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3. Manual Handling
Equipment in this section:
3.1 Slide Sheets
3.2 One Way Glide Sheets
3.3 ‘Satin Type’ Sheet Systems
3.4 Bed management Systems
3.5 Transfer board
3.6 Handling belt
3.7 Patient turner
3.8 Stand Aid
3.19 Hoist powered
3.10 Slings
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General considerations:
All prescribers for manual handling equipment must have completed mandatory manual handling training to an appropriate level and attended mandatory updates. Regulation of mandatory updates vary slightly across agencies, prescribers need to comply with their employing agency and professional body.
All prescribers of manual handling equipment must complete tissue viability training to an appropriate level.
All prescribers must refer to manufactures guidance and advice regarding the use and maintenance of the equipment.
Additional advice on manual handling can be obtained from manual handling advisors in your respective agencies.
Risk assessment and prescriptions forms must be completed as part of your assessment for all manual handling equipment.
Prescribers should refer to the Tissue Viability pathway and seek further advice from the Tissue Viability services when in doubt
Weight limits of equipment apply
Consider user environments- space and hazards to person and carers
Prescribers must work within legal and organisational frameworks
Single use due to risk of cross contamination
Maintenance- prescribers/delivers of equipment need to reinforce with users/carers the need for equipment to be regularly checked- particularly aids that are at risk of deterioration. If user is unable to take on this responsibility an alternative arrangement needs to be identified.
Consider social and dignity issues for users.
Consider training and support needs of carers
Consider consent and compliance issues for users and carers.
Additional or second slings should only be prescribed as a result of an identified need and not automatically.
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Related policies and guidance documents:
.
Manual Handling Operations Regulations 1992 (as amended): Guidance on Regulations. L23. HSE Books. ISBN 0 7176 2823 X[4]
Getting to grips with manual handling: A short guide. INDG143 [368KB]
The Manual Handling Operations Regulations 1992
Management of Health and Safety at Work Regulations 1999
Manual Handling Operations Regulations 1992 (MHOR) as amended 2002
Handling home care HSG 225[1]
achieving safe, efficient and positive outcomes for care workers and clients.
Health and safety in care homes HSG 220[2]
this book is targeted at owners and managers of care homes, as well as employees and safety representatives.
Manual handling in the health services ISBN 0 7176 1248 1[3]
provides guidance, which is intended to help everybody who plays a part ensuring that risks from manual handling are minimised.
Getting to grips with handling problems ISBN 0 7176 0622 8[4]
provides practical advice and guidance on manual handling in the Health Services.
Cornwall Council’s Manual Handling Policy
PCH’s Manual Handling Policy
Charterest Society of Physiotherapy (2014) Manual Handling Guidance
College of Occupational Therapists (2006) Manual Handling Guidance
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3.1 Equipment: Slide Sheets
Description: slide sheets are made from very low friction material that slides against its self. They are multidirectional, with or without handles. There are tubular and flat designs which can be used for many different purposes eg repositioning on bed or chair, or to assist with fitting of garments or slings. The sheet MUST NOT be left in situ. Risk assessment is essential regarding how many carers are required to move the person with the slide sheet.
Dimension: various
Related policies/Guidance; See documents listed at beginning of this section
Example Brand names:
Indicators
The person needs additional support to complete a sliding transfer or to reposition them.
Carers need additional support to reposition or transfer the person
Ladder Approach Contraindications Safety & function Prescriber/assessor Actions
All alternatives have been explored:
Different technique
Referral to other services e.g. Rehab OT
Shearing risks – consider the size of the person and whether all of body to be moved/just a body part when deciding which size to supply
Poor balance
Person gets confused
Carer ability
Uneven or poor transfer surfaces
User environment
Access to both sides of the bed
Balance
Progression of condition
Must not be used if there are any signs of equipment wear & tear
Weight limits
Sliding sheet must be
Risk assess
Manual handling training
Product familiarisation completed
Assessment of carer’s needs
Risk assessment
Refer to MHRA, HSE guidance & local MH policy
Prescription goals identified.
Teach user appropriate techniques
Demo/delivery planned
Review date
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Consider in risk assessment - Where patient using it alone may slide off bed
removed immediately following its use.
Safety Checking of Community Loan Equipment
DESCRIPTION
STANDARD EQUIPMENT ITEMS
FI Bar Coded
Manufacturer’s Instructions Supplied to User/Carer
Single use Items
Legislation Comments/ technical
instruction N R LOLER PUWER
Easi slide
M
N/A
N Y Y
Key: FI - Final Inspection, N – New, R – Recycled, M – Manufacturer, C - Community Equipment Loan Store
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3.2 Equipment: One Way Glide Sheets
Description: A cushion/sheet which allows sliding easily in one direction whilst resisting sliding in another direction.
Dimensions: various
Related policies/Guidance; See documents listed at beginning of this section
Example Brand names: Immedia (Etac) OneWayGlide, Prism One Way Glide Sheet,
Indicators
Used to help prevent a person sliding forward in wheelchair, day chair or bed.
The person needs additional support with positioning in a chair, wheelchair or bed
Facilitates independent or assisted positioning back in the chair
Ladder Approach Contraindications Safety & function Prescriber/assessor Actions
All alternatives have been explored:
Different technique (eg prompting the person to sit back in the chair)
Referral to other services e.g. Rehab OT
Assess suitability of seating – is that causing the person to slump forwards?
Shearing risks
Poor balance
Person gets confused
Carer ability
Uneven or poor transfer surfaces / compatibility with pressure relieving products (discuss with TV)
Incontinence
User environment
Must not be used if there are any signs of equipment wear & tear
Risk assess
Manual handling training
Product familiarisation completed
Carers assessment
Risk assessment
Refer to MHRA, HSE guidance & local MH policy
Prescription goals identified.
Teach user appropriate techniques
Demo/delivery planned
Review date
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Safety Checking of Community Loan Equipment
DESCRIPTION
STANDARD EQUIPMENT ITEMS
FI Bar Coded
Manufacturer’s Instructions Supplied to User/Carer
Single use Items
Legislation Comments/ technical
instruction N R LOLER PUWER
Easi slide
M
N/A
N Y Y
Key: FI - Final Inspection, N – New, R – Recycled, M – Manufacturer, C - Community Equipment Loan Store
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3.3 Equipment: ‘Satin Type’ Sheet Systems
Description: Suitable for independent or semi-dependent people. Reduces friction between user and bed in order to reduce shear forces on person and reduce work load of care givers. 2 direction base sheet, 2 way or 4 way draw sheet. Remains in bed.
Dimension: mini, midi, maxi or double
(Images Copyright PRISM Medical)
The following dimensions relate to the PRISM Medical products.
Mini – under trunk/hip section
Midi – under trunk/hip and shoulder
Maxi – whole bed
The midi and maxi have a choice of 60 cm and 70 cm widths.
2 Direction Satin sheet
Maxi flat: 240x200cm or 200x200 cm (Used same as standard flat sheet tucked in)
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Maxi corner: 90x200 cm has elastic straps at the corner in order to fix the sheet ontop of the mattress.
Maxi fit: 90x200 cm fitted sheet with locking strings and a lower satin area which covers the entire width of the mattress.
Maxi Double: 280x200 cm flat sheet for double bed with satin on one side.
Draw sheet (if combined with a satic 2 direction base can be used to assist with turning).
Mini: 200x100 cm.
Midi: 200x140 cm.
4 Direction Satin sheet
Satin sheet 4 direction midi: 200x140 cm (drawsheet with satin on underside).
Satin sheet 4 direction maxi: 200x200 cm (as above).
Related policies/Guidance; See documents listed at beginning of this section
Example Brand names: Immedia (by Etac and Prism) Satin Sheet System, Wendylett (by Romedic)
Indicators
Helps independent user turn in bed
Carers need additional support to reposition or transfer the person in bed
Ladder Approach Contraindications Safety & function Prescriber/assessor Actions
All alternatives have been explored:
Different technique
Referral to other
Shearing risks
Uneven or poor transfer surfaces / compatability with
Ensure sheet can be tucked out of the way when person is transferring from bed
Risk assess – inparticular with relation to person’s weight (NB PRISM satin sheet has no safe working weight limit)
Risk assessment
Refer to MHRA, HSE guidance & local MH policy
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services e.g. Rehab OT
Rope ladder
Bed lever
pressure relieving products
Incontinence
If to be used in conjunction with profiling bed, person must be able to lift up their shoulders from side to side (to reduce friction)
Assess provision of bed rails to use alongside satin type sheets
Stripes indicate glide direction
Incontinence pad with satin also available
Manual handling training
Product familiarisation completed
Carer’s assessment
Prescription goals identified.
Teach user appropriate techniques
Demo/delivery planned
Review date
Safety Checking of Community Loan Equipment
DESCRIPTION
STANDARD EQUIPMENT ITEMS
FI Bar Coded
Manufacturer’s Instructions Supplied to User/Carer
Single use Items
Legislation Comments/ technical
instruction N R LOLER PUWER
Easi slide
M
N/A
N Y Y
Key: FI - Final Inspection, N – New, R – Recycled, M – Manufacturer, C - Community Equipment Loan Store
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3.4 Equipment: Bed Management Systems
Description: In-bed systems for severely immobile patients. Ideal for use with immobile patients who are in pain, and those with pressure ulcers.
Dimension: standard or Maxi for large and heavy users.
Three different models of Nylon Sheet:
Lock on the sheet and Non-slip along the bedside. Lock on the sheet. 3 lock on the sheet and Non-slip along the bedside.
Images Copyright ETAC
The following dimensions relate to ETAC products
4 Way glide LPL
4 Way Glide Mattress: 140x200 cm.
4 Way Sheet LPL NS-lock NS sides: 85x200 cm.
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4 Way Sheet LPL NS-lock: 85x200 cm.
4 Way Sheet LPL with 3 x NS-lock NS sides: 85x200 cm.
Safe working weight limit maxium 200 kg
4 Way glide Maxi
4 Way glide LPL maxi mattress: 180x210 cm.
Nylon Sheet LPL Maxi with NS Lock NS sides: 110x200 cm.
Safe working weight limit maxium 300 kg
Related policies/Guidance; See documents listed at beginning of this section
Example Brand names: Prism, Etac, Immedia 4 Way glide system, Ross Turnsheet.
Indicators
The person is fully dependent for transfers and repositioning
The person needs support on the bed to enable the carer to carry out personal care tasks
Can be used with support of a hoist
Ladder Approach Contraindications Safety & function Prescriber/assessor Actions
All alternatives have been explored:
Consider satin type sheet systems
Risk assessment required if pressure relieving system in situ
Consider continence – incontinent versions
Assess re whether bed rails should be supplied in combination with the bed management system
Risk assess
Manual handling training
Product familiarisation completed
Carer’s assessment
Risk assessment
Refer to MHRA, HSE guidance & local MH policy
Prescription goals identified.
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available
Consider provision of second ‘top sheet’
Consider number of carers available to undertake transfer
Ensure person fits entirely on bed management system/no body parts are dragged
Teach user appropriate techniques
Demo/delivery planned
Review date
Safety Checking of Community Loan Equipment
DESCRIPTION
STANDARD EQUIPMENT ITEMS
FI Bar Coded
Manufacturer’s Instructions Supplied to User/Carer
Single use Items
Legislation Comments/ technical
instruction N R LOLER PUWER
Easi slide
M
N/A
N Y Y
Key: FI - Final Inspection, N – New, R – Recycled, M – Manufacturer, C - Community Equipment Loan Store
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3.5 Equipment: Transfer board
Description: Transfer boards have a smooth wooden surface, tapered at either end.
Dimension: maximum user weight 30stone (190kg).
Related policies/Guidance
Example Brand names: Boomerang by Smitcare. Some other designs remain in circulation within CELS
Indicators
The person needs additional support to transfer between two even surfaces.
A carer needs assistance to transfer the person between two even surfaces.
Ladder Approach Contraindications Safety & function Prescriber/assessor Actions
All alternatives have been explored:
Alternative technique
Referral to other agencies
Risk assessment Care assessment Increased care package
Shearing & pressure care
Stability & balance
Uneven &/or unsteady surfaces
User confusion
Weight limits
Carer ability
Ability of user to lift own body weight
User environment
Progression of condition
Impact upon care package
Balance
Dexterity
Risk assess
Manual handling training
TV training
Product familiarisation completed
Risk assessment
Refer to MHRA, HSE guidance & local MH policy
Prescription goals identified.
Teach user appropriate techniques
Demo/delivery planned
Review date
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Safety Checking of Community Loan Equipment
DESCRIPTION
STANDARD EQUIPMENT ITEMS
FI Bar Coded
Manufacturer’s Instructions Supplied to User/Carer
Single use Items
Legislation Comments/ technical
instruction N R LOLER PUWER
Transfer board
M C
Y Y
Key: FI - Final Inspection, N – New, R – Recycled, M – Manufacturer, C - Community Equipment Loan Store
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3.6 Equipment: Handling belt
Description: Handling belts are made of contoured fleece fabric, (deluxe model has an anti slip section) and quick release buckle, with padded handles at each end. They have a selection of horizontal and vertical handles along the outside surface.
Dimension: Mini- 510-1140mm (20-45”). Maxi- 610-1140mm (24-45”). Maxi plus 915-1520mm (36-60”). “
Related policies/Guidance
Example Brand names: Smitcare
Indicators
The person needs additional support to transfer or reposition.
A carer needs assistance to transfer or reposition the person.
To provide support whilst mobilising
Ladder Approach Contraindications Safety & function Prescriber/assessor Actions
All alternatives have been explored:
Alternative technique
Sliding board
Bed lever
Referral to other agencies
Risk assessment Care assessment Increased care package
Stability & balance
Uneven &/or unsteady surfaces
User confusion
Weight limits
Carer ability
User environment
Progression of condition
Balance
Dexterity
Ensure correct size is used
Not to be used as a lifting belt
Please consider the condition of the service user’s skin when assessing
Risk assess
Manual handling training
TV training
Product familiarisation completed
Risk assessment
Refer to MHRA, HSE guidance & local MH policy
Prescription goals identified.
Teach user appropriate techniques
Demo/delivery planned
Review date
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whether to use non slip version.
Safety Checking of Community Loan Equipment
DESCRIPTION
STANDARD EQUIPMENT ITEMS
FI Bar Coded
Manufacturer’s Instructions Supplied to User/Carer
Single use Items
Legislation Comments/ technical
instruction N R LOLER PUWER
Handling belt
M C
N Y
Key: FI - Final Inspection, N – New, R – Recycled, M – Manufacturer, C - Community Equipment Loan Store
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3.7 Equipment: Patient turner
Description: circular metal disc for patient to stand on with two handled angle stem with integral knee blocks.
Dimension: for Etac handle height 890mm to 1260mm. Max user weight 150kg/ 23.5stone.
Related policies/Guidance
Example Brand names: Etac Patient turner plus a limited stock of Rotastand solo & Homecraft turner at CELS
Indicators
Person needs assistance to complete a swivel/pivot transfer.
Carers need assistance to complete swivel/pivot transfers with person.
Reduce the number of carers needed to support a swivel/pivot transfer. (individual risk assessment is required to identify if 1or 2 carers are needed)
Ladder Approach Contraindications Safety & function Prescriber/assessor Actions
All alternatives have been explored:
Alternative technique
Turn table
Bed lever
Referral to other agencies e.g. physio/Rehab OT
Risk assessment Care assessment Increased care package
Person must always be supervised in its use
Instability if person pulls up on turner
Weight bearing
Standing balance
Carer ability
person has poor cognitive ability
User environment – space & surfaces
Appropriate adjustment of equipment to user height
Not to be used a s a mobility aid.
Risk assess
Manual handling training
Product familiarisation completed
Risk assessment
Refer to MHRA, HSE guidance & local MH policy
Prescription goals identified.
Teach user appropriate techniques
Demo/delivery planned
Review date
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Safety Checking of Community Loan Equipment
DESCRIPTION
STANDARD EQUIPMENT ITEMS
FI Bar Coded
Manufacturer’s Instructions Supplied to User/Carer
Single use Items
Legislation Comments/ technical
instruction N R LOLER PUWER
patient turner
M C
Y Y
Key: FI - Final Inspection, N – New, R – Recycled, M – Manufacturer, C - Community Equipment Loan Store
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3.8 Equipment: Stand aids
Description: wheeled platform with spreader bar and raise mechanism.
Dimension: Length- 1170-1220mm. Height 1138mm. Turning radius 1250mm. Width 610-1240mm.
Related policies/Guidance:
Example Brand names: Manual & powered versions available. Oxford 140.
Indicators
The person can actively assist with transfers but needs additional support to stand.
Equipment will help to maintain a function.
Equipment will enable user to maintain weight bearing.
As part of a rehab program.
1 or 2 carer use determined by risk assessment.
Ladder Approach Contraindications Safety & function Prescriber/assessor Actions
All alternatives have been explored:
Technique
Small transfer aids e.g. handling belts, turn tables, sliding boards, patient turners.
Change of routine
Change to living space e.g. moving furniture
Transfers over long distances or room to room
Weight bearing
Reliability of stand
User environment
Carer ability
Manoeuvrability of stand aid in environment
Pain
Shearing & TV
Extreme behaviour of
Storage
Weight limit
Progression of condition
Confused patients
Risk assess
TV training
Manual handling training
Product familiarisation completed
Risk assessment
Refer to MHRA, HSE guidance & local MH policy
Prescription goals identified.
Prescription form
Demo/delivery planned
Teach user appropriate techniques
Review date
Add to maintenance & service contract
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Risk assessment Carers assessment Increased care package costs
person
Ability of carer
Mental capacity
Safety Checking of Community Loan Equipment
DESCRIPTION
STANDARD EQUIPMENT ITEMS
FI Bar Coded
Manufacturer’s Instructions Supplied to User/Carer
Single use Items
Legislation Comments/ technical
instruction N R LOLER PUWER
stand aids
M C
Y Y
Y
Key: FI - Final Inspection, N – New, R – Recycled, M – Manufacturer, C - Community Equipment Loan Store
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3.9 Equipment: Mobile hoist powered
Description: A metal base or chassis with legs - wheeled, usually two with brakes with a mast - the vertical support. This
incorporates the lifting mechanism which uses a battered powered pump operated by switches on a flexible cable. Wheeled legs
can be widened to accommodate floor transfers and some equipment. The boom extends from the mast to provide the reach
across and has the spreader bar attached. The spreader bar provides the width to span the user’s shoulders and the attachment
points for the slings. The battery can be removed for recharging
Dimension: Midi- weight limit 25stone/ 170kg
Major- weight limit 47 stone /190kg
Related policies/Guidance: Choosing a mobile hoist fact sheet from DLF
Example Brand names: Oxford Mid & Major. Other designs remain in circulation within CELS e.g. TX, Molift, stowaways
Indicators
The person is unable to safely transfer from one position/place to another.
Person not able to tolerate jerky movements of manual hoist.
The person can operate hoist lift/lower themselves.
1 or 2 carer use determined by risk assessment.
The carers are not able to safely support the person to transfer from one place/ position to another.
Carers are not able to operate a manual hoist.
Powered hoist enables single carer to safely complete transfers.
Temporary solution during DFG
To prevent hospital admission
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Ladder Approach Contraindications Safety & function Prescriber/assessor Actions
All alternatives have been explored:
Technique
Small transfer aids e.g. handling belts, turn tables, sliding boards, patient turners.
Change of routine
Change to living space e.g. moving furniture
Manual mobile hoist Risk assessment Carers assessment Increased care package costs
Transfers over long distances or room to room
User environment
Carer ability
Manoeuvrability of hoist in environment
Pain
Shearing & TV
Extreme behaviour of person
Mental capacity
Storage
Weight limit
Progression of condition
Manual mobile hoists are not a long term option
Consider implications of long term use on carers.
Confused patients
Risk assess
TV training
Manual handling training
Product familiarisation completed
Risk assessment
Refer to MHRA, HSE guidance & local MH policy
Prescription goals identified.
Prescription form
Demo/delivery planned
Teach user appropriate techniques
Demonstrate to user battery charging & maintenance needs
Review date
Add to PAT list
Add to maintenance & service contract
Safety Checking of Community Loan Equipment
DESCRIPTION
STANDARD EQUIPMENT ITEMS
FI Bar Coded
Manufacturer’s Instructions Supplied to User/Carer
Single use Items
Legislation Comments/ technical
instruction N R LOLER PUWER
mobile hoist powered
M
C
Y Y
Y
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Key: FI - Final Inspection, N – New, R – Recycled, M – Manufacturer, C - Community Equipment Loan Store
- 25 -
3.10 Equipment: Slings
Description: Slings are available in a range of fabrics and sizes. Most companies have a range of standard or universal slings as well as specials designed
for specific purposes e.g. to be sat on all day, bathing, toileting, paediatrics. Sizes, styles, and weight limits vary. They may be provided in fabric such as
polyester, fleece-lined, mesh and low friction fabrics such as parasilk. Options include head support, extended leg and shoulder sections and chest
straps. There are a number of companies who produce made to measure slings. These can take a long time to be provided, as well as being very
expensive and there is no guarantee that they will be a solution, so should be a last resort. Assessment of slings should consider users needs, carer’s
needs, environment and transfers to be completed.
Dimension: seek manufactures guidance
Related policies/Guidance
Example Brand names: stock slings
Access sling- small, medium & large
Quickfit deluxe- small, medium & large
Quickfit – small, medium & large
Standaid sling- standing & transport
Indicators
The person needs to be transferred/repositioned using a hoist/stand aid.
Standard or universal slings should be explored and excluded before progressing to more specialist slings.
Second slings maybe required due to continence, bathing, transfer surfaces/locations.
Ladder Approach Contraindications Safety & function Prescriber/assessor Actions
Risk assessment Carers assessment Increased care package
Compatibility of sling & hoist
Types of transfers to be undertaken- is more
Risk assess
TV training
Risk assessment
Refer to MHRA, HSE
- 26 -
costs Muscle tone
Strength
Tissue viability
Pain
Temperature control
Level of understanding & participation of person
Level of understanding & participation of carers
than 1 sling needed
Continence- frequency of washing
Loops are for correct positioning of person not to alter sling size
Slings maybe requested for use in settings with multiply users- slings should only be assessed & provided for individual user
If slings are to be used in none home settings prescriber needs to confirm who is responsible for maintenance of hoist that it will be used with & check compatibility.
Manual handling training
Product familiarisation completed
guidance & local MH policy
Prescription goals identified.
Prescription form
Demo/delivery planned
Review date
Add to maintenance & service contract
- 27 -
Safety Checking of Community Loan Equipment
DESCRIPTION
STANDARD EQUIPMENT ITEMS
FI Bar Coded
Manufacturer’s Instructions Supplied to User/Carer
Single use Items
Legislation Comments/ technical
instruction N R LOLER PUWER
slings
M C
N Y
Y
Key: FI - Final Inspection, N – New, R – Recycled, M – Manufacturer, C - Community Equipment Loan Store