Transporting Kids in Wheelchairs: Webinar: Transporting Kids in Wheelchairs: Nuts, Bolts, and Tips for Making It Safe Presenters: Therese Pelicano, Frederick County Public Schools and Carolyn Darrehmane, Public Health Nurse, CPST, and Parent Please put your phones on MUTE in order to minimize background noise, as the presentation is being recorded so that we can archive the slides & audio on our website. Please save questions/comments until the end of the presentation. Complete and mail back the evaluation form and the participant information form. .

Wheelchair Transportation and the school bus How to safely transport students/ Children Therese L. Pelicano Transportation Specialist

History of the wheelchair Earliest known wheelchair: 1595 Called an invalid chair Unknown inventor for Phillip ll of Spain 1783 Bath wheelchair was invented Named for Bath England Out-sold all other wheelchairs throughout the early part of the 19th Century Was not comfortable and many improvements were made during the last half of the century

History of the wheelchair Wheelchairs were not designed to be used as a seating position in a motor vehicle Best practice – if at all possible, student/child should be transferred to the seat. Motor vehicle seat with lap and shoulder belt Appropriate child safety restraint system ( car seat ) Many school buses do not have lap and shoulder belts due to compartmentalization Some students are too medically fragile to transfer

Start with the right equipment USE A WC 19-APPROVED MOBILITY DEVICE VOLUNTARY STANDARD DEVELOPED BY REHAB AND SAFETY EXPERTS WITHSTANDS CRASH FORCES OF 30G -- 30 MPH CRASH HAS 4 CRASH-TESTED SECUREMENT POINTS- plus crash-tested lap and shoulder belt CLEARLY MARKED ON THE MOBILITY DEVICE

Securing the wheelchair Must be forward-facing Center chair over the tracking Attach front tiedowns 3-8 inches out from chair Attach rear tiedowns to ideally achieve 30 to 45 degree angle of the rear tiedown straps

Securing the occupant Upper belt of the occupant restraint should be coming across the clavicle Lap portion should fit low across the pelvis Do not use wheelchair seatbelt unless it is approved for transport

WC 19 or Transit option wheelchair Designed as a seat in a motor vehicle Crashworthy frame No sharp edges Some manufacturers provide a crash- tested seat belt Lap belt will be labeled to allow connection with a vehicle-mounted shoulder belt

CLEARLY MARKED FOR EASY SECUREMENT Must be able to hook the tiedown within 10 seconds or less 4 identified locations on the wheelchair

Labeling Established in 2012 Labeling that complies with the latest version of WC 19

Non WC 19 Compliant wheelchair Attach securements to the main frame of wheelchair at welded junctions Secure at structural points as close to the seating position as possible Do not attach to removable parts (examples: armrests, footrests or wheels)

Non wc 19 compliant wheelchair Difficult to secure tiedowns Must choose structural securement points close to seating position

WC 18 COMPLIANT WTORS – Wheelchair Tiedown and Occupant Restraint system 4 tiedowns that attach to the floor of the vehicle Have been crash-tested and passed 30 mph dynamic test Provides both upper and lower torso restraint to protect the rider

Utilizing lifts to load and unload students Brakes must be applied while on the lift Safety belt must be engaged in order for lift to operate All postural support devices must be used Only wheelchair user rides up and down on lift Power off motorized chairs while on the lift

Emergencies - BE PREPARED Know your Students and their Wheelchairs Work with physical or occupational therapist to familiarize yourself with straps, removable parts, seating position Work with school staff to familiarize yourself with each student’s physical capabilities Have a written plan in place for evacuation in event of an emergency Have Emergency Slider Kit and belt cutter on vehicle at all times

Additional equipment

Additional Equipment Slider Sheet Belt Cutter

resources University of Michigan Transportation Research Institute www.travelsafer.org Rehabilitation Engineering Research Center on Wheelchair Transportation Safetywww.rercwts.org www.kennedykrieger.org or call 888-554-2080 The Johns Hopkins Hospital 601 North Wolfe Street Meyer 1-130 Baltimore, Maryland 21287 Phone: 410-614-3234 National Rehabilitation Hospital in Partnership with Children’s National Medical Center 102 Irving Street, NW Washington, District of Columbia 20010 Phone: 202-877-1000 

Thank you! .

That’s how we roll…. A PARENT’S PERSPECTIVE ON USING WHEELCHAIRS FOR TRANSPORTATION Carolyn Darrehmane, RN, cpst

Points to consider when choosing a new chair for your child: Transit Ready (4 point tiedown) Crash Tested Wheelchair or Stroller? Positioning needs Caregiver needs Choosing a Chair Did you know: There are no federal safety standards for wheelchairs used for transportation

TYPES OF CHAIRS Manual Wheelchair Lightweight Stroller Heavy, sturdy, better positioning from therapeutic stance Lighter, easier to maneuver over rough terrain, poor position for child, fixed tilt

Secure the wheelchair USING AN ADAPTED VAN Standard tiedown Auto retractors Docking station Secure the child Secure other objects (tray, medical equipment) USING AN ADAPTED VAN Did you know… A wheelchair adaptation may add $20,000 to the price of a van, but it can be claimed as a medical deduction

Using a Passenger Car or Van Use of appropriate safety seat, travel vest or vehicle seat Transporting the empty chair –parent safety issues with lifting Where to put other devices (tray, medical equipment) Did you know…. Insurance may not pay for a stroller if already funding a wheelchair, but it may be funded by LISS funds or other grants or funding

Transporting at School Advocate for your child when others are transporting Verify and advocate for your child Request transport go on the IEP

Transporting in Community Transporting in community (daycare providers, religious groups, extended family) Advocate for your child and educate other people who may be transporting your child Transporting in Community

Where can parents go to get more information? Additional Resources: Wheelchair tiedown and seatbelt placement Travelsafer.org (PDF in English and Spanish) Crash-tested chairs: rercwts.pitt.edu Equipment and stroller funding: http://dda.dhmh.maryland.gov/SitePages/liss.aspx Van funding: MD Assistive Technology Loan Program mdod.maryland.gov http://www.braunability.com/wheelchair-van-grants-funds/ EZ-on Travel vests for wheelchairs: ezon.impactfulmedia.com Where can parents go to get more information?

Thank you for participating today! The evaluation form is available on our website: http://www.miemss.org/EMSCwww/CPSHome.htm; alternatively, we can email it to call participants. Return your completed evaluation along with the contact info page. If you want to order materials, complete this form. 1 CEU credit for CPSTs is available for participants who return their completed evaluation form. The full presentation will be available on our website in a couple of weeks in case you wish to re-visit it, or refer a colleague to it.