Advanced Wheelchair Checkout Flashcards
(16 cards)
Skills Possible
- Wheelies
- Up and down Curbs
- Up and down Ramps
- Falling Backwards and getting back up
- Floor to Wheelchair
- Assist Up and Down Curbs (Caregiver)
- Dependent Transfer from Floor
- Pressure Relief
Wheelies Safety Considerations
- No wheelies without guarding
- Seat Belt Buckled
- Gait Belt around back of wheelchair w/ tight grip
- Stay close behing the WC
- If you feel your self going backward, pull the wheel BACKWARD
Falling Backward Safety Conisderations
- Keep seatbelt on and lock wheelchair
- Throw arm over legs and push them down
- Tuck head and bring arm behind to protect
- DO NOT REACH BACK
- Use strong arm to push yourself Up
Independent Floor to Wheelchair Transfer Safety Considerations
- Gaitbelt on
- Lock WC
- Have caregiver position legs
- May assist on ascent or descent at safety belt
- Only push/pull on frame
Pressure Relief
Options: WC push ups, front lean, side lean
-2 min every 30 mins
C7
1. Lock wheelchair and bring it close to mat
2. Loosen seatbelt
3. Put hands on wheels an push up (if not strong enough, can lock out elbows or intervals equal to 30s)
4. Bottom needs to clearly lift; cue to make sure thighs lift to arm rest or sensation of lifting
C5 (forearm hook)/C6 (wrist hook)
1. Lock wheelchair and bring it close to mat
2. Remove seatbelt and armrest
3. Hook arm around and lean to side OR reach for the ground
4. Caregiver needs to check each side to bake sure entire bottom is lifted up; cue to make sure thighs lift to arm rest or sensation of lifting
might need to remove footrests if not getting enough relief
Falling Backwards and Getting Up
- Lock WC and put on seatbelt
- Protect head and push legs down
- Do not reach back
- Caregiver slowly lowers Pt w/ leg supporting
- Simulate Locking WC while on the floor
- Prop up on elbows; use weak arm to grab frame and strong arm to hold body up
- PUSH frame of wheel chair as far as they can reach
- With small pushes of strong arm walk arm forward, bring back of WC up
- Caregiver slow descent or warn Pt to anticipate quick righting
Static Wheelies
- Stress safety measures
- Seatbelt on; gait belt buckled around wheelchair back w/ secure hold
- Care giver tilt Pt back into a position that feels most “even” or where least help is needed by caregiver too give Pt reference
- Check in with caregiver before attempting a wheelie
- Pull back slightly then push wheels forward quickly and head back to lift front wheels and maintain (head hips)
- Pull backward if you feel like you are falling back
- Ask caregiver how much they were holding
Dynamic Wheelie
- Stress safety measures
- Seatbelt on; gait belt buckled around wheelchair back w/ secure hold
- Check in with caregiver before attempting a wheelie; find a spot on floor to wheelie
- Start moving forward then push wheels forward quickly and head back to lift front wheels and maintain (head hips)
- Pull backward if you feel like you are falling back
- Ask caregiver how much they were holding
Independent Curbs
-low curb (static) and high curb (dynamic)
Up:
1. Check safety and guarding
2. DO dynamic wheelie to get front wheels on the curb
3. Very QUICKLY bring chest to knees to force back wheels up using head/hips
Down:
1. Come down backwards
2. Get big wheels off then turn to the side to keep one caster on
3. Baby wheelie to get the wheel down
- Come down forwards while maintaining wheelie
Ramps
Up:
1. Check safety and guarding
2. DO dynamic wheelie to get front wheels on the curb
3. Very QUICKLY bring chest to knees to prevent rolling backward
4. Do short and quick pushes to geet up
5. Caregiver needs to keep from going off side
Down:
1. Come down backwards
2. Bring chest to knees to prevent tipping
3. Slowly whel back until wheels starts to go down then hold tight and SLOWLY control the way down
- Come down forward
- Come down in a wheelie
Floor to Wheelchair: Descent
Front:
1. Caregiver provide cushion/stool under legs; keep legs in frog leg position
2. Pt bring hips forward in WC push up to edge of WC
3. Push up at edge and lower onto pillow; then onto floor
Side (need strong lats, traps, serratus, lower level injuries):
1. Bring hips forward
2. Caregiver move legs op of side coming down
3. Control drop of arm to the floor (caregiver guarding)
4. Controlled fall down
5. Reposition legs
Floor to Wheelchair: Ascent
Back (need strength and flexibility; not great for short people):
1. Have Caregiver straighten legs out
2. Pt push up onto stool
3. Reach behind to WC frame and push up while bringing head foreward to bring butt up
4. Sit at edge and have caregiver reposition legs and remove stool
5. Final scoot backwards
Side (need strong lats, traps, serratus, lower level injuries):
1. Bend knees in sidelying parallel to WC
2. 1 hand on fram of WC and another on the floor
3. Head hips to lift onto WC (guarded)
4. Final scoots
Front (most strength needed):
1. Bend knees in sidelying facing WC
2. Pt hand hands on WC seat and uses arms to push into tall kneeling (guarded and pushing into WC)
3. Weight shift to get arms onto arm rest
4. Which ever side Pt is turning towards, hand needs to be more forward on armrests
5.Push up an twist body into seat (will need to demo)
Dependent Transfer From Floor: Descent
-will need 2 people, Pt cannot help
- Lock Wheelchair and Pt seatbelt
- Grap the push hand AND frame of wheelchair (not foot rest)
- Instruct caregiver to get into a squat position then transform into kneeling
- Instruct Patient to cover face in case her legs come down (C6)
- Slowly bring Pt down
- Unlock breaks and seatbelt
- Pull Pt legs to chest to lift bottom
- Other pull out wheelchair from under and support Pt legs
Dependent Transfer From Floor: Ascent
- Pull Pt legs to chest to lift bottom
- Other pulls wheelchair under butt and bring as close to seat
- Put on breaks and seatbelt
- Get into kneeling position
- Each caregiver put one hand under shoulder and back and grab push handle (make sure they don’t pull)
- Grab frame of WC and push up
- Halfway up stop and have 1 check feet
Assisted Curbs
-could do with empty WC to practice mechanics
Ascent/Up Forwards:
1. Seatbelt on
2. Have caregiver get close to curb
3. Use front leg to support weight of WC and shift weight onto forward leg
OR put foot on bar on sides and arms to push into a wheelie
4. Maintain wheelie to get casters on
5. Extra push by shifting weight full from back foot to front foot to bring back wheels up
Descent/Down Backwards:
1. Bring back of WC to edge of curb
2. Brace WC against leg in tall position and shift weight on back leg to slowly lower back wheels down
3. Bring casters to edge
4. Bring into slight wheelie and back up to bring casters off
5. Slowly lower back down against leg after clearing foot rests
Dependent Transer Safety Considerations
-lock wheelchair
-lock seatbelt
-have pt protect head
-Don’t pull on shoulders
-grab WC frame
