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Transporting children in wheelchairs in passenger vehicles: a comparison of best practice to observed and reported
Janell Yonkman1, Joseph O'Neil, Judith Talty
1National Center for the Safe Transportation of Children With Special Health Care Needs, Riley Hospital for Children, Indiana University School of Medicine, 575 West Drive, Room XE 004, Indianapolis, IN 46202, USA. jyonkman@clarian.org
Insights
Many children with special health care needs in wheelchairs are not transported safely in vehicles. Observed practices often deviate from recommended guidelines, indicating a need for better caregiver education on wheelchair and occupant securement.
Area of Science:
- Pediatric transportation safety
- Assistive technology in vehicles
- Child passenger safety
Background:
- Children with special health care needs often use wheelchairs.
- Safe transportation of these children in vehicles presents unique challenges.
- Voluntary standards exist for best practices in wheelchair transportation.
Purpose of the Study:
- To compare observed and reported wheelchair transportation practices.
- To evaluate these practices against established voluntary standards.
- To identify discrepancies in real-world application.
Main Methods:
- Observation of vehicles with children in wheelchairs exiting a children's hospital.
- Data collection on driver demographics and child's condition.
- Assessment of wheelchair and occupant securement methods by certified technicians.
Main Results:
- 90% of wheelchairs were secured with four-point tie-down systems.
- 88% of wheelchairs were tied down correctly.
- Only 20% of occupants used separate lap-shoulder belts.
- 25% used non-recommended lap trays.
- 15% had medical equipment secured improperly.
Conclusions:
- Significant deviations from best practice guidelines were observed.
- Areas for improvement include occupant securement and medical equipment safety.
- Increased awareness, education, and resources are needed for caregivers.
Objective:
We compared observed and reported practice among children with special health care needs transported in wheelchairs with the recommendations from the American National Standards Institute/Rehabilitation Engineering and Assistive Technology Society of North America Committee on Wheelchairs and Transportation voluntary standards for best practice for using wheelchairs in vehicles.
Method:
A convenience sample of vehicles exiting the garage of a children's hospital was observed. Certified child passenger safety technicians gathered driver demographics and the child's reported medical condition, weight, age, clinic visited, and relation to the driver. Technicians observed how the wheelchair and occupant were secured.
Results:
A sample of 20 vehicles showed that 90% used four-point tie-down systems to secure the wheelchairs. A total of 88% of drivers tied the wheelchairs down correctly; only 20% used a separate lap-shoulder belts to secure the occupants. Twenty-five percent used lap trays, which are not recommended. Fifteen participants traveled with medical equipment secured inappropriately.
Conclusion:
Many deviations from best practice were observed and highlight areas for increased awareness, education, and resources for caregivers.
