Arm Sleeve - Jobskin · 2020. 7. 2. · 2a 3a 4a Garment styles Code L R Description 0501 Arm...
Transcript of Arm Sleeve - Jobskin · 2020. 7. 2. · 2a 3a 4a Garment styles Code L R Description 0501 Arm...
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Shoulder attachment measurements
1. Distance last arm tape to inside edge
of bra strap
2. Top of shoulder, circumferentially under opposite
breast
3. Top of shoulder, circumferentially under opposite
axilla
4. Top of shoulder, diagonal to waist
Bra Loop (cm) Female Body Strap (cm)Male/Child’s
Body Strap (cm)
Waist Attachment (cm)
(with clips) 1 2 3 4
Distance last arm tape to base of neck
2a 3a 4a
Garment styles
Code L R Description
0501 Arm Sleeve (wrist to axilla)
0503 Arm Sleeve with Shoulder Attachment
0506 Arm Sleeve with Bra Loop
0515 Forearm/Upper Arm
1140 Stump Sleeve (closed end to axilla)
1141 Stump Sleeve with Shoulder Attachment
Arm zipper locations
Location FullLength
Or Specify Length cmL R
Lateral/Radial Aspect
Medial/Ulnar Aspect
Other:
Options and modifications
Code L R Description
SBE Silicone Backed Elastic
1190 Anterior Elbow Insert
0000 Elbow Contracture Seam ...............degrees
0000 Elbow Contracture Seam ...............degrees
1164 Zippers (20cm or less)
1165 Zippers (over 20cm)
1172A Zipper Loop (leather)
ZCT Zipper Closure Velcro® Tab (top of zipper)
1163B Zipper Fastening Aids (along length of zipper)
0000 Zipper Lining Satin Elastic0027 Padded Zipper Lining
1167 Lining - Inside Elbow Satin Cotton1168 Lining - Full Elbow Satin Cotton1167B Lining - Posterior Elbow Satin Cotton1188 Lining - Elsewhere (indicate on TBSA map) Satin Cotton1195 Fully Lined Garment Satin Cotton
SilonTEX® lining – indicate location and size on either hand outline, TBSA map or printed photo
0027 Padding - Soft (indicate on TBSA Map) Pocket Attached0027 Padding - Velfoam Pocket Attached1202 Motif
Stump Sleeve with Shoulder Attachment 1141
Arm Sleeve Wrist to Axilla 0501
Arm Sleeve with Shoulder Attachment 0503
Arm Sleeve with Bra Loop 0506
Forearm/Upper Arm 0515
Stump Sleeve Closed End to Axilla 1140
Powernet colour selection guide
Fabric & Thread: Black, Brown, Beige, Light Beige, Purple, Navy, Royal, Light Blue, Red, Pink, White, Camouflage
Contrast Thread: Orange, Hot Pink, Lime, YellowDual Stitching: nominate 2 colours
Fabric Thread Qty
1 1
2 2
Must provide extra colour options
1 1
2 2
Towards
Axilla
Upper limb circumferences
Pleat Pleat
Left Wrist End Right
cm/mm cm/mm41/2
3
11/2
0
11/2
3
41/2
6
71/2
Elbow 9
101/2
12
131/2
15
161/2
18
191/2
Pleat Axilla End Pleat
0503
0506
0501
1140
1141
0515
0515
0503
0506
0501
1140
1141
0515
0515
0503
0506
0501
1140
1141
0515
0515
0503
0506
0501
1140
1141
0515
0515
0503
0506
0501
1140
1141
0515
0515
0503
0506
0501
1140
1141
0515
0515
0503
0506
0501
1140
1141
0515
0515
Comments
®Velcro is a registered trademark of VELCRO BVBA
Measurement Form – Page 1 of 1
Arm Sleeve
Patient details (Please print in black with CAPITAL letters)
Last name
First name
Date
DD/MM/YYYY
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Garment returns
Unit 1, Level 1, 100 Station Street Nunawading Victoria 3131, Australia T 1800 772 577 F 1800 773 577 E [email protected] W www.jobskin.com
Unit 1, Level 1, 100 Station Street Nunawading Victoria 3131, Australia
Email, fax or return forms to:
All measurements taken with no tension and in centimetres only.
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2a
3a
4aArm measuring tips Pleat instructions Reading the tapes
Position the arm straight and horizontal, and measure using a Purple JOBSKIN arm tape.
At elbow9
For a Full Length Sleeve begin by securing tape 9 directly around the elbow. The last tape should fall just below the wrist bone (distal to styloid process). Pleating at the spine occurs ONLY at the wrist and axilla if required.
For a Forearm Sleeve begin tape at wrist and pleat at proximal end if required.
When pleating the last tape, measure the distance between the pleated tape and its neighbour from mid point to mid point (see diagram). Measurements must be recorded in millimetres.
Always read along the straight edge in the direction of the arrows indicated below.
Standard Arm Sleeve: This will automatically include soft elastic at the proximal end.Elbow Contracture Seam: Measure as for a regular sleeve, then record the elbow contacture angle in the space provided. A photograph is also useful.Stump Sleeve: Apply measuring tapes to extend as far distally on the stump as possible. A photograph of the stump with the tapes in place is required.
Shoulder attachment options
Arm sleeve definition, hints and tips
Bra Loop1. Distance last arm tape to inside edge of bra strap.
Female Body Strap2. Top of shoulder
circumferentially under opposite breast.
2a. Distance last arm tape to base of neck.
1
2
3
4
1
2a
3a
4a
Waist Attachment4. Top of shoulder diagonal
to waist.4a. Distance last arm tape
to base of neck.
Male/Child’s Body Strap
1
2
3
4
1
2a
3a
4a
1
2
3
4
1
2a
3a
4a
3. Top of shoulder circumferentially under opposite axilla.
3a. Distance last arm tape to base of neck.
Pleat
Measurement from midline
of tapes
21.8cm not 22.2cm
22.1cm not 23.9cm
Scalloped edgeStraight edge
Last name: First name: Date: Left Pleat Wrist End: Left Arm -4 1/2cm: Left Arm -3cm: Left Arm -1 1/2cm: Left Arm 0cm: Left Arm 1 1/2cm: Left Arm 3cm: Left Arm 4 1/2cm: Left Arm 6cm: Left Arm 7 1/2cm: Left Arm Elbow 9cm: Left Arm 10 1/2cm: Left Arm 12cm: Left Arm 13 1/2cm: Left Arm 15cm: Left Arm 16 1/2cm: Left Arm 18cm: Left Arm 19 1/2cm: Left Pleat Axilla End: Right Pleat Wrist End: Right Arm -4 1/2cm: Right Arm -3cm: Right Arm -1 1/2cm: Right Arm 0cm: Right Arm 1 1/2cm: Right Arm 3cm: Right Arm 4 1/2cm: Right Arm 6cm: Right Arm 7 1/2cm: Right Arm Elbow 9cm: Right Arm 10 1/2cm: Right Arm 12cm: Right Arm 13 1/2cm: Right Arm 15cm: Right Arm 16 1/2cm: Right Arm 18cm: Right Arm 19 1/2cm: Right Pleat Axilla End: Garment Options/Modes: 1190 Left: OffGarment Options/Elbow1: 0000 Left: Off0000 Elbow Contracture Seam1: Degrees: 0000 Elbow Contracture Seam2: Degrees: Garment Options/Modes: 1164 Left: OffGarment Options/Modes: 1165 Left: OffGarment Options/Modes: 1172A Left: OffGarment Options/Modes: ZCT Left: OffGarment Options/Modes: 1163 Left: OffGarment Options/Zipper Lining: 0000 Left: OffG: Options/Zipper Lining: 0000 Satin: OffOptions/Zipper Lining: 0000 Elastic: OffOptions/Lining Inside Elbow: 1167 Satin: OffOptions/Lining Inside Elbow: 1167 Cotton: OffOptions/Lining Full Elbow: 1168 Satin: OffOptions/Lining Full Elbow: 1168 Cotton: OffOptions/Lining Post: Elbow: 1167B Satin: Off Elbow: 1167B Cotton: Off
Options/Lining Elsewhere: 1188 Satin: OffOptions/Lining Elsewhere: 1188 Cotton: OffOptions/Fully Lined Garment: 1195 Satin: OffOptions/Fully Lined Garment: 1195 Cotton: OffOptions/Soft Padding: 0027 Pocket: OffOptions/Soft Padding: 0027 Attached: OffOptions/High Padding: 0027 Pocket: OffOptions/High Padding: 0027 Attached: OffOptions/Motif: 1202 Left: OffOptions/Motif: 1202 Right: Off
Garment Options/Modes: 0027 Left#1: OffGarment Options/Modes: 1167 Left: OffGarment Options/Modes: 1168 Left: OffGarment Options/Modes: 1167B Left: OffGarment Options/Modes: 1188 Left: OffGarment Options/Modes: 1195 Left: 0: 0: Off
Silontex Left: OffGarment Options/Modes: 0027 Left#2: OffGarment Options/Modes: 0027 Left#3: OffGarment Options/Modes: SBE Right: OffGarment Options/Modes: 1190 Right: OffGarment Options/Elbow2: 0000 Right2: OffGarment Options/Modes: 1164 Right: OffGarment Options/Modes: 1165 Right: OffGarment Options/Modes: 1172B Right: OffGarment Options/Modes: ZCT Right: OffGarment Options/Modes: 1163 Right: OffGarment Options/Zipper Lining: 0000 Right#1: OffGarment Options/Modes: 0027 Right#1: OffGarment Options/Modes: 1167 Right: OffGarment Options/Modes: 1168 Right: OffGarment Options/Modes: 1167B Right: OffGarment Options/Modes: 1188 Right: OffGarment Options/Modes: 1195 Right: OffSilontex Right: OffGarment Options/Modes: 0027 Right#2: OffGarment Options/Modes: 0027 Right#3: OffPowernet Color Fabric 1: Powernet Color Thread 1: Powernet Color Fabric 1 Qty: Powernet Color Fabric 2: Powernet Color Thread 2: Powernet Color Fabric 2 Qty: Powernet Extra Color Option 1: Powernet Extra Thread Option 1: Powernet Extra Color Option1 Qty: Powernet Extra Color Option 2: Powernet Extra Thread Option 2: Powernet Extra Color Option2 Qty: 1: Bra Loop CM:
2: Female Body Strap CM:
2a: Female Body Strap CM:
3: Male/Child Body Strap CM:
3a: Male/Child Body Strap CM:
4: Waist Attachments CM:
4a: Waist Attachments CM:
Left Arm Zipper Location: Lateral/Radial Ascpect: OffLeft Arm Zipper Location: Medial/Ulnar Ascpect: OffLeft Arm Zipper Location: Other: OffArm Zipper Location: Other: Right Arm Zipper Location: Lateral/Radial Ascpect: OffRight Arm Zipper Location: Medial/Ulnar Ascpect: OffRight Arm Zipper Location: Other: OffFull Length cmLateralRadial Aspect: OffFull Length Medial/Ulnar Aspect: OffOther Arm Location Full Length: OffOr Specify Length cmLateralRadial Aspect: Or Specify Length cmMedialUlnar Aspect: Or Specify Length cmOther: CommentsRow1: Garment Options/Modes: SBE Left: 0: Off
0501 L: 0: 0: Off1: Off
1: 0: Off1: Off
2: 0: Off1: Off
3: 0: Off1: Off
4: 0: Off1: Off
5: 0: Off1: Off