Use of Wheelchairs

Wheelchairs have been provided in the following locations around campus for transport of injured or ill people:

In assessing situations where the use of these wheelchairs is appropriate the following must be taken into account:

1. In the event of the wheelchair being used as a mobility aid in a first aid situation the client must first be assessed by the nominated First Aid Representative for that particular location. All relevant First Aid precautions and assessments should be undertaken before the use of the wheelchair is considered. For medical emergencies phone security on 2222 (main Crawley Campus) or 6488 2222(off campus)
2. A UWA wheelchair should only be used if the client is able to transfer into the wheelchair independently. The only assistance required by the staff member supervising the transfer be appropriate verbal prompts. (See Appendix 1 for transfer procedures). In a first aid situation if the person requiring the wheelchair is unable to transfer independently an ambulance should be called.
3. If the client is reporting chest pain an ambulance should be called.
4. If the client has sustained a head injury or a suspected neck/spine injury an ambulance should be called and the wheelchair not used.
5. Only staff trained in the use of the wheelchair should assist clients with their transfers and with pushing the wheelchair.

Important Considerations

• The paths leading to the Medical Centre are, in many places, uneven. A rough ride can aggravate a client’s condition thereby adding to their discomfort. This needs to be taken into consideration when deciding whether to take someone to the UWA Medical Centre or to call an ambulance.
• The combined weight of wheelchair plus individual can be easily above 70 kilograms. Pushing the chair over an extended distance (and over rough ground) can therefore present risks. Only persons trained in the use of the wheelchair should push the chair. At least two members of staff should alternate pushing duties over distances of 30 metres or more.
• Never hang bags etc on the back of the wheelchair as this can unbalance the chair making it more liable to tip backwards. 
• The list of contact people is provided so that access to the wheelchair by another area can be facilitated. These people are not responsible for the collection return or transfer of the injured person.
• It is important that wheelchairs should be checked regularly and serviced by an approved repairer. Each School/Section should also carry out regular maintenance checks to keep their wheelchair in safe working order. (See Appendix 2).

Appendix 1 - Assisting a Client to Use the Wheelchair

Assisting a client to transfer into the wheelchair.

1. Make sure that both of the brakes are ‘on’, and the front casters are swivelled forwards.
2. Fold up both footplates and swing them to the sides and out of the way.
3. If possible, get another person to hold the handles of the wheelchair so that it will not move. If this is not possible then stand behind the chair and hold the handles yourself.
4. Ask the client to stand then, with both hands on the front of the armrests, get them to lower him/herself onto the seat.
5. Swing the footrests to the front and fold down the footplates. If required, assist the client to place their feet on the footplates, with their heels well back.
6. Ensure that the client’s elbows are not sticking outside the wheelchair when going through doorways. Also ensure that their hands are on their laps and not hanging outside the chair where they can catch in the spokes etc.

Assisting a client in transferring out of a wheelchair.

1. Back the wheelchair so that the front casters swivel forwards.
2. Make sure that both the brakes are on.
3. Fold up both footplates and swing them to the sides, out of the way.
4. If possible, get another person to hold the handles of the wheelchair so that it will not move. If this is not possible then stand behind the chair and hold the handles yourself.
5. Ask the client to move forwards on the seat.
6. Ask the client to place both feet firmly on the ground, slightly apart and with one foot further back.
7. Ask the client to place both hands on the front of the armrests, then get them to lean forwards with their head and shoulders over their knees to give balance. From this position they should be able to push themselves to standing. Always encourage the client to take their time with each step of the procedure.

Assisting a client in transferring sideways from a wheelchair to anther form of seating.

1. Place the wheelchair alongside, and at 45°, to the chair/toilet/bed/car etc that they wish to transfer to.
2. If possible back the wheelchair up slightly so that the front casters swivel forwards.
3. Ensure that both the brakes are on.
4. Fold up both footplates and swing them to the sides out of the way.
5. Remove the armrest on the side to which the client is transferring.
6. If possible, get another person to hold the handles of the wheelchair so that it will not move. If this is not possible then stand behind the chair and hold the handles yourself.
7. Ask the client to place one hand on the remaining armrest and the other palm down, on a stable area of the surface they are transferring to.
8. Ask the client to move forwards on the seat.
9. Ask the client to lean slightly forwards, push up and slide their bottom across to the other surface.

Negotiating kerbs Whenever possible, it is best to avoid kerbs. Instead, always try to use dropped kerbs or ramps. If a kerb is unavoidable then the following precautions should be taken:

Pushing an occupied wheelchair down a kerb. It is safer to go down a kerb backwards. It requires less strength and gives a gentler ride. Care should however be taken due to the weight of the chair and because the task involves stepping backwards into a road.

1. Practise with an empty wheelchair first.
2. Always keep the wheelchair user informed about what you are intending to do.
3. Make sure the road is clear, and then back the wheelchair to the edge of the kerb.
4. Ensure that the chair is lined up at 90° to the kerb.
5. Slowly roll the rear wheels down from the kerb and onto the road surface, making sure that both wheels touch down at the same time.
6. When the front casters are at the edge of the kerb, push down and forward on the tipping lever with your foot whilst gently pulling back on the handles and at the same time. This will balance the wheelchair and its occupant on the rear wheels. Do not tip the wheelchair back more than necessary.
7. Carefully pull the wheelchair further back into the road and, when the occupant's feet are clear of the kerb, gently lower the front to the road. Check that the road is clear before turning around and crossing.

Pushing an occupied wheelchair up a kerb. It is safer to go up a kerb forwards; it requires less strength and gives a gentler ride.

1. Practise with an empty wheelchair first.
2. Always tell the person in the wheelchair what you are about to do.
3. When the occupant's feet are nearly touching the kerb, push down and forwards on the tipping lever with your foot whilst gently pulling back on the handles and at the same time. This will balance the wheelchair and its occupant on the rear wheels.
4. When the front casters are just clear of the kerb, push the wheelchair forwards until the casters rest on the pavement. Do not tip the wheelchair back more than necessary.
5. Push the wheelchair forwards until the back wheels just touch the kerb and then lift up on the handles as you continue pushing forwards to place the rear wheels on the pavement. The occupant can help with this stage by pushing forwards on the handrims (if they are capable of doing so).

Appendix 2 – Wheelchair Maintenance Checklist

It is important that wheelchairs should be checked regularly and serviced by an approved repairer. Each School/Section should also carry out regular maintenance checks to keep their wheelchair in safe working order.

Weekly Checks:

Tyres

• The pressure in the tyres should be checked weekly. Use a tyre pressure gauge and pump up to the correct pressure marked on the tyre side.
• Check for punctures or weak/cracked tread.

The following should be checked every month:

Wheels

• Check they are free spinning. If there is any wobbling the wheel requires repair.

Spokes

• Check for loose or broken spokes.

Hand rims

• Check for rough or sharp edges.

Brakes

• Ensure brakes are tight and functioning correctly.
• Check that the brakes and tyres are making contact. An incorrectly inflated tyre will diminish the effectiveness of the braking mechanism. If necessary, pump tyres to correct pressure.
• Ensure braking mechanism moves freely. If lubrication is required use silicon spray not oil or grease.

Footrests

• Check that all pivot parts move freely. If lubrication is required use silicon spray not oil or grease.

Armrests/legrests

• Check for sharp edges.

Push handle grips

• Check that they are secure.

Frame

• Check for small dents or cracks - these can affect the frame strength.
• Dirt should be removed with a damp cloth.

Ball bearings

• Unusual noise or excessive wheel wobble usually indicates that the bearings are weak and need replacing.