Effective: 10-01-24
Supersedes: 06-22-20
Purpose: To provide procedural and safety guidelines for Chair Car Operators on how to properly secure a patient when in the Chair Car.
Policy: Chair Car Operators are required to follow the guidelines listed below and on MyBrewster regarding the chair car restraint system.
Procedure:
Once introductions and patient/customer identification has occurred, ensure that the patient is seated in their own wheelchair or a Company provided wheelchair. Chair car patients/customers are not to ambulate to the Chair Car unless it is safe to do so, and the vehicle has an integrated step/stair system.
Ensure you have the appropriate documents/belongings for the patient/customer.
No patient shall be transported on the lift without being seated and secured in a wheelchair; no patient shall be transported up or down more than three stairs by a wheelchair. If there are more than three stairs into or out of any structure, Chair Car operator must call for a lift assist.
The EMT or Paramedic that responds to the lift assist will perform the lift/carry of that patient / customer.
If the weight of the patient / customer requires additional assistance and a three or four-person style lift is required, the Chair Car operator may assist.
Any patient / customer that requests or insists they be transported in their wheelchair down more than three stairs shall be informed that it is against company policy for their safety and the safety of the crew. If this does not resolve the situation, a supervisor shall be requested at the scene.
Securing Patient in Chair
Ensure the foot/leg supports are properly engaged; secure the patient/customer with either a wheelchair seat belt or by using a nine-foot strap provided in the Chair Car Operator bag. Only belts with metal buckles should be used. Restraints with plastic clips should not be used.
Loading Chair in Vehicle
All wheelchairs must face forward in the van. Load the wheelchair facing forward on to the ramp, and apply the wheel locks. In the case of an electric wheelchair, have the patient carefully maneuver their wheelchair on to the ramp. Once on the ramp, ensure the power has been shut off and brakes applied to secure the electric wheelchair. Even though the power is off, move the patient’s hand away from the control knob and remind them not to touch it to eliminate any chance of accidental movement while on the lift.
The chair car operator shall remain on the ground and closely monitor the client / patient while the lift is in motion. Do not ride on the lift with the patient.
Once the lift is fully raised, the chair car operator should release the wheel locks on the manual wheelchair and push the chair forward off of the ramp and into the vehicle to the extent possible and again set the wheel brakes. In the case of an electric wheelchair, the chair should be powered up, brakes released, and the chair moved forward slightly into the vehicle and then powered off and secured. The chair car driver will then enter the vehicle and pull the wheelchair forward completely into the vehicle.
Securing the Patient in the Vehicle for Transport
All related floor, chair and shoulder restraints are to be used during transports (no exceptions). Wheelchairs must be properly secured in the front and back. Ensure the securement straps are not attached to a moveable or removable part of the wheelchair. Please see the MyBrewster for the full version of the manufacturer’s user guide.
Off-Loading at Destination
Upon arrival at the destination, the vehicle should be parked in a level area that affords enough clearance to deploy the lift. Ensure all safety mechanisms / wheel stops are in place and secure prior to placing the patient on to the elevated lift. Operate the lift via the remote control while standing on the ground and closely monitoring the status of the patient.
Once the wheel chair is off the lift and you are prepared to bring the patient into the destination, secure the lift. Do not leave the ramp of the Chair Car in the down position while the vehicle is unattended, as this may pose a trip hazard for pedestrians or subject the lift to damage from passing vehicles.