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August 01, 2008  |   Comments (32)   |   Post a comment

The Dos and Don'ts of Wheelchair Transport Safety

While the availability of safety standard-compliant wheelchairs and restraint systems has increased, passenger protection still relies on several key policies and procedures.

by Lawrence W. Schneider and Miriam A. Manary


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Photo courtesy of University of Michigan

Photo courtesy of University of Michigan

After the Education for All Handicapped Children Act of 1976 became law, it was common practice to transport children in wheelchairs facing sideways in school buses, with the large wheels captured by mechanical rim-pin clamps, with bungee cords attached to the most-available wheelchair components, such as the armrests and footrests, or by other inadequate securement methods.

Seat belts, if provided at all, were often placed around the student’s abdomen instead of low on the pelvis and over the shoulder. In other words, students in wheelchairs were not provided with the same level of crash protection as students seated on the forward-facing, closely spaced, high-back, padded seats required by Federal Motor Vehicle Safety Standard (FMVSS) 222.

In fact, at the time, FMVSS 222 excluded children in wheelchairs from the crashworthiness provisions of the standard, identifying them as students facing 45 degrees or more to the longitudinal axis of the vehicle.

Fortunately, the opportunities for safe transportation for students in wheelchairs have increased significantly over the past two decades. In 1992, FMVSS 222 was modified to include wheelchair-seated students and now requires all wheelchair stations provided by school bus manufacturers to be installed for forward-facing travel and equipped with four-point, strap-type wheelchair tiedown and three-point pelvic/shoulder belt restraint systems that meet static strength requirements.

Most school bus wheelchair stations are now equipped with wheelchair tiedown and occupant restraint systems (WTORS) that comply with SAE J2249, a recommended practice that was completed in 1996 by the Restraint Systems Task Group of the Society of Automotive Engineers’ Adaptive Devices Subcommittee.

In addition, it is now possible for students to travel in wheelchairs that comply with ANSI/RESNA WC19, which means that they have been designed and crash tested for use as seats in motor vehicles. A key feature of WC19- compliant wheelchairs is four accessible attachment points on the wheelchair frame to which tiedown straps can be easily and effectively attached.

Best practices
While changes to FMVSS 222 and increased availability of WTORS and wheelchairs that comply with voluntary industry safety standards provide greater opportunities for wheelchair-seated students to travel more safely to and from school, it is important that school bus operations implement transportation policies and procedures based on basic principles and best practices of transportation safety.

Assuming that the buses are equipped with properly installed WTORS that comply with FMVSS 222 and, ideally, SAE J2249, there are several fundamental DOs and DON’Ts that should be part of every school transportation program involved with the transport of students who use wheelchairs.

DO consider transferring students in wheelchairs to the school bus seats.
It is generally considered safest for students who use wheelchairs to transfer to the vehicle seat when this can be done safely and without compromising special medical and seating needs. However, even when transfer is feasible, it may not always be the safest option in the school bus environment.

For example, if a student is using a WC19-compliant, crash-tested wheelchair that facilitates proper placement of vehicle-anchored seat belts, the student may actually be safer traveling in their wheelchair than sitting on a bus seat that’s not equipped with shoulder and pelvic belt restraints.

For students who transfer to a school bus seat, safety can be enhanced beyond the level provided by compartmentalization through the use of crash-tested harnesses. In addition, postural support vests can help keep smaller children positioned on the bus seat.

DO encourage the purchase and use of WC19 wheelchairs.
As noted earlier, WC19-compliant wheelchairs provide four easily accessible attachment points that greatly facilitate effective wheelchair securement using a four-point, strap-type tiedown. Because these wheelchairs have been successfully crash tested, transportation personnel can have confidence that the wheelchair will support the student and be effectively secured if the vehicle is involved in a crash or rollover. Therefore, school transportation personnel should encourage parents to choose WC19- compliant wheelchairs whenever there is an opportunity to do so.

DON’T deny transportation to students who do not have a WC19 wheelchair.
Although WC19-compliant wheelchairs will make wheelchair securement easier and more reliable, students should not be denied school bus transportation if they don’t have a WC19- compliant wheelchair. Denying transportation to students in wheelchairs will generally result in having them travel to and from school in smaller vehicles that are more likely to be involved in a crash, thereby putting the student at greater risk of injury.

Rather than denying transportation, school transportation personnel should work as a team to identify and permanently mark the best and strongest wheelchair securement points on structural members of the base or seating system. This may require attaching webbing {+PAGEBREAK+} loops sold by most WTORS manufacturers to frame members to create accessible tiedown attachment points. Modifications to plastic trim of powerbase wheelchairs may be necessary to allow access to the most effective securement points.

DO make sure that students in wheelchairs are using crashworthy pelvic and shoulder belt restraints that are properly positioned.
Although effective wheelchair securement is important, it will do little to protect the student in a crash, vehicle rollover or sudden movement if the student isn’t restrained by a properly positioned and relatively snug pelvic belt and diagonal shoulder belt. Most WTORS manufacturers provide detailed instructions and warnings on how to use and position the seat belts, including:

 

  • DON’Troute pelvic belts outside the wheelchair side frames and wheels or over wheelchair armrests.
  • DOposition the pelvic belt inside of the wheelchair side frame so that the webbing and buckle are in contact with, or very near, the student’s body and with the pelvic belt placed as low across the front of the pelvis as possible.
  • DOangle the pelvic belt up from anchor points behind the wheelchair at 30 degrees or more to the horizontal with the belt placed inside of the wheelchair armrest and side frame.
  • DOposition the upper part of the shoulder belt across the middle of the outboard shoulder and connect the shoulder belt to the inboard side of the lap belt (often on the latch plate of the buckle) near the hip of the student while keeping the buckle away from wheelchair components.

    Following these instructions may not be easy, even on many WC19-compliant wheelchairs, because armrests and side frames can interfere with proper positioning of the pelvic belt. In some cases, it may be necessary to thread the ends of the lap belt through openings in or between wheelchair components.

    One WTORS manufacturer facilitates seat belt threading by stiffening the anchorage ends of the pelvic belt so that they can be more easily inserted around the occupant and through wheelchair openings from the front before attaching them to pin-bushing connectors on the tiedown anchorages. To improve seat belt routing and positioning, select a WC19-compliant wheelchair that has been rated A (excellent) or B (good) with regard to accommodating the proper use and positioning of belt restraints.

    DON’T mix components of WTORS from different manufacturers.
    The various components of a WTORS, and especially anchorage track and anchorage components on tiedown assemblies, are carefully designed to function together to form a complete and effective wheelchair securement and occupant restraint system. Although components from different manufacturers may look similar, they may not engage effectively. It is therefore critical that equipment from different manufacturers not be mixed. Doing so can result in improper use and reduced effectiveness of the equipment when needed in a collision or emergency vehicle maneuver.

    DO allow students to use postural supports during transportation.
    There has been much confusion on the use of different types of postural supports in transportation of students in wheelchairs. A summary of the concerns and recommended practices are in a report by the Rehabilitation Engineering Research Center on Wheelchair Transportation Safety (RERCWTS) titled “Guidelines for Use of Secondary Postural Support Devices by Wheelchair Users During Travel in Motor Vehicles” (available at www.rercwts.org/info). A few basic principles should be followed:

     

  • Use of postural supports during travel in motor vehicles should generally be encouraged, particularly if they improve the occupant’s seated posture, since this will also improve the fit and effectiveness of vehicle seat belts.
  • Postural supports should be positioned so that they don’t interfere with the proper fit and function of belt restraints of WTORS.
  • Postural supports should not be relied on for protection during a crash.
  • Anterior head restraints attached to the wheelchair seatback to limit forward head movement should be designed to break away at the minimum force that allows the device to perform its intended function.
  • When head support using a neck support/collar is medically necessary, the softest and lightest material that achieves the needed results should be used.

    DO remove and store wheelchair add-on equipment.
    In the rare event of a school bus collision or rollover, heavy and/or rigid objects that are not adequately secured can become a hazard. Consideration should therefore be given to removing wheelchair add-on items, such as oxygen tanks and trays, and securing them to the vehicle using tiedown straps or other crashworthy storage methods. If these items cannot be removed and stored, add-on items should be attached to the wheelchair by tiedown straps, and dense padding should be placed between hard trays and the student in the wheelchair. Consideration should also be given to replacing hard trays with support surfaces made from dense foam during transportation.

    DO make sure that bus drivers are given detailed training on different types of wheelchairs.
    Much of the challenge to providing effective wheelchair securement and occupant restraint is due to the wide variety of wheelchair makes and models, many of which do not yet comply with WC19 and for which proper placement of seat belts is difficult. One of the keys to successfully meeting this challenge is an active driver training program. Most WTORS manufacturers provide excellent written and video training materials with their equipment and on their Websites. In addition, WTORS manufacturers often host training seminars at conferences and at their company facilities.

    Using these and other materials, such as the Ride Safe Brochure (www.travelsafer.org) and the wheelchair transportation safety education tool box (www.rercwts.org), bus drivers should be trained in the basic principles of transportation safety, including the need for both wheelchair securement and occupant restraint.

    Most importantly, drivers need hands-on instruction on how to achieve effective securement and occupant restraint on different types of WC19-compliant and non-compliant wheelchairs. Permanent marking of team-selected securement points on non-compliant wheelchairs will make it much easier for drivers to properly and consistently secure different wheelchairs.

    Lawrence Schneider is a research professor with the University of Michigan Transportation Research Institute (UMTRI) and director of the RERCWTS. Miriam Manary is a senior research associate with UMTRI.

 


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My Son is 220lbs and when the bus lift moves upwards and/or downwards, it seems as the lift itself is not 90 degrees. The lift slants down quite a bit and even with the wheel locks secured..he slants forward. The bus company and the school have my several inquiries on this but nobody will respond with an answer. They keep saying they have repaired the lift but I can see that it is not right. The only thing that is changed is the creaking sound that it made is no longer present when its in motion. Im terrified every day and have to hold onto the front of the chair as it ascends with great pressure. PLEASE let me know if the lift has a 90 degree guideline while in motion. My instincts tell me this is a disaster pending. Bus personnel seem aloof and unresponsive to my fears. THANK YOU VERY MUCH !!

Kerry Dodero Beswick    |    Nov 06, 2014 09:17 AM

What about standees in walkers or those who cannot walk up stairs but who need the lift?

Jill K    |    Oct 29, 2014 12:47 AM

Is it required by the state to be certified by the state to transport students in wheelchairs, and if not what is the liability to the driver in an accident if not properly secured.

Diana Hillig-Shronts    |    Oct 21, 2014 03:31 PM

Question--Should a specially made wheelchair for a student require a seat belt on the lift.

marie moss    |    Oct 17, 2014 02:53 PM

Betty, I have received a response to your question from Miriam Manary, one of the authors of this article. She says,"Falls from the lift are the primary source of injuries associated with the use of wheelchair lifts on buses. To minimize the likelihood of this event, we would like the combined center of gravity of the person and the wheelchair to be as close to the side of the vehicle as possible. In common configurations, the CG is usually located just below the occupant's hips. This means that when on the lift, the best safety practice is to have the wheelchair and occupant face away from the vehicle for the most stability."

Nicole Schlosser    |    Sep 30, 2014 08:31 AM

Sharyn, I have a response to your question from Miriam Manary, one of the article's authors. She says, "I would consult the latest National School Transportation Specifications and Procedures for a definitive answer. My understanding is that the required number and type of emergency exits need to be unblocked and available. If a wheelchair is blocking an emergency exit, then there should still be sufficient accessible exits for safe evacuation of the vehicle."

Nicole Schlosser    |    Sep 30, 2014 08:31 AM

Rebecca, here's a response to your question from Miriam Manary:"You should reposition the upper shoulder anchor point (to the vehicle) to get the best fit possible so the shoulder belt crossed the torso from collarbone, across the sternum and to the opposite hip. Most commercial wheelchair tiedown and occupant restraint systems (WTORS) have a method for adjusting the fit. The student should ride in the most upright position that they can tolerate for trip. Often a call to the WTORS manufacturer can be helpful."

Nicole Schlosser    |    Sep 30, 2014 08:31 AM

Steve, I have an answer to your question from Miriam Manary:"The federal regulation that addresses school buses, called FMVSS 222, requires a full WTORS system, including a vehicle mounted shoulder belt for buses equipped for transporting students who use wheelchair during transportation. This regulation applies to all new buses sold in the U.S."

Nicole Schlosser    |    Sep 30, 2014 08:30 AM

I Have a ? that was asked to me by a wheel chair student. why do we load a wheel chair student in the reverse position on the wheel chair lift instead of forwards what is the safety issue that prevents us from that

Betty    |    Sep 26, 2014 11:11 PM

On school buses can wheelchairs block emergency windows? I know that harnesses and protech seating can not be used in a emergency window seat.

Sharyn    |    Sep 24, 2014 09:36 PM

With lightweight umbrella-stroller wheelchairs, is there a law in the state of CT that specifically requires that the brakes on the chair be in working order while boarding the student on & off the lift ? With this particular student, there is always an Aid inside the van, the driver operating the lift outside, and another aid on the opposite side of the lift.

Pam Peters    |    Sep 12, 2014 05:40 PM

I am very concerned about the school district I drive for. Special Ed. drivers refuse to use the shoulder/lap belts for wheelchair students. They have no education on this matter and have made many uneducated inappropriate comment on not to use them. No one person knows how to pre trip a bus; yet still fills out the paperwork stating they did The director has no clue on the do and don't for affective transportation.

Joanna Horn    |    Sep 01, 2014 07:27 PM

What do you do when the shoulder belt does not position properly for a student, such as students whos wheelchair must be in reclined position for medical reasons?

rebecca    |    Aug 17, 2014 04:06 PM

IN NYC IS IT MANDATORY TO HAVE A SEAT BELT ATTACHED TO THE WALL OF A SCHOOL BUS THAT CARRYS WHEEL CHAIR BOUND CHILDREN

STEVE    |    Aug 06, 2014 04:46 AM

Every driver and aide should be shown the manufacturer literature on the tie-down devices. Every driver and aide should be given opportunity to practice the Emergency evacuation twice a year. I disagree with refusing transportation to persons without properly rated wheelchairs. The driver is responsible for the safety of the passenger in every instance. Just knowing the passenger is not in a crash rated wheelchair opens the driver up for the liability. I refuse transportation of wheelchairs not suitable for transport.

Roberta    |    Jul 29, 2014 04:13 AM

where should a bus be parked at one of his stops

John    |    Jul 14, 2014 10:41 AM

John    |    Jul 14, 2014 10:40 AM

Where should a wheelchair bus be parked at one of his pickups

John    |    Jul 14, 2014 10:40 AM

I would like to know how many bus companies or school districts inspect students wheelchair manuals prior to transporting? Who has students that have been required to transfer even though they can not do so independently?

smertes    |    May 12, 2014 07:45 AM

I like this site. But i have a question. I am a wheel chair school bus driver in Canada. I have a student that refuses to wear her seat belt. So they developed a chair that has a vest that fastens to the back of the chair. Now they are telling me that the chair doesn't require that she wear her lap or shoulder belt. So basically she isn't going to wear a seatbelt at all. When i asked for something in writing to say that she doesn't have to wear her seatbelt they refuse to give it. What should i do?

David Slade    |    Feb 05, 2014 04:30 AM

This is to answer Kathleen Bound's question. If you are in an accident with a wheelchair bus, and all of your occupants are in wheelchairs, and the emergency doors can not be opened, remember that the front windows, as well as most of the other windows are designed so that they can be kicked out from the inside. In the case of a fire, you should remove the children that are closest to the fire first and work your way out. You may have to remove the children from their wheelchairs and drag them, but it's better than letting them remain in danger. If you have a bus aid, then he/she should be on the outside of the bus to receive the children that you are bringing out. Also, a strong older child, if on the bus, can also help to receive the kids as they come out of the bus. The MOST IMPORTANT thing to do, though is to remain calm. If you remain calm, then the children will too, and that will make your job of evacuating the bus much easier. I've got to say, though, I can't really think of any situation where ALL of the emergency exits are blocked. There is at least one on the roof, and two on each side of the bus. They should be tested before a different driver starts each route. This not only ensures that the driver can make sure that the exits are all operating properly, but it also makes sure that the driver knows where all of the exits are. I hope this helps. I was a school bus driver for many years, and most of my driving was special ed buses and wheelchairs.

Dianna    |    Aug 06, 2013 07:56 PM

I don't think wheelchair lefts are safe. It is to easy to lower left without someone on it.Need a electric eye to keep this from happening. Talk to you may bus drivers that this has happened. Don't know if there has ever been any injuries, sure there has.

walt kelly    |    Jun 06, 2013 06:34 PM

WHeelchairs transported in conversion vans is there specific regs as to size/space required for a wheelchair? If conversion van has a fold up seat can a wheelchair be positioned next to that seat?

Kathy B    |    Apr 19, 2013 08:09 AM

If anyone can help answer this very important question right away I would be grateful; If you drive a handicap passenger bus where all people are in wheelchairs and an accident occurs where the exit doors are blocked or there if a fire and the doors cant be opened, what is the procedure to get all the wheelchair bound people out to keep them safe? Also, is it permissable to transport a wheelchair positioned by the lift door?

Kathleen Bound    |    Apr 19, 2013 08:02 AM

Never crisscross the tie-down straps. In a collision or force the chair can fold up.

Mina    |    Jan 09, 2013 06:28 AM

The image with the article shows an unsafe lift operation with no explaination. The driver should be on the sidewalk operating the lift after assuring that the wheelchair brakes are set, and while having a hand on the chair to be sure that there is no unexpected motion of the chair. The aide on the bus should not lean out of the bus, but release to or receive from the driver at the top of the lift.

Max    |    Jan 08, 2013 08:08 AM

I know some drivers that crisscross bottom tie down straps and drivers that never have. Is there a proper procedure or a rule of thumb

Peggy    |    Dec 04, 2012 10:06 AM

you should but wheelchair lift up front in stead

sunshine    |    Jun 18, 2012 04:50 AM

I live in Long Island New York. I want to know is it a state law that wheelchairs themselves be equipped with their own seat belts (sort of like the ones in our cars) before they are allowed on a wheelchair school bus lift or even in a wheelchair school bus at all.

Tina Buckley    |    May 17, 2011 11:39 AM

If you have an answer to my question below please email me at paulaperkins80@yahoo.com

handicap buses emergency    |    Aug 27, 2010 05:58 PM

If anyone can help answer this very important question right away I would be grateful; If you drive a handicap passenger bus where all people are in wheelchairs and an accident occurs where the exit doors are blocked or there if a fire and the doors cant be opened, what is the procedure to get all the wheelchair bound people out to keep them safe? Our busese have the large back and side push out emergency windows but how do you get all the people out who cant walk? please help thanks

handicap buses emergency    |    Aug 27, 2010 05:56 PM

Hello I have been checking out your web page, We would like to introduce our product to you, we have invented a front and rear lift belt for lift equipped buses, the belts will fit on both Ricon and Braun lifts, We can sell the set for $80. and it takes less than 5 minutes to install with no modification to the lift. The belts are tested to over 1200 lbs and manufactured by Besi Inc. They have been building safety products for school buses for over 35 years. We have several incident reports filled out by drivers telling how the belts have saved several accidents and injuries. Colorado CDOT is in the process of writing our belts into their Specs. We believe our belts are a must in the par transit bus industry. Just compare the cost to one accident or law suit. RTD in Denver just ordered new buses from Startrans and ordered the belts installed. Their legal department has a letter from Braun saying the belt in no way interfere with the warranty on the lifts, as I said no modification required for either belt. We would like to see if you might be interested in offering the belts as an option for your buses? You may check us out at Access-Arize.com Thank You For your Time! Dale Binkley 303-880-0961 binkls@msn.com Access-Arize.com

Dale    |    Jul 20, 2010 01:36 PM

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