MAO Manual

Never connect the tie-downs to a moving part of the wheelchair, such as the leg rests, arm rests, or the wheels themselves. Connect the tie-downs to the frame of the wheelchair instead. If you practice this in general, you should have no problems securing a custom wheelchair of any kind. The fastening procedure is based on the same concept no matter what type of wheelchair you are working with.

The three-point system consists of a lap belt and a shoulder belt. The lap belt should be thread through the arm rests of the wheelchair when possible so that it sits as closely as possible to the lap of the patient. The belt should not be placed over the arm rests as they allow a patient to slide under the belt during a collision. It may also place the belt over the abdomen instead of the pelvis, leaving the patient subject to abdominal injury in the case of a collision. The shoulder belt should attach to the lap belt at the hip of the wearer extending at an angle to cross the patient’s chest up to the shoulder region. It should extend beyond the patient to a track system on the wall of the vehicle. Tip: Use the back of your hand against the patient’s body when bringing the lap belt up from the floor and through the wheelchair. Coming into contact with patient’s body always use the back of your hand. FAILURE TO SECURE THE PATIENT Not securing the patient correctly can cause a patient to become severely injured. In a collision, even if the wheelchair stays secured to the van, the patient will be ejected from his/her seat. The patient can strike the inside of the vehicle and become seriously hurt.

IMPORTANT: The wheelchair should always be in four-point restraints when the vehicle is in motion even if there is no patient on board. Remember to consider “crashworthiness” at all times. SECURING THE PATIENT In addition to the four-point wheelchair restraint system, the Americans with Disabilities Act (ADA) recommends the use of a secondary restraint system to secure the patient. While the four-point system is designed to keep the wheelchair in place, the secondary restraint system is designed to keep the patient in place. This system is used in conjunction with the standard seat belt. There is more than one approved system. The two-point system is a lap belt which attaches to either the floor track or to the base of the rear tie-downs. The lap belt is to be worn across the pelvic region.