After you secure the wheelchair to the vehicle floor, then next step is to keep the person in the wheelchair. Most injuries occur in secondary impacts when the person is ejected from the wheelchair and strikes the inside of the vehicle. Only the skeleton is strong enough to handle the forces applied to the body by the occupant restraint. Lap and shoulder belts for wheelchair stations are designed to act like regular seatbelts in a car. The lap belt part should be low and snug across the pelvis. The shoulder belt should come from the top anchor across the middle of the shoulder and across the breast bone to anchor near the hip. Belts that fall off the shoulder or go across the abdomen could allow serious injury. Using both the lap and shoulder belt is important. The top shoulder belt anchor should be adjustable for different sizes of people. Some wheelchairs have something that looks like a regular seatbelt, but may not have been crash-tested. Most positioning or postural belts are NOT strong enough to handle crash forces. The following videos demonstrate the contribution of an occupant restraint.
Unrestrained Wheelchair-Seated Occupant
If you don’t use an occupant restraint, you can be ejected from the wheelchair and be injured from contact with the vehicle interior.
Using Only Postural Belts 1
This could happen if you use postural belts that haven’t been crash tested.
Using Only Postural Belts 2
This is another example of what could happen if you use postural belts that haven’t been crash tested.
Restrained by Lap Belt Only
Using just a lap belt could keep you in the wheelchair. However, no shoulder belt allows your upper torso to rotate, which could lead to contact and injury.
Lap/shoulder Belt Routed Over Wheelchair Armrests
If you only use a shoulder belt, or place the lap belts over the wheelchair armrests, there’s nothing to keep the lower part of your body in the wheelchair. This movement is called submarining and can lead to serious injury to the abdomen and chest.
Properly Positioned 3-Point Belt Restraint
This video shows how a properly position lap and shoulder belt is supposed to work.