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Afternoon folks,

I am working on putting together a training course on special vehicle modifications for handicap drivers/passengers.

I've been in touch with nmeda.org and they seem interested in working with me to get this information together.

Does anyone else out there have experience or information about extricating patients from these modified vehicles? I would appreciate any advise or information sources.

Thanks in advance.

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Hi.

I'm a retired FD LT who happens to have been burried in a collapse, had my neck brok and have been in a wheelchair since 1982. I am still very active in the fire service community and also the handicap community. What are you looking for? How may I help?

Rich Kukac
LaGrange FD, IL
Lt, ret.
Good morning,

I am sorry to hear about your accident, but I am glad that you are still active.

I'm trying to learn more about the various vehicle modifications and how they might affect how we extricate handicapped patients from their vehicles. Mostly I want to know how to make vehicles safe and easily removed the patient from the special restraints used to hold a wheel chair inside the vehicle.

I'd appreciate any input or suggestions that you may have.

Engineer Heather Langston
Deltona Fire, FL

Rich Kukac said:
Hi.

I'm a retired FD LT who happens to have been burried in a collapse, had my neck brok and have been in a wheelchair since 1982. I am still very active in the fire service community and also the handicap community. What are you looking for? How may I help?

Rich Kukac
LaGrange FD, IL
Lt, ret.
September 5, 2009


Heather,

I apologize for not responding quicker to your request for assistance with researching the proper ways to extricate or otherwise assist mobility impaired individuals involved in vehicular accidents.

As a former Lt. on a Chicago suburban department, one thing I learned is that no two accidents are exactly alike. Interestingly, I am also “disabled” and have used a wheelchair (27 years) as the result of a spinal cord injury sustained in a partial structural collapse in 1982. And, on two different occasions, I needed the assistance of an FD while driving. Once, when the throttle-return spring broke and my van sped out of control and ran into a brick home. The other time was when the electrical ground system went out so none of the wheelchair-lift functions, or the power door would work.

First, as a driver, a disabled person may drive from either their wheelchair or the driver’s seat – depending on the extent of their disability. If they are in what appears to be a regular driver’s seat in a van, most likely, it is a power seat the can rotate inward toward the passenger seat so that the driver can transfer back and forth between the seat and their wheelchair. It may also have a slide function which allows the whole seat to move back and forth. The third function may be one which adjusts the height of the seat. All of these functions are normally run on DC motors from the van’s battery or a secondary battery dedicated for these functions. The controls for these functions are either rocker or bayonet switches which are usually located on door side of the seat. With this type of seat, the driver would “belted” in with a standard chest/lap seatbelt – if they use the belt.

Many high-level spinal cord injuries, cause some loss of hand/arm usage so the steering wheel may have to have an adaptor added to allow one-handed steering with the right hand while they use their left hand to control the accelerator and breaks. In a front end collision, the aid mounted on the steering wheel, may either break a wrist/hand (as happened to me) or act as another item for the driver to hit with their head, face or chest.

If the airbag deploys, it may cause substantial facial, neck or chest injuries as most long-term wheel chair bound individuals, have some form of ostiopinia or osteoporosis. This means bone fractures; flailed chests and spinal injuries are much more common, even in low impact accidents as are lower extremity injuries. In higher speed impacts, because the power seat is an after-market installation of a modular unit, there is a greater possibility of the entire seat breaking away from the floor and throwing the driver forward with greater force or even ejecting them from the van.

If the driver remains in their wheelchair while driving, or as a passenger the wheelchair usually drops down into slots or wheel-wells and is held in place by a mechanical hold-down system. These systems can anchor just the large rear wheels or both the front of the chair and the rear wheels. The seatbelt that is used typically is only the lap belt that comes with the chair and affords much less protection than the typical chest/lap belt systems.

As for extrication – if the vehicle is a full-size van and the disabled person is in either front seat position and the doors can be opened and/or removed, this is your easiest point of access and removal. Talk to victim if you can. Many times they can assist you with their extrication by telling you where seat controls or lock-down releases are. If the victim is in a wheelchair behind the front seats and is conscious, they may be able to be removed via the side door and lift. Otherwise, I have found that entering through the back doors, folding down the back seat and transferring the victim to a backboard or collapse-a-cot will allow the easiest removal for you and the victim.

The other thing that is very important to the victim is their wheelchair. Most manual chairs collapse by folding inline with their direction of travel. This is usually accomplished by removing the seat cushion which may be held in place by Velcro and then grabbing the seat by the front and back in the middle and lifting. If it is a bower-assist or full power chair, the chair will be much heavier (up to 150 pounds empty) and does not fold. Try to determine that the batteries are intact and not leaking so as not to sustain any acid burns. I always remembered what we were taught in Emergency Rescue Technician training, the safety of you and your crew comes first!

The other advise I can offer is to go to some of your local van conversion dealers and become familiar with the various types of conversion out there. The internet is also a great source for pictures and data.

Hopefully, this is helpful to you. If you like, you may contact me direct via e-mail at Rkukac@aol.com.

Good luck with your research.

Rich Kukac
LaGrange FD, IL
Lieutenant, Ret.
It is my turn to apologize for not responding sooner. Thank you so much for your insight and valuable information. Prior to reading your post, I hadn't even considered most of the things you mentioned.

I'm looking for a local company that does modifications to see if I can get some more information and suggestions from their end.

Thank you again,

Heather Langston
Deltona Fire Department.

Rich Kukac said:
September 5, 2009


Heather,

I apologize for not responding quicker to your request for assistance with researching the proper ways to extricate or otherwise assist mobility impaired individuals involved in vehicular accidents.

As a former Lt. on a Chicago suburban department, one thing I learned is that no two accidents are exactly alike. Interestingly, I am also “disabled” and have used a wheelchair (27 years) as the result of a spinal cord injury sustained in a partial structural collapse in 1982. And, on two different occasions, I needed the assistance of an FD while driving. Once, when the throttle-return spring broke and my van sped out of control and ran into a brick home. The other time was when the electrical ground system went out so none of the wheelchair-lift functions, or the power door would work.

First, as a driver, a disabled person may drive from either their wheelchair or the driver’s seat – depending on the extent of their disability. If they are in what appears to be a regular driver’s seat in a van, most likely, it is a power seat the can rotate inward toward the passenger seat so that the driver can transfer back and forth between the seat and their wheelchair. It may also have a slide function which allows the whole seat to move back and forth. The third function may be one which adjusts the height of the seat. All of these functions are normally run on DC motors from the van’s battery or a secondary battery dedicated for these functions. The controls for these functions are either rocker or bayonet switches which are usually located on door side of the seat. With this type of seat, the driver would “belted” in with a standard chest/lap seatbelt – if they use the belt.

Many high-level spinal cord injuries, cause some loss of hand/arm usage so the steering wheel may have to have an adaptor added to allow one-handed steering with the right hand while they use their left hand to control the accelerator and breaks. In a front end collision, the aid mounted on the steering wheel, may either break a wrist/hand (as happened to me) or act as another item for the driver to hit with their head, face or chest.

If the airbag deploys, it may cause substantial facial, neck or chest injuries as most long-term wheel chair bound individuals, have some form of ostiopinia or osteoporosis. This means bone fractures; flailed chests and spinal injuries are much more common, even in low impact accidents as are lower extremity injuries. In higher speed impacts, because the power seat is an after-market installation of a modular unit, there is a greater possibility of the entire seat breaking away from the floor and throwing the driver forward with greater force or even ejecting them from the van.

If the driver remains in their wheelchair while driving, or as a passenger the wheelchair usually drops down into slots or wheel-wells and is held in place by a mechanical hold-down system. These systems can anchor just the large rear wheels or both the front of the chair and the rear wheels. The seatbelt that is used typically is only the lap belt that comes with the chair and affords much less protection than the typical chest/lap belt systems.

As for extrication – if the vehicle is a full-size van and the disabled person is in either front seat position and the doors can be opened and/or removed, this is your easiest point of access and removal. Talk to victim if you can. Many times they can assist you with their extrication by telling you where seat controls or lock-down releases are. If the victim is in a wheelchair behind the front seats and is conscious, they may be able to be removed via the side door and lift. Otherwise, I have found that entering through the back doors, folding down the back seat and transferring the victim to a backboard or collapse-a-cot will allow the easiest removal for you and the victim.

The other thing that is very important to the victim is their wheelchair. Most manual chairs collapse by folding inline with their direction of travel. This is usually accomplished by removing the seat cushion which may be held in place by Velcro and then grabbing the seat by the front and back in the middle and lifting. If it is a bower-assist or full power chair, the chair will be much heavier (up to 150 pounds empty) and does not fold. Try to determine that the batteries are intact and not leaking so as not to sustain any acid burns. I always remembered what we were taught in Emergency Rescue Technician training, the safety of you and your crew comes first!

The other advise I can offer is to go to some of your local van conversion dealers and become familiar with the various types of conversion out there. The internet is also a great source for pictures and data.

Hopefully, this is helpful to you. If you like, you may contact me direct via e-mail at Rkukac@aol.com.

Good luck with your research.

Rich Kukac
LaGrange FD, IL
Lieutenant, Ret.

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