underthe child extending fromthe top of the shouldersto base of the spine.

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Elevate child's thorax to bring c-spine and airway intoproper anatomical alignment:

• Bolster should be made fromany suitably padded material(i.e. blankets, sheets).

• Padding must be of anappropriate height tooffset the occipital

prominence.• Call Jerome at 1-800-257-8440 for information on theJerome AirWay® Pad.

Position child witharms to the side,shoulders down and

head aligned centrally(nose over belly button).

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After placement of padding, the second caregiver canapply the back portion of the collar symmetrically underchild's neck before log rolling the child into position.

Compromised Airflow Unrestricted Airflow

No Spinal orOccipital Support

No Padding / No Collar Airway/C-Spine Alignment

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Slide the Back Piece behind the child's neck andcenter it or logroll the child and place the Back.

M i a m i J r . ® a p p l i c at i o n

33

Flare sides of theFront out, slide itup the chest and

scoop it up under the chin.

44Sides of the Frontshould be orientedup, off the shoulder

and toward the ears.

55HOSPITAL SETTING:Optional for P2 & P3 collars: Attach theAssist Strap to the Front Piece of the collar.The Assist Strap can act like an extra pair ofhands to hold the Front Piece in place whenapplying the collar to a sitting child.

While holding theFront securely,curl the ends

snugly against child’s neck.Apply the velcro strap andsecure the opposite side ofthe collar in the samefashion. Tighten strapsalternately, one at a time, to an equallength on bothsides.

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M i a m i J r . ® a p p l i c at i o n

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Velcro straps must bealigned symmetrically andoriented "blue-on-blue" to

the Front adhesive sections. Whenthe collar is properly fit, thereshould be equal amounts of excessvelcro over-hanging the Front blueadhesive sections. These may betrimmed.

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ANGULATION BUTTONS: used to fine-tune the fitof the collar for better anatomical conformity, pressuredistribution and comfort. Minor adjustments in angulationof the Chin and Occipital Support can significantly reducepressure areas at these critical contact points.

- Slide up to relieve chin tippressure or discomfort.- Slide down to relieve jaw / mandibular pressure ordiscomfort.

f i n a l a d j u s t m e n t s- Slide up to relieve occipital pressure or discomfort.- Slide down to enhance extension control.

UNLOCK POSITION LOCK For a heart-shape face,set the Chin SupportButtons to top position. For a square shape face,set the Chin SupportButtons to down position.

CHIN SUPPORT POSITIONING GUIDELINES:

OCCIPUT SUPPORT POSITIONING GUIDELINES:

STERNAL PAD The Miami Jr.® (sizes P1, P2 & P3only) include a removable sternal padto distribute ambulatory pressure. Itmay be removed if child’s anatomydictates, for comfort during sleepand/or during meals to ease chewingand swallowing.

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Wash front ofneck with mildfacial soap and

water and completely drythe skin. Observe for anyredness or irritation underthe collar, especially overbony areas like the chin,clavicles or occiput (backof head).

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Slide the Backcarefully behindthe child's neck.

Make sure it is centeredevenly.

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Clean the Front and Back of collar and replace thesoiled pads with clean ones as directed in “CollarCleaning” section.44

Your child must be lying down in proper anatomical (airwayand c-spine) alignment to remove the collar, unless yourdoctor gives you permission to do this in a sitting position.

Collar Removal & Skin Care

Before removing the collar,note or mark with a penwhere the ends of the

velcro straps are. When the collaris replaced, the straps should bereturned to the same position.

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Undo the velcrostraps. Removethe Back of the

collar, sliding out fromunder neck if necessary.

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Remove collarFront. If present,unfasten the

elastic Assist Strap thatgoes around the back ofthe neck.

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Unless otherwise specified by your child's doctor:Do not remove the collar except to wash under it andchange the pads.

R o u t i n e c o l l a r c a r eKeeping your child's Miami Jr.® or Papoose® and the skinbeneath clean is an important part of treatment. Dailycleaning will help to prevent skin irritation. Cleaning thecollar will require at least one set of replacement pads. While at home, your child should shower or bathe with thecollar on. After bathing, you will need to remove the collarto wash his/her neck and change the pads.

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Attach new pads. Fold pads inhalf with dull side out next tothe velcro (shiny side goes

against skin); then center pad in thewhite shell.

44

Peel the soiled, blue pads offvelcro attachment. Lookcarefully at the shape as you

remove them so that you canreposition the clean pads properly.

11

Wash pads with mild facialsoap and water. DO NOT usebleach or harsh detergents.

Thoroughly rinse pads with cleanwater. Wring out excess water andsqueeze pads in a towel. Lay pads outflat to air dry. It should take lessthan 60 minutes for them to dry.

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Call Jerome Customer Service ( 1-800-257-8440 ) to purchase extra pads.

c o l l a r c l e a n i n gReplace collarFront by sliding itup the chest wall

and scooping it up! underthe child’s chin.

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Undo the velcrostrap on the topside of the collar

and fold the Back downto clean and check theback of the child's headfor redness or irritation.

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Gently roll thepatient ontohis/her side.88

Wipe white plastic collar shellclean with mild soap andwater.33

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ProblemLower edge of collar digginginto clavicle or trapezius.

Collar fit too closely / tightlyagainst the neck.Assist Strap is in the way.Pressure or redness on chin orocciput.

Chin slips in collar.Running out of velcro whensecuring the collar.

Patient complaining of chewingand swallowing problems.Other problems, questions, orconcerns?

SolutionRe-fit anterior half of the collarand direct sides up toward theears.

Align velcro straps "blue-on-blue".Size "up" to the next taller size.

Remove it.Remove pillows from behindpatient's head.

Check that Angulation Buttonsare properly set and that routineskin care is being performed.Snug it up!Check size. Either thecircumference is too large or thecollar is too short.Remove Sternal Pad during meals.

Contact Jerome CustomerService: 1-800-257-8440

www.jeromemedical.com

An improperly applied Miami Jr.® will look like the bottom illustrations:

t r o u b l e s h o o t i n g

Too Small Too Large Just Right!

A properly applied Miami Jr.® will look like the above illustrations:

F I N A L C H E C K L I S T

Collar extends from jaw to just below sternal notch.

Chin is centered comfortably in the chin piece. Chinshould not extend over edge of SorbatexTM pad, nor fallinside collar.

Velcro straps oriented blue-on-blue, both the same length.

No plastic touching skin. Blue SorbatexTM pads extendbeyond all plastic edges.

The large front/back openings are centered on the neck.

Sides of the Back should overlap sides of the Front.

No slack or gaps in any of the straps.

Front of collar angled up toward ears. Lower plastic edgeshould not be resting on patient's clavicles nor digginginto shoulder.