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Item # 216 (extra large - 116cm chest)Item # 217 (large - 106cm chest)Item # 218 (medium - 86cm chest)Item # 219 (small - 66cm chest)The Coughing Jacket is worn by patients who have trouble with chest pains when they are trying to cough. Used after open heart surgery, or could be used for other respiratory problems.To Fit:1) Wear the Jacket so the arms are through the shoulder straps and the webbing handles are at the front.2) Adjust the shoulder strap length so the Jacket sits around the chest wall/rib cage region.3) When coughing - provide support for the chest by pulling the handles across the chest (the left hand pulls the right side & vice versa).4) When not coughing, the Jacket will just hang loosely from the shoulder straps, but it will be easily accessible when coughing arises.Washing: Hand or machine wash only, up to 80°C. Do not tumble dry or wring - air dry only.