Wheelchair Transport Safety
Development of Improved Options

Nordic Seating Symposium, October 6, 2001
Stockholm, Sweden
Douglas Hobson, Ph.D

Slide1
Wheelchair Transport Safety Development of Improved Options
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Nordic Seating Symposium, October 6, 2001

Stockholm, Sweden

Douglas Hobson, Ph.D

Slide 2
Learning Objectives

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1)What are the transport safety concerns?

  • injury prevention
  • technology issues

2) What problem-solving is being done today

3) Action that clinicians can take today

4) What the future may bring

5) Summary of Key Points

6) How you can get more information

Slide 3
A - The concerns and goals

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Slide 4
Injury Prevention

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Basic Goals:

To provide a level of transport safety equal to that of non-disabled riders,

Maximize independence within the context of safe transport

Minimize the risk of injury of non-disabled riders

Slide 5
Injury Prevention Concepts -general

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Occupant orientation in vehicle is important-front facing most practical and safe,

Seat, restraint belt and vehicle interior design must function as a safety system,

Vehicle design features also important,

All seats must be securely fastened to vehicle.

Slide 6
Injury Prevention Concepts -
general (cont.)
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Velocity change and time are the key determinants of occupant loading during crash event,

Restraint systems can significantly lower the crash loads incurred by vehicle occupants,

Contact with vehicle interior or ejection most often cause of injury or fatality.

Slide 7
Occupant Restraints Reduce Injury by

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Increasing the time over which the occupant comes to a stop,

Decreasing the occupant’s forward travel,

  • thereby reducing risk of secondary impact with the vehicle interior.

Preventing ejection from the vehicle

Slide 8
In the case of W/c Transportation

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1. W/c must be able to substitute for vehicle seat

2. W/c must be secured to the vehicle,

3. Occupant must be restrained while in W/c,

4. W/c, W/c securement, occupant restraint and vehicle must all function as a safety system,

5. W/c must not impinge on occupant during impact event.

Slide 9
Wheelchair transport safety is a system challenge

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Any good solution must address the following as an injury prevention system:

  • the vehicle
  • the wheelchair
  • the wheelchair seating/accessories
  • the wheelchair securement to vehicle
  • the wheelchair occupant restraint

Slide 10
The Technology Issues

graphic descripton follows

Variety

  • wheelchairs
  • W/C securemen
  • people

W/C Structures

Vehicles

Interfacing

Accessories

Graphic description: an illustration of a typical manual wheelchair two large wheels on the rear and two small castered wheels on the front.

Slide 11
Variety-Wheelchairs

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Constantly expanding and changing

Only minimal concern for transport safety

Graphic description: a photo taken in an exhibit hall showing a large selection of both manual and powered wheelchairs, very few of which have any transport safety features.

Slide 12
Variety-Wheelchairs

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Graphic description: Two side by side photographs. The left photo is a side view of a JAZZY powered wheelchair which features large drive wheels located in the the middle of the chasis with two smaller casters in the rear. On the front are two more smaller wheels that only come in contact with the floor if the occupant accidently tips the wheelchair forward when getting in or perhaps reaching or lifting a heavy object. The seat is a fully padded, contoured beige seat that looks much more functional and comfortable than typical seats. The drive control is located on the left armrest . The powered base is given the "jazzy" look by use of form-fitting dark green plastic cover.

On the right is a vertical stack of five maual wheelchair bases , all different colors and sizes, intentded to illustrate Jazzy's new contempory base design ranging from large adult on the bottom to small child's on the top of the pyramid.

The point of both of these photos in this context is that there is no ready method to attach any type of know securement system for safe use in a motor vehicle.

Slide 13
Variety-Wheelchairs

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Graphic description: Two side by side photographs. The left photo shows a person seated on an older style three-wheel scooter that is positioned in a typical wheelchair station in a low floor transit bus. It illustrates how little space there is to accomodate scooters since they are usually longer then regular wheelchairs.

The right photo shows two contempory wheelchairs, one a large adult wheelchair and the second a small child size. The intent is to illustrate that in addition to different frame styles, successful securement must also accomodate a wide range of wheelchair sizes.

Slide 14
Structures-Manual

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Graphic description: Two side by side photos. The left shows a side view of typical light weight manual wheelchair with arrows pointing to different locations on thefront of the wheelchair frame, one to an area at about seat height and the second to an area just above the front caster. There is a question mark between the two arrows, begging the question as to where is the best location to secure this wheelchair.

Right photo also shows a front view of a different manual wheelchair with arrows pointing to two possible securement locations, one on the frame and the other on the upper foot rest assembly.

Both photos are intended to illustrate that even those wheelchairs that can be secured offer multiple choices, some of which are much safer than others.

Slide 15
Structures-Powered

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Graphic description: Shows two more different powered wheelchairs with arrows pointing to posible securement points.

The left chair is again the Jazzy which has question marks front and back--again emphasizing that there really is no where

that designs of this type can secured and therefore used as safe seats in motor tranport. The caption reads " What do you do with this one?"

The right photo is a traditional powered base with a powered tilt seat. Three arrows point to different frame locations. The caption reads "Take your best quess?"

Slide 16
Structures-Specialty Bases

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Graphic description: Side by side photos of two speciality seating bases. The left is a side view of a light weight, child size, collapsable stroller with arrows pointing to the two strength-tested securement fixtures, one on the front area and the other of the rear area of the stroller frame. The caption below reads "can this be strong enough?"

The right photo is of a different style specialty seating base, with arrows pointing to three possible securement locations? The caption reads "where do you grab this one?"

Slide 17
Accessories

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Graphic description: Shows a photo of an array of different commercially-available wheelchair seating inserts for children with the caption that reads " Yikes!, None are designed for transport safety"

Slide 18
Accessories

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Graphic description: Two side by side photos: The left photo showing a commonly used seating insert for children that has many sharp metal components. The right shows the top view of a child sitting in a manual wheelchair with his knees contained within a form -fitting knee bolster or block. The point being that these are additional components and seating accessories that may or may not be injurious to the users during an impact event.

Slide 19
Accessories

graphic description follows

Graphic description: Two side by side photos: The left photo showing a commonly used seating insert for children that has many sharp metal components. The right shows the top view of a child sitting in a manual wheelchair with his knees contained within a form -fitting knee bolster or block. The point being that these are additional components and seating accessories that may or may not be injurious to the users during an impact event.

Slide 20
Vehicles

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Graphic descrription: A graphical illustration showing five different motor vehicles. The vehicles shown are: a van, trolly, private car, large bus, school bus. The main point being that a variey of vehicles must be given consideration when planning and developing safer transport concepts.

Slide 21
Variety-Wheelchair Securement

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Graphic description: Four photos showing different styles or methods used to secure wheelchairs in motor vehicles.

Upper left: the experimental rear docking device by Mobile Tech. It shows one of two "D" rings mounted on the lower rear frame of a wheelchair just prior to its engagement with a self-latching docking device permanently mountrd to the vehicle floor.

Upper right: A side-facing manual wheelchair secured to a school bus side wall by two "U" shaped clamps with pins passing through the large rear wheels. Virtually all aspects of this approach is in contrast to today's transport safety principles.

Lower left: a front view of the Ezi-loc docking device showing an adapter hardware addition to the lower frame of the wheelchair that contains a large downward protruding pin. The pin auto-engages with a mating receptacle mounted permanently to the floor of the vehicle to secure the wheelchair. The Ezi-loc is used mainly to give people independent securement when using private vehicles.

Lower right: A transport operator seated in a manual wheelchair in his large van-size people tranporter illustrating how he secures both the wheelchair and the occupant. The wheelchair is side facing in the vehicle, backed against a fold-up seat. One long strap coming from the lower seat frame crosess the drive wheels, armrests and latches with its mating strap on the lap of the occupant. Virtually all aspects of this approach is in contrast to today's transport safety principles.

Slide 22
Industry standard: four-point strap-type tiedown

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Problems:

  • time consuming
  • dependence of user
  • hard to apply
  • some W/cs impossible

Graphic description: Shows a side view mock-up of manual wheelchair being secured by four strap-type securement devices, two in the front and two in the rear. The straps run from the floor "pocket-type" attachment points to suitable locations on the fromt and rear of the wheelchair frame. The arrangement is considered the acceptable industry standard method for wheelchair securement today. The intent is to recognize the remaining shortcomings of the four strap-type securement approach.

Slide 23
Problems: Interfacing

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Graphic description: two photos showing different types of end-fittings commonly used on securement straps. Upper left diagram shows the 'pocket' syle fittings thjat are recessed into the fllor of the vehicle. Lower right photo shows two hook type and two strap type end fittings used to attached the securement strap to the wheelchair, one on each side.

Slide 24
Variety - People

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disability

body sizes

activities

levels of independence

attitudes

Public

Graphic description: Illustration of a group of ten standing adults intended to emphasize the variety that exists across the population.

Slide 25
Safety vs. Equality
What are the limits?

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Graphic description: a humerous graphic showing a wheeelchair user overly strapped and chained down in their wheelchair with a standing passenger causually standing in the isle and holding on with one hand. The operater turns and says" Everybody secure back there?"

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Last Updated: February 28, 2002

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