The Hidden Risk of Wheelchair Use

Abstract

Not knowing how to unfold or even sit in a wheelchair the right way can cause a catastrophic injury to patients, visitors, volunteers, and staff of a healthcare facility. Wheelchairs are one of the most common assistive devices used in healthcare facilities, from admission to discharge. They are often found at the entrance of a facility for use by both patients and visitors with mobility issues. Hospital volunteers, transport staff, and clinical staff use wheelchairs to take patients to different care areas to have tests performed. Many facilities require that patients be transported in a wheelchair upon discharge. However, not knowing the proper method of unfolding a wheelchair or where to place your hands when sitting down in the seat can cause injuries, specifically to fingers, ranging from lacerations to amputations. An analysis of reports from the Pennsylvania Patient Safety Reporting System (PA-PSRS*) over the past decade identified 12 adverse events related to finger injuries involving wheelchairs in both inpatient and outpatient settings. Additionally, the U.S. Food and Drug Administration’s Manufacturer and User Facility Device Experience (MAUDE) reporting system, which “houses medical device reports submitted to the FDA by mandatory reporters (manufacturers, importers and device user facilities) and voluntary reporters such as health care professionals, patients and consumers,” contains hundreds of reports involving wheelchair injuries dating back to 2012. These reports indicate different kinds of wheelchairs (e.g., manual, bariatric, transport, and motorized) from myriad manufacturers are associated with these injuries. Although the type of injury and mechanism of injury reported varies from a head injury sustained from tipping over the wheelchair to a laceration from a screw, numerous reports of adverse events involved finger injuries, which are the focus of this safety announcement.