PASSENGER ASSISTANCE TRAIN THE TRAINER

TRAININGWheelchair Securement

& Lift Operation

Provided by RLS & Associates Inc.

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COURSE PURPOSEYou will learn:

Americans with Disabilities Act Different types of disabilities Lift operations Proper securement techniques

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AMERICANS WITH

DISABILITIES ACT

(ADA)

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AMERICANS WITH DISABILITIES ACT

The purpose of the Americans with Disabilities Act of 1990 is to:

(1) to provide a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities;

(2) to provide clear, strong, consistent, enforceable standards addressing discrimination against individuals with disabilities;

(3) to ensure that the Federal Government plays a central role in enforcing the standards established in this Act on behalf of individuals with disabilities; and

(4) to invoke the sweep of congressional authority, including the power to enforce the fourteenth amendment and to regulate commerce, in order to address the major areas of discrimination faced day-to-day by people with disabilities.

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BASIC PARTS

Cite: 49CFR37 Transportation Services for Individuals with Disabilities

Cite: 49CFR38 Accessibility Specifications for Transportation Vehicles

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EMPLOYEE TRAINING

Requirement to train personnel to proficiency

Operate vehicles and equipment safely Provide level of service as required Treat individuals with disabilities in a

respectful, courteous way

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LIFT AND SECUREMENT USE

All “Common Wheelchairs” and their users must be transported

Common Wheelchair defined as:Not exceeding 30” wideNot exceeding 48” long, when

measured 2” above groundDoes not weight more than 600 lbs.

occupied Securement system MUST be

used to secure wheelchair (paratransit)

Cannot deny service on basis of difficulty in securing wheelchair 7

LIFT AND SECUREMENT USE

Must permit standees to use lift to enter vehicle

Each securement location must have a 3-point passenger restraint system

Can only require passenger restraint if ALL passengers are required to use

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LIFT AND SECUREMENT USE

Transfer from wheelchair to vehicle seat can be recommended, but not required

Where necessary or requested, drivers must assist with use of:Securement SystemRampLift

This assistance is required even if the driver must leave his/her seat to do so

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ADA QUESTIONS & ANSWERS

May a transit operator require common wheelchairs be secured to the vehicle? Yes

What kinds of securement equipment must be provided Two part securement system

May a transit operator deny boarding to a rider whose common wheelchair is difficult to secure No

Does a wheelchair user have to use the seatbelt and shoulder harness No - unless

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ADA QUESTIONS & ANSWERS

What if the accessibility equipment is missing or not working Must maintain

Does a wheelchair need brakes in order to use public transit No

Can a transit operator require a person to transfer from a wheelchair to a vehicle seat No

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MAINTENANCE OF LIFTS

Regular and frequent lift maintenance program must be developed and instituted

Drivers must report non-operating lifts by the most immediate means available

Every effort must be made to repair lifts before the next day of service

If vehicle with inoperative lift is on route with headways > 30 min., must provide alternate transportation

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MOBILITY AIDS AND LIFE SUPPORT SYSTEMS

Service animals must be allowed to accompany passengers

Passengers must be permitted to travel with life support, including:RespiratorsPortable Oxygen

Can only deny if to transport would violate rules concerning the transportation of hazardous materials

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HOW CAN YOU HELP

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PERSONS WITH DISABILITIES

Take the time necessary to allow passengers with disabilities to board

comfortably and safely: Be courteous Patient Accepting

The invisible barriers that continue to stand in the way of persons with

disabilities: Negative attitudes Fear Stereotyping Lack of knowledge 15

APPROPRIATE TERMINOLOGY

Use Disabled Non disabled Congenital disability Does not speak

Instead Of Handicapped Able-bodied Birth defect Mute or dumb

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Language plays a powerful and important role in shaping ideas and attitudes creating either a positive or insensitive view of people:

APPROPRIATE TERMINOLOGY

Proper Usage

Hearing impaired Partially sighted Speech impaired Blind People who are... Persons with…

Avoid Using

Victim Afflicted with Cripple Invalid Wheelchair bound Confined to a

wheelchair

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CONSIDER THIS

When we are very young, we depend on others for basic levels of care. Often as

we age, we are again dependent on others. For this reason, people in the

disabled community consider others as “temporarily abled.”

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VISUAL IMPAIRMENTSPeople can be born blind or become

blind later through an accident or disease. When transporting a visually

impaired person: Introduce yourself Offer assistance Use normal tone of voice Clear concise instructions Respect guide dog Use care in giving directions Notify the individual if you are leaving

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HEARING IMPAIRMENTSPersons with severe hearing

impairment rely upon their eyes for signals which represent ideas. When

you transport a person with a hearing impairment:

Introduce yourself Speak clearly and distinctly Provide a clear view of your mouth Use normal tone Speak directly to the person Careful of facial expression

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COGNITIVE DISABILITIESThe range of a persons disability may

be classified as mild, moderate, severe, or profound. When you

transport a person with developmental disabilities:

Introduce yourself Do not talk down to the person Offer assistance, but do not push it Give directions one step at a time Do not assume the person is sick Be patient Treat adults as adults

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SEIZURESThere are several different types of seizures convulsive

seizures or grand mal seizures are the most recognized, and the easiest to control with

medication. They should be allowed to run their course naturally. What should you do?

Stop the vehicle Leave the person in the seat belt if possible Protect them Don’t loosen any tight clothing Roll them to one side Stay with them Help re-orientate the person Notify dispatch Do not put anything in their mouth

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SEIZURESKeep in mind there are several different types

of seizures. There are three types of minor seizures:

Absence seizure – staring into space, rapid eye movements, eyes rolling back into the head.

Simple partial seizure – tremors or trembling along one side of the body, sensory distortions and hallucinations.

Complex partial seizure – inappropriate behaviors such as aimless walking, pulling at clothes and smacking lips.

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NEUROMUSCULAR CONDITIONS

Cerebral Palsy is the result of damage to the nerve tissues of the brain. Mobility problems are caused by imperfect muscle control. Decreased sense of balance May have extensive spasticity Experience problems in communicating May be fully capable intellectually and should be

treated as such

Multiple Sclerosis is a chronic degenerative disease of the central nervous system (brain and spinal cord). Extremes of strength Mobility coordination

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NEUROMUSCULAR CONDITIONS

Muscular Dystrophy is an inherited disease that causes increasing weakness in the muscles. Difficulty in walking Speech problems Poor vision

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OTHER DISABILITIES IMPAIRMENTS CONTINUED

Stroke occurs when the blood supply to a part of the brain is cut off. The person may:

Have difficulty walking Paralysis to one side Difficulty speaking Difficulty understanding what you say Difficulty judging distances Visual impairment

Spinal Cord Injury or disease affecting the spinal cord. The level of damage will determine what

movement or feeling remains: May have partial or complete paralysis of both legs May have partial or complete paralysis of both arms

and legs Paralysis on one side Loss of skin sensation

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OTHER DISABILITIES IMPAIRMENTS CONTINUED

Arthritis is a long-term condition causing pain and stiffness of the joints. It can occur in young people

as well as older people.

May have difficulty walking Maybe unable to walk May have difficulty with hand functions

Hidden disabilities can be one or a combination of impairments, such as epilepsy, heart or lung problems, diabetes, cancer or kidney failure.

May appear non-disabled May have difficulty climbing steps May be unable to walk short distances

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MOBILITY & ACCESSIBILITY

Wheelchairs provide mobility for persons with paralysis, muscle

weakness, lack of coordination, nerve damage, and/or stiffness in joints. When you transport a person who

uses a wheelchair: Do not automatically hang on a persons

wheelchair Offer assistance, but do not insist Talk directly to the person

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ASSISTIVE WALKING DEVICES

ASSISTANCE

One arm assist and two arm assist are two very simple, but incredibly helpful

techniques for assisting passengers to a standing position.

Make sure the person is steady before walking

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USING THE LIFT

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INSPECTIONIt is very embarrassing to arrive at your first

stop and find that you do not have the necessary tie-downs to secure a wheelchair

or that the equipment is inoperable. You must have four retractors w/proper floor

anchorage fittings Pull out retractor and inspect webbing Ensure retractors are locking Ensure metal parts are not cracked or damaged Ensure all hardware (nuts/bolts) are secure Ensure floor anchorages are clean and clear of all

dirt and debris

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INSPECTION CONT. One lap belt assembly or lap shoulder belt combination

Check shoulder belt anchorages for proper securement and operation

Inspect lap/shoulder belt webbing for damage or contaminates

Check buckles for damage and proper operation Check pin connector bushing to ensure it is not broken,

cracked or missing Inspect any other parts of the securement system and

accessories that may not be specifically indicated, but are pertinent to safe operation

Webbing Loops Belt cutter

Any parts in question should be immediately reported and replaced. Do not mix securement (manual/retractors)

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LIFT OPERATIONS The lift must always be operated from the ground. Greet your passengers Offer assistance Communicate Back onto lift Set the wheel locks Have the passenger place their hands in their lap Hold onto the wheelchair while in operation Raise the lift three inches off the ground and check the

toe plate Raise to floor level Push chair in as far as you can with control & set

wheel locks Push into vehicle and set wheel locks

Never leave a wheelchair sitting on the platform unattended

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LIFT OPERATION

Park in a suitable location

Open doors and secure

Press unfold button until lift reached floor level

BOARDING A PASSENGER

Assist passenger onto lit & set wheel locks

Ask passenger to turn off the power on a power chair

Make sure wheelchair clears the outer barrier

BOARDING A PASSENGER Locate passenger

or standee on the center of the lift

BOARDING A PASSENGER Make sure the

passengers feet and footrests are clear of the folded outer barrier

BOARDING A PASSENGER Push the UP

button on the lift control

Make sure the outer barrier folds and locks

Keep an eye on the passenger while the lift is rising

BOARDING A PASSENGER

Raise the lift to floor level

If possible assist the passenger off lift and into the vehicle, clear of bridge plate

Set wheel locks Partially fold the lift so

passenger cannot fall off lift while driver goes around to secure

MANUAL LIFT OPERATIONS

Remove cover from pump panel Remove pump arm from cover Insert pump arm into bleeder valve &

turn Once lift is deployed place pump arm

tighten the valve. Insert the pump arm into the pump

opening

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MANUAL LIFT OPERATIONSManual operation in case of power or equipment

failure only

MANUAL LIFT OPERATIONS

MANUAL LIFT OPERATIONS

MANUAL LIFT OPERATIONS

MANUAL LIFT OPERATIONS Manual operation

of the lift is only to be used in case of power failure

SECUREMENT

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SECUREMENTThere are many different brands, styles

and models of wheelchairs many of which are challenging to secure.

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SECUREMENTInspect the chair for anchorage points

during the loading process.

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SPORT CHAIR DESIGN

Cambered wheels

Tilt Bar Axle Position

Handle Grips

SECUREMENTIt may be necessary to use the webbing loop on a solid frame member to create

an anchorage point.

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SECUREMENT Make sure you have all of your

securements out and ready

Position the wheelchair in the securement station facing forwardOnce in place lock the wheel locks and

turn-off the power on a motorized wheelchair

While you are handling the wheelchair begin looking for anchorage points

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PennTRAIN

SECUREMENT LOCATIONS Locate mobility device in

center of the 4 floor attachments. Set wheel locks/turn off power.

Rear belts parallel with rear wheels.

Front belts flair out slightly for lateral stability.

Belts should not bend around any part of wheelchair/scooter.

PennTRAIN

REAR SECUREMENT

Apply to chair at a solid junction of frame, if possible about 2” below seat level.

Straps should be about 30-45 degrees.

Tighten securely

PennTRAIN

REAR TIE-DOWN ANGLES

PennTRAIN

FRONT TIE-DOWN ANGLES

SECUREMENT Attach the lap/shoulder belt on the

occupantSecuring the passenger will always

require some minor physical contactAlways place the female lap belt section

with the release button on the aisle side of the passenger

Ensure a snug fit

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PennTRAIN

OCCUPANT RESTRAINT--LAP BELT

Locate lap belt low at pelvic area not over abdomen.

45-75 degrees from horizontal. Snug but not tight.

Postural belts on wheelchair frames are generally NOT designed for safety during

transportation!!!

PennTRAIN

OCCUPANT RESTRAINT-SHOULDER BELT

Locate over shoulder as shown at right.

Shoulder belt should be attached to lap belt.

If not spring tensioned leave some slack--fist test.

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NO OCCUPANT RESTRAINT

LAP BELT ONLY (JACK KNIFE)

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SUBMARINE EFFECT

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POSTURAL BELT

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PennTRAIN

RECOGNIZING A WC19 WHEELCHAIR

Four labeled securement loops attached to wheelchair frame with hardened bolts

PennTRAIN

“TRANSIT OPTION” WHEELCHAIRS

Crash tested wheelchairs will have 4 attachment locations with hook logo and anchored with hardened bolts.

Use them if present

NON WC-19 WHEELCHAIR

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VARIOUS MOBILITY AIDS

& HOW TO SECURE THEM

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PennTRAIN

SECUREMENT BELTS

PennTRAIN

LOOP SECUREMENT BELT

PennTRAIN

3 WHEELED SCOOTER

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SCOOTER BELT IN USE

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FRONT SECUREMENT BELT

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FRONT SECUREMENT ALTERNATIVE

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REAR SECUREMENTS

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SEAT BELT/ATTACHMENT HOOKS

Lap Belt

Lap Belt

5th Belt

PennTRAIN

REAR SECUREMENTS

Lap belt under arm rest support

PennTRAIN

REAR SECUREMENT

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REAR SECUREMENT ALTERNATIVE

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QUANTUM

PennTRAIN

NEVER SHOCKS/SPRINGS OR WHEELS

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FRONT SECUREMENT

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FRONT ATTACHMENT

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FRONT ATTACHMENT ANOTHER VIEW

PennTRAIN

REAR SECUREMENT PLACEMENT

If at all possible… not here!

PennTRAIN

REAR SECUREMENT PLACEMENT

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PRONTO

PennTRAIN

RIGHT FRONT

PennTRAIN

SAME AREA WITH DIFFERENT VIEW

PennTRAIN

SOLID FRAME MEMBER BENEATH SEAT

PennTRAIN

RIGHT REAR

PennTRAIN

TRY TO MAINTAIN 45 DEGREE ANGLE

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PennTRAIN

PennTRAIN

RIGHT REAR-ANOTHER VIEW

PennTRAIN

OVERSIZED PRONTO

PennTRAIN

Pronto M94 Bariatric Power Wheelchair (Invacare)

From Pronto M94 Owners Manual Revision 07/07 © Invacare Corp.

PennTRAIN

NOT HERE

PennTRAIN

IF NOT FOR SECUREMENT…WHAT’S IT FOR?

PennTRAIN

TRY TO MAINTAIN A 45 DEGREE ANGLE

PennTRAIN

A SECUREMENT LOOP MAY WORK BETTER HERE

PennTRAIN

SOLID FRAME MEMBER

PennTRAIN

NEVER HERE!

QUESTIONS????????????

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