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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.
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.
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.