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Respiratory
Equipment & Products
Bi-Level
Positive Airway Pressure/BiPap - A
device that provides ventilation for patients by delivering air to the lungs
at two levels of pressure, either cyclically in an anaesthetized patient or
triggered by the patient’s attempts at breathing when awake.
Continuous
Positive Airway Pressure (CPAP) – One of the most common
sleep disorders is sleep apnea - a disorder that causes a person's airway to
close several times during one night's sleep. For those with sleep apnea,
relief usually comes with continuous positive airway pressure (CPAP). Continuous
Positive Airway Pressure (CPAP) devices deliver a prescribed level of
positive pressure non-invasively to the upper airway for the treatment of
sleep apnea. Extremely easy to use, CPAPs come with different features such
as ramping to allow comfortable adjustment to the pressure; software to
capture specific usage and breathing events; and automated altitude
adjustment. Accessories, such as nasal interface applications and
humidification devices are provided to afford maximum comfort to ensure patient
compliance.
Liquid
oxygen systems - consist of a large main tank and one or two
portable units. The portable units are used as needed for travel outside of
the home. When they are empty, they can be refilled from the large tank.
Portable units can be carried with a shoulder strap or cart. Liquid oxygen
will evaporate if not used frequently. Therefore the portable units should be
filled just prior to use.
Cylinders
- are available in various sizes. Carrying cases or carts are
used for the different size tanks.
M2 - Weighs less than 2 pounds and only 7.9 inches in length, this
extremely lightweight, compact medical oxygen cylinder is the perfect
solution for anyone who needs a convenient, easily transportable medical
oxygen supply for a short amount of time. This cylinder is the smallest
aluminum oxygen cylinder in the world yet can supply up to 2 hours of oxygen.
M4 - medical oxygen cylinder is a great solution for anyone who needs a
convenient, easily transportable medical oxygen supply for a short amount of
time. This cylinder weighs under 3 pounds and is
only 12 inches in length. This cylinder can supply up to 7 hours of oxygen.
M6 – extremely popular medical oxygen cylinder is the perfect balance between
portability and oxygen supply duration. The M6 cylinder is less than 15
inches in length and weighs only 3 pounds and can supply up to 10 hours of
oxygen.
ML6 - Similar to the M6 cylinder, the ML6 is a great balance between
portability and oxygen supply duration. This cylinder weighs under 4 pounds and is shorter and wider than the M6
cylinder. This cylinder can provide up to 10 hours of oxygen.
M9 – a popular cylinder is a great balance between portability and oxygen
supply duration. The M9 is less than 16 inches in length and weighs only 4.5
pounds yet can supply up to 14 hours of oxygen.
Portable
E Tanks - Portable smaller units called E tanks are used for
transport. A key is required to turn the tank on and off. The portable tanks
must be replaced when empty. Therefore, the family must plan ahead for trips
outside of the home. Portable E tanks may be used for backup in case of power
failure.
Helios
Portable Oxygen Systems and Reservoirs - small, lightweight,
and long-lasting, encourages an active lifestyle for
long-term oxygen therapy patients. No tubes, heavy canisters or batteries are
required. The system is also extremely economical. Its pneumatic oxygen
conserving device gives it a conservation ratio over continuous flow oxygen
of approximately 4:1. This provides up to 10 hours of use at a setting of 2.
The portable unit can be refilled in about 40 seconds from the home
reservoir, which typically lasts four to six weeks between refills.
Nebulizer
- is a type of inhaler that provides a fine mist of
medication to the lungs. This is performed by breathing the medicated mist
through a mouthpiece or mask attached to the nebulizer device, which is
driven via a plastic tubing, attached to the
compressor unit. The medications used in nebulizers help you by loosening the
mucus in the lungs so it can be coughed out more easily, and by relaxing the
airways so that more air can move in and out of the lungs. Nebulizer
treatments take approximately 15 minutes to deliver the medication and are
prescribed by your physician.
Pediatric
Nebulizer - A special breathing device usually used 3 or 4
times daily as needed; or as directed by your doctor. It works in the lungs
by opening breathing passages to make breathing easier. This device is
intended for use in children but may also be used for adults requiring smaller
doses.
Oxygen
Concentrators - electronically powered device with a series
of filters that extract oxygen from room air. Also, a backup system, usually
a stationary compressed gas system must always accompany a concentrator in
case of power failure or other emergency. Regular household current is
sufficient for its use. In limited cases, a humidifier bottle may be
necessary to increase moisture to the oxygen as it passes through the tubing
to the mask or cannula.
Common Diagnoses:
- Chronic Obstructive
pulmonary diseases (COPD)
- Emphysema
- Asthma
- Chronic Bronchitis
- Lung Cancer
- Acute Myocardial Infarction
- Acute Pulmonary Heart
Disease
- Congestive Heart Failure
- Viral Pneumonia
- Bacterial Pneumonia
- Bronchlectasis
Oxygen
Conservers - are types of regulators, which conserve the
amount of gaseous oxygen in portable cylinders. Oximetry
testing is required to ensure proper oxygen saturation during use of a
conserver.
Portable
Oxygen Systems - incorporate either the
electronic conserving device, the pneumatic conserving device, or standard
flow regulators. These systems provide individuals with a convenient,
lightweight supply of oxygen. Systems are available with one or multiple M4,
M6, M9, MD, or ME cylinders, fiber-wrapped cylinders, shoulder, horizontal,
backpack, or fanny pack style carrying bags, cart, regulator, cannula, and supply tubing. All systems are also
available with a straight post valve, handtight or
a toggle CGA870 valve.
Ventilators
- An automatic mechanical/pneumatic device designed to reduce
or provide the work required to move gas into and out of the lungs.
Mobility
Products
Canes
– adjustable height canes can improve balance and reduce
fatigue. Travel canes can fold up and be carried in a travel case. Standard
crook canes are lightweight and durable to help improve balance and reduce fatigue . Quad canes are used when there is a need for
additional stability. Quad canes have a base with four legs, affording
greater stability than straight canes. Quad canes can be ordered with narrow
or wide bases.
Crutches
– Standard adjustable crutches are lightweight and easily
adjust to size. Forearm crutches have contoured arm cuffs for extra comfort
and stability.
Lifts/Seating
Systems - Power lift chairs gently move the person to a
standing, seated, or reclined position.
Patient Lifts –
(power or hydraulic) for assistance with patient transferring. Lift/commode
is an FDA registered medical device, ideal for people with musculoskeletal or
neuromuscular limitations. It is motorized and designed to operate as a lift
system and as an adjustable-height commode. It can be used as a bedside
commode (helps reduce bedpan use) or as a transfer system to move a person
from a bed to a seated or standing position.
Ramps
- portable ramps for wheelchairs and scooters roll up for
easy carrying with storage bag. Scooter ramps have side rails and center
panels that slide easily into place, locking securely to provide a solid
drive surface. Suitcase ramps are convenient and compact, fold up easily and
have a built-in carrying handle. Telescopic channel ramps each extend to be
used on steps, vans, or curbs. For storage, simply pick up each rail and
depress the guide buttons to collapse. Chair lifts allow you to lift and
carry your power chair fully assembled.
Walkers
– are available in a variety of styles to meet individual
needs. Folding, adjustable walkers can be easily transported in vehicles.
Hemi-walkers allow for one-hand utilization. Wheeled walkers minimize
lifting. Many accessories, such as walker trays, baskets or pouches are
available.
Disease
States:
Hypertension:
Blood pressure greater than or equal to 140/90 mmHg.
COPD:
Chronic obstructive pulmonary disease (COPD) is a catch-all term for a number
of respiratory diseases. The diseases of COPD include chronic bronchitis,
pulmonary emphysema, asthma, and bronchiectasis (a
chronic inflammatory or degenerative condition of one or more bronchi or
bronchioles marked by dilatation and loss of elasticity of the walls).
Asthma:
Hyper-responsive airways manifested by a narrowing of the airway.
Sleep
Apnea: A chronic medical condition where the affected person
repeatedly stops breathing during sleep. These episodes last 10 seconds or
more and cause oxygen levels in the blood to drop. It can be caused by
obstruction of the upper airway, resulting in Obstructive Sleep Apnea, or by
a failure of the brain to initiate a breath, called Central Sleep Apnea. It
can cause and worsen other medical conditions, including hypertension, heart
failure, and diabetes.
Diabetes:
Disease in which blood glucose levels are above normal
a.
Type 1 diabetes:
diabetes of a form that usually develops during childhood or adolescence and
is characterized by a severe deficiency of insulin secretion resulting from
atrophy of the islets of Langerhans and causing
hyperglycemia and a marked tendency toward ketoacidosis
-- called also
insulin-dependent diabetes, insulin-dependent diabetes mellitus, juvenile
diabetes, juvenile-onset diabetes, type 1 diabetes mellitus
b.
Type 2 diabetes: a
common form that develops especially in adults and most often in obese
individuals and that is characterized by hyperglycemia resulting from
impaired insulin utilization coupled with the body's inability to compensate
with increased insulin production -- called
also adult-onset diabetes, late-onset diabetes, maturity-onset diabetes,
non-insulin-dependent diabetes, non-insulin-dependent diabetes mellitus, type
2 diabetes mellitus
CHF:
Heart failure in which the heart is unable to maintain adequate circulation
of blood in the tissues of the body or to pump out the venous blood returned
to it by the venous circulation
Urinary
Incontinence: Incontinence is the inability to control the
passage of urine. This can range from an occasional leakage of urine to a
complete inability to hold any urine. Urinary incontinence affects
approximately 13 million people in the United States and is more common in
women than in men. It occurs in 10 percent to 25 percent of women younger
than age 65 and in 15 percent to 30 percent of women older than age 60 who do
not live in nursing homes. Among nursing home residents, incontinence is even
more common, affecting more than 50 percent of female patients.
Cystic
Fibrosis (CF): A life-threatening disorder that causes severe
lung damage and nutritional deficiencies. CF is an inherited (genetic)
condition affecting the cells that produce mucus, sweat, saliva and digestive
juices. Normally, these secretions are thin and slippery, but in CF, a
defective gene causes the secretions to become thick and sticky. Instead of
acting as a lubricant, the secretions plug up tubes, ducts, and passageways,
especially in the pancreas and lungs. Respiratory failure is the most dangerous
consequence of CF. Each year approximately 3,200 white babies are born in the
United States with CF. The disease is much less common among black and
Asian-American children. Most babies born with CF are diagnosed by age 3,
although mild forms of the disease may not be detected until the third,
fourth, or fifth decade of life. In all, about 30,000 American adults and
children are living with the disorder. Although there's still no cure, the
emerging field of gene therapy may someday help correct lung problems in
people with CF.
Hepatitis
C HCV (Hepatitis C Virus): An inflammation of the liver
causing soreness and swelling. It is the most common chronic blood-borne
infection in the United States. The hepatitis C virus usually is transmitted
through contact with infected blood, most commonly by sharing needles during
intravenous drug use, or getting a blood transfusion before 1992. Hepatitis C
also may be spread through unprotected sexual intercourse, but this is
uncommon. Most people don't feel sick when they are first infected with
hepatitis C. Instead, the virus stays in their liver and causes chronic liver
inflammation.
Multiple
Sclerosis: A chronic, potentially debilitating disease that
affects your brain and spinal cord (central nervous system). The illness is
probably an autoimmune disease, which means your immune system responds as if
part of your body is a foreign substance.In MS,
your body directs antibodies and white blood cells against proteins in the
myelin sheath surrounding nerves in your brain and spinal cord. This causes
inflammation and injury to the sheath and ultimately to your nerves. The
result may be multiple areas of scarring (sclerosis). The damage slows or
blocks muscle coordination, visual sensation, and other nerve signals.The disease varies in severity, ranging from a
mild illness to one that results in permanent disability. Treatments can
modify the course of the disease and relieve symptoms.An
estimated 400,000 Americans have MS. It generally first occurs in people
between the ages of 20 and 50. The disease is twice as common in women as in
men.
Muscular
Dystrophy: A group of rare inherited muscle diseases in which
muscle fibers are unusually susceptible to damage. Muscles, primarily your
voluntary muscles, become progressively weaker. In the late stages of
muscular dystrophy, fat and connective tissue often replace muscle fibers. In
some types of muscular dystrophy, heart muscles, other involuntary muscles
and other organs are affected. There are many forms of muscular dystrophy,
some noticeable at birth (congenital muscular dystrophy), others in
adolescence (Becker MD), but the 3 most common types are Duchenne,
facioscapulohumeral, and myotonic.
The various types of the disease affect more than 50,000 Americans. There's
no cure, but medications and therapy can slow the course of the disease.
Osteoporosis:
A disease in which the density and quality of bone are reduced, leading to
weakness of the skeleton and increased risk of fracture, particularly of the
spine, wrist, hip, pelvis, and upper arm. Osteoporosis and associated
fractures are an important cause of mortality and morbidity.
In many affected people, bone loss is gradual and without warning signs
until the disease is advanced. Osteoporosis is also known as "the silent
crippler" because a person usually doesn't know they have it until it's
too late. Unfortunately, in many cases, the first real "symptom" is
a broken bone. Loss of height – with gradual curvature of the back (caused by
vertebral compression fractures) may be the only physical sign of
osteoporosis.
In the United States, osteoporosis causes more than 1.5 million fractures
every year — most of them in the spine, hip, or wrist. And although it's
often thought of as a women's disease, osteoporosis affects many men as well.
About 8 million American women and 2 million American men have osteoporosis,
and nearly 18 million more Americans may have low bone density. Even children
aren't immune.
Parkinson's
Disease: Parkinson's disease belongs to a group of conditions
called movement disorders. It is both chronic, meaning it persists over a
long period of time, and progressive, meaning its symptoms grow worse over
time.
Parkinson's disease occurs when a group of cells, in an area of the brain
called the substantia nigra,
that produce a chemical called dopamine begin to malfunction and eventually
die. Dopamine is a neurotransmitter, or chemical messenger, that transports
signals to the parts of the brain that control movement initiation and
coordination. When Parkinson's disease occurs, for unexplained reasons, these
cells begin to die at a faster rate and the amount of dopamine produced in
the brain decreases. The four primary symptoms are:
- tremor of the
hands, arms, legs, jaw, and face;
- rigidity or
stiffness of the limbs and trunk;
- bradykinesia or slowness of
movement, and
- postural instability or
impaired balance and coordination.
Wheelchairs
and Components:
Manual Wheelchairs
Lightweight/Sports
Chairs - The most popular type of wheelchair for everyday use
for a person with good upper body mobility is the lightweight manual
wheelchair. Lightweight chairs provide maximum independence of movement with
a minimum of effort. Many active wheelchair users also prefer the sportier
look of the lightweights compared with the more standard-looking everyday
chair. It should be noted, however, that heavy or obese persons may be unable
to use these types of chairs because the lighter weight of the frame results
in a reduced user capacity as compared to standard everyday chairs. Once used
primarily by wheelchair athletes, the lightweight chair today is used by
people in virtually all walks of life as a preferred mode of assisted
mobility. Three-wheeled chairs, also developed for such sports as tennis and
basketball, are also an everyday chair alternative.
Standard/Everyday
Chairs - Some wheelchair users still prefer or require a
standard wheelchair, which is characterized by a cross-brace frame, built-in
or removable arm rests, swing-away footrests, a mid- to high-level back, and
push handles to allow non-occupants to propel the chair.
Child/Junior Chairs
- Children and young adults need chairs that can accommodate
their changing needs as they grow. In addition, it is important that
wheelchairs for children or teens be adaptable to classroom environments and be "friendly looking" to help the user fit more
readily into social situations. Manufacturers today are becoming increasingly
sensitive to these market demands and are attempting to address them with
innovative chair designs and a variety of "kid-oriented" colors and
styles.
Specialty Chairs -
Because of the diverse needs of wheelchair users, wheelchairs have been
designed to accommodate many lifestyles and user needs. Hemi chairs, which
are lower to the floor than standard chairs, allow the user to propel the
chair using leg strength. Chairs that can be propelled by one hand are
available for people who have paralysis on one side. Oversized chairs and
chairs designed to accommodate the weight of obese people are also offered.
Rugged, specially equipped chairs are available for outdoor activities.
Aerodynamic three-wheeled racing chairs are used in marathons and other
racing events. Manual chairs that raise the user to a standing position are
available for people who need to be able to stand at their jobs, or who want
to stand as part of their physical conditioning routine. These and other
specialized chair designs generally are manufactured by independent
wheelchair manufacturers who are trying to meet the needs of specific target
markets.
Institutional/Nursing
Home/Depot Chair - The least expensive type of chair
available, an institutional chair, is designed for institutional usage only,
such as transporting patients in hospitals or nursing homes. It is not an
appropriate alternative for anyone who requires independent movement, as the
institutional chair is not fitted for a specific individual. These types of
chairs are now also used as rental chairs and by commercial enterprises (such
as grocery stores and airports) for temporary use.
Manual Wheelchair Components
Frame -
The two most common types of frames currently available are rigid frame
chairs (where the frame remains in one piece and the wheels are released for
storage or travel), and the standard cross-brace frame (which enables the
frame to fold for transport or storage).
Upholstery -
must withstand daily use in all kinds of weather. Consequently,
manufacturers provide a variety of options to users, ranging from cloth to
new synthetic fabrics to leather. Many manufacturers also offer a selection of
upholstery colors, ranging from black to neon, to allow for individual
selection and differing tastes among consumers.
Seating System -
are sold separately from the wheelchairs themselves, as seating must be
chosen on an individual basis. It is important when selecting a wheelchair or
a seating system to ensure that the two components are compatible.
Brakes – or
wheel locks are available in several different designs, and can be mounted at
various heights to maximize convenience to the user.
Wheels/Tire -
Most wheelchairs use four wheels, with two large wheels at the back and two
smaller ones (casters) at the front. The standard tire used for the rear
wheels on most wheelchairs is a pneumatic tire, for which the standard size
is 24 inches. Smaller and larger sizes, however, also are available. Many
manufacturers now also offer other types of tires--such as solid tires,
semi-pneumatic, or radial tires--at extra cost. Mag
wheels and off-road wheels also are options on some chairs. Casters, too,
vary in size (ranging from six to eight inches in diameter) and composition
(pneumatic, solid rubber, plastic, or a combination of these).
Footrests -
usually are incorporated into the frame of the chair as part of the design.
Cross-brace folding chairs often have footrests which swivel, flip up, and/or
can be removed.
Armrests -
Many lightweight manual chairs are designed to be used without armrests.
The absence of armrests makes it easier for the user to roll up to a
desk or table, and many active wheelchair users prefer the streamlined look
of a chair with no armrests. However, armrests are helpful if the user has
difficulty with upper body balance while seated. Armrests come in a variety
of styles including desk length (to allow the user closer access to desks and
tables) or full length and both types may be flip-up, fixed, or detachable.
Powered Wheelchairs
A powered wheelchair must be selected carefully in order to ensure it not
only meets the needs of the individual who will use it but also represents
good value for the money being invested in it. Physical considerations
include posture, strength, sensation, visual acuity and perception, and the
ability to learn how to use the wheelchair safely. A functional evaluation
should include actual use of the wheelchair in everyday settings; an
evaluation of the individual's ability to get in and out of the wheelchair;
and the ability to perform needed activities from the wheelchair.
Transportation to and from various settings also is an important
consideration: Is a van available to transport the individual in the chair,
or is it necessary for the chair to fold or disassemble in order to be
carried in an automobile trunk?
Powered Wheelchair Components
Frames -
Many traditional-style models utilize the traditional cross-brace frame which
allows the chair to be folded or collapsed for storage and transport once the
batteries have been removed. Other traditional models and some power base
chairs disassemble for transport. A number of chairs, however, are designed
to be transported while carrying the user; consequently, they do not fold or
disassemble.
Upholstery - for
wheelchairs must withstand daily use in all kinds of weather.
Consequently, manufacturers provide a variety of options to users, ranging
from cloth to new synthetic fabrics to leather. Many manufacturers also
offer a selection of upholstery colors, ranging from black to neon, to allow
for individual selection and differing tastes among consumers.
Seating System - Sold
separately from the wheelchairs themselves, as seating must be chosen on an
individual basis. It is important when selecting a wheelchair or a seating
system to ensure that the two components are compatible. Power base chairs,
because of their more modular construction, frequently feature customized
chair-style seating systems.
Brakes - Most
powered chairs utilize a dynamic braking system in which the motor and brakes
work together to slow and stop the chair when the joystick or other
controller is released, and which automatically engages the brakes when the
power is off or when the chair is not being powered in a forward or reverse
motion with the controller.
Wheels/Tires -
Power base chairs typically use four wheels of the same size, usually 8 to 10
inches in diameter. These chairs may have pneumatic, semi-pneumatic, or solid
tires.
Footrests -
A variety of footrest assemblies are available on both types of
wheelchairs. They may be a rigid single unit, 90 degree-90 degree
platforms, folding, flip-up, detachable, adjustable length, hemi- height, or
have a combination of features.
Armrests -
Armrests also come in several styles or with a combination of features. They
may be full- or desk-length, or wraparound, and they may be fixed, removable,
pivoting, and/or adjustable height.
Controls - Powered
chairs generally include as a standard feature a manually controlled joystick
to regulate the chair's speed and direction. However, most manufacturers
offer customized control options to accommodate the varied abilities of the
user, including sip-n-puff systems, head and chin switches, push-button
controls, trackballs, and tillers. Many chairs also have programmable control
features which allow the user or a dealer to adjust or set the chair's speed
and control limits as the user's abilities change.
Drive System -
the means by which power is delivered to the chair's wheels. Standard drive
systems include gear drive, direct drive, and belt drive. The type of drive
system affects the power available to propel the chair and the amount and
type of maintenance the chair requires.
Batteries - A
determining factor in the range and power of a powered chair. Generally, the
larger the chair's batteries, the greater the power and the longer the
chair's range between charges. Many chairs require two rechargeable 12-volt
batteries. Most wheelchairs utilize U1, group 22 or 24 batteries, although
other batteries are also used. More manufacturers are designing chairs around
the group 24 battery because it affords a longer range. The type of battery
required is also an important consideration in terms of safety, maintenance,
and transport. Powered chairs may utilize lead acid, gel cell, or sealed wet
batteries. Gel cell batteries require the least maintenance and have less danger
of leaking than do the other battery types. Gel cell batteries are also
required by a number of airlines when transporting powered
chairs.
Special Powered
Features - Powered chairs may offer specialized powered
features to meet the user's needs, either as customization or options on a
standard chair or as a chair designed specifically for a particular purpose.
Among the available features are elevating and lowering seats, and reclining
and/or tilt-in-space seats. Specialized chairs have the capacity to
raise the user to a standing position, to negotiate stairs, or to be used as
a lift or in transferring.
Scooters
Typically, scooter users have some ability to walk, but are limited in
distance or stamina--stroke survivors or people with milder forms of cerebral
palsy, multiple sclerosis, post-polio syndrome, arthritis, and cardiac
conditions, among others. Scooters are used to increase and extend the range
of personal mobility and help conserve energy. Scooter users often have
difficulty propelling manual wheelchairs, but do not require the
sophisticated electronic controls and seating systems common in powered
wheelchairs.
A number of other physical factors must also be evaluated when determining
whether a scooter is an appropriate mobility aid. A scooter user generally
must be able to sit upright for extended periods and have sufficient seated
balance to maintain an erect posture. Further, sufficient upper body and arm
strength to master the controls and steer and maneuver the unit are
required. In addition, uncorrected vision disabilities, or conditions
which may cause confusion or memory loss or which inhibit proper safety
awareness may render a scooter an unsatisfactory mobility aid.
Scooter Configurations and
Components
Base Unit - is
basically the body of the scooter. Generally it consists of a steel,
aluminum, or composite frame with a fiberglass or composite floor to support
the feet and batteries. Some scooter bases also include a shroud over the
front wheel and drive head, creating a dashboard for the unit. The base also
includes the wheels and the drive train. In some scooters, the seat post is
also part of the base. The base unit is the primary determinant of whether
the scooter is designed for indoor or outdoor use, the vehicle's
maneuverability, the size of its wheelbase, its ground clearance, its turning
radius, and its overall dimensions.
A scooter should not tip easily during sharp turns or on inclines such as
curb cuts (if the scooter is designed for outdoor use). Anti-tip wheels
should be included as part of the frame to help support and stabilize the
scooter. On front-wheel drive units, anti-tips are often located laterally
just behind the front wheels because they generally lack the power for steep
inclines. Because most rear-wheel drive scooters are intended to negotiate
more rugged terrain, they are usually equipped with rear anti-tips to support
the scooter on hills. Side anti-tip wheels are sometimes offered as options.
It should be noted that lateral anti-tippers may cause difficulties on curb
cuts and ramps.
On some scooters, the base unit may be comprised of modular units or may
otherwise be disassembled for transport and storage. These same features may
also allow the scooter to be converted from three- to four-wheeled models
and/or from indoor to outdoor use.
Drive Train,
Brakes, and Power System - The drive train is an integral
part of the base unit and provides either front- or rear- wheel drive for the
scooter. Front-wheel drive is usually found on smaller scooters designed
primarily to be used indoors or outdoors on flat, paved surfaces. The motor
of the front-wheel drive scooter is located over the front wheel and drives
only that wheel. Because of the motor and wheel configuration, front-wheel
drive scooters are usually direct-drive units, eliminating chains and belts.
However, this also means that the front wheel pulls the weight of the unit
and the rider. Consequently, these types of scooters have a lesser capacity
to move their load than do rear-wheel drive models, and are therefore less
capable of handling hills, curb cuts, and other outdoor terrain. This is
compounded by the fact that front-wheel drive models generally have smaller
motors, causing them to have a shorter range, less speed and power, and a
smaller rider weight capacity.
Rear-wheel drive scooters are powered by motors connected to the rear
axle, either via a chain, a belt, a transaxle unit, or some
combination. Because the scooter is driven by the rear wheels, they
push the combined weight of the unit and the rider, rather than pull it. The
combined weight of the rider, the motor, and the batteries over the rear
wheels, generally create better traction than that usually provided by
front-wheel drive models. The increased traction combined with the more
powerful motors used on rear-wheel drive scooters results in better climbing
ability. The units also have a greater maximum speed, a longer traveling
range between battery charges, and a larger rider weight capacity. These
scooters have a wider wheel base and a greater overall length, making them
less maneuverable and rendering some models unsuitable for indoor use. They
may also be too large for van or bus lifts.
Brakes -
most rear-wheel drive scooters utilize an electronic or electro-mechanical
dynamic, regenerative braking system. This type of braking system works in
tandem with the motor, first to slow and then stop the vehicle when the
pressure is released on the thumb levers or the controls are otherwise
disengaged. When the scooter is not being powered forward or in
reverse, the brakes are engaged, thus preventing the scooter from moving.
During the application of the brakes, excess power from the motor is
channeled to the batteries, providing recharging. Because the brakes are
engaged when the scooter is being actively powered, most scooters with this
braking system are equipped with a clutch on the motor or another release
lever to manually disengage the brakes to allow the scooter to be pushed in
case of emergency.
Some scooters also use disc brakes or disc brakes in combination with the
braking system discussed above. Some scooters--usually front-wheel drive
models--are not equipped with electronic or electro-mechanical brakes. In the
absence of a brake system, a manual parking brake applied by lever to a rear
wheel is provided. Manual parking brakes may also be offered either as
optional or standard features on other scooters to provide extra braking on
hills and inclines.
Batteries -
most scooters utilize 12- or 24-volt motors and electrical systems generally
with one or two 12-volt batteries to power the drive train and
controls. Twelve-volt systems are most frequently found on front-wheel
drive scooters, and usually require one 12-volt battery, although two
six-volt batteries are sometime used. Some manufacturers offer add-on units
for 12-volt systems which allow them to utilize two batteries to extend the
scooter's range between charges, although speed and power are not affected.
Rear-wheel drive systems generally require two twelve-volt batteries to power
24-volt systems.
These batteries are "deep cycle" batteries intended for
wheelchairs and scooters and generally last between 12 and 18 months,
although with conservation and regular charging, longer life may be achieved.
Deep cycle batteries are designed to provide a steady supply of power and be
discharged and recharged on a regular basis. Automotive and marine batteries,
on the other hand, are designed to be starter batteries, providing short
bursts of power only. Consequently, marine and automotive batteries should
never be substituted for deep cycle batteries.
There are three basic types available for use with scooters: Lead acid (or
wet cell) batteries, sealed lead-acid batteries, and gel cell
batteries. Lead acid batteries are the least expensive of the three
types, but they also require the most maintenance. In addition to
regular charging, electrolyte and water levels must be checked regularly,
with water added frequently to maintain appropriate levels. Because these
batteries are not sealed, there is danger of acid spillage and explosion if
the batteries are not handled properly. Despite these potential problems,
lead-acid batteries provide the benefits of a two- to six-month longer
battery life and up to a ten percent greater running time than other battery
types. Sealed lead acid batteries are maintenance-free versions of
these batteries. Because they are sealed in cases, it is unnecessary
to add water and the danger of acid spillage is reduced or eliminated. The
cases are vented to prevent gas build-up that can lead to an explosion.
Finally, gel cell batteries are the most commonly used battery type on
scooters. They are sealed in their cases and require no maintenance other
than regular charging. Gel cells are the safest of the battery types, with no
danger of spillage and limited risk of explosion. However, gel cells are more
expensive, and may have a somewhat shorter life than other battery types.
Wheels and Tires -
The size of the wheels and tires on a scooter have a direct effect on the
scooter's ability to surmount obstacles and its stability. Scooters are
generally equipped with six-, eight-, or ten-inch wheels, although other
sizes may also be used. Some models use the same size wheels both front and
rear, while others may have smaller wheels in front and larger rear wheels.
Smaller wheels are generally found on front-wheel drive scooters intended for
indoor use. As a rule, the intended use of the scooter should dictate
the size of the wheels and tires. The larger the wheels, the more stable the
unit. Similarly the larger and wider the tires, the greater the unit's
traction and capacity to manage such obstacles as curb cuts and uneven
outdoor terrain.
Several types of tires are available for scooters. Manufacturers generally
offer a specific tire as standard equipment, with others available as
extra-cost options. Pneumatic tires include air-filled tubes and are similar
to those found on automobiles. Air pressure should be checked regularly to
maintain proper levels, and tires may need to be replaced if punctured. The
addition of an anti-flat compound before inflation reduces the risk of tires
going flat. They provide good shock absorption when properly inflated. Foam
filled tires are similar to pneumatic tires, but include foam inserts rather
than air-filled tubes. These tires cannot be deflated and, therefore, require
less maintenance. They may be more expensive than pneumatic tires and may not
offer a consistently comfortable ride. The least expensive tire option is the
solid rubber tire. These tires require the least maintenance, but provide
minimal shock absorption and are intended primarily for indoor use.
Seating -
The most common seat found on scooters is a chair-style seat similar to those
found on boats. The basic seat is molded hard plastic or fiberglass, but most
manufacturers offer a padded-seat option, usually with a choice of vinyl or
fabric upholstery. Vinyl upholstery is frequently less expensive, but because
it is a slipperier surface, it may not be the best choice for those whose
disability makes it difficult to maintain position or balance.
Armrests -
are another consideration in seating. Some scooters offer armrests only as an
option; others offer fixed armrests as standard with flip-up armrests
available.
Tiller - The
control and steering mechanism for the scooter, usually containing the
controls to drive the scooter forward or in reverse, as well as steering the
front wheel or wheels. Most scooters offer one type of standard tiller with
other controllers available as options. Possibilities include thumb levers,
loop handles, joysticks, and others. Thumb levers are the most common
controls, allowing the user to keep both hands on the handle bars while using
the left thumb to power the scooter in reverse and the right to power the
scooter forward. The amount of pressure applied to the lever will determine
the speed of the vehicle (unless it is equipped with a proportional speed
control). Consequently, a fair amount of hand control is necessary for safe
operation. Finger control levers or a joystick may be alternatives. Some
manufacturers may also be able to adapt controls to user requirements at
extra cost.
The tiller itself is often an upright post attached to the front wheel.
However, it is also becoming common to find flexible, accordion-style tillers
which can be adjusted for height and/or position. This not only enables the
user to place the tiller in the most comfortable position while driving, but
also allows it to be moved up and out of the way during transfers. In the
absence of a dashboard or shroud over the front wheel, a control box with the
key lock, battery level indicator, speed controller, and other features may
be
affixed to the tiller handlebars.
Since a joystick controls both speed and direction, scooters equipped with
them generally do not have the post-and-handlebar tiller; the joystick is
usually attached to an armrest or to an armrest extension, with a choice of
right or left mounting. While this frees the space in front of the user and
may accommodate easier transitions for some, the lack of handlebars may make
transfers more difficult for others.
Other Accessories -
In addition to the standard features common to all scooters discussed above,
manufacturers offer a variety of standard features and optional
accessories. Most scooters are equipped with a key lock for turning the
scooter on and off, thus conserving battery life and preventing unauthorized
use; a battery-level indicator and a proportional speed controller to limit
maximum speed.
A wide range of accessories also are offered on most scooters, such as
crutch and cane holders, oxygen carriers, front and rear baskets, trailers,
headlights, tail lights, horns, canopies, and others. Some manufacturers even
offer sidecars to allow an additional passenger. As when purchasing a car,
options and additional features increase the base cost of the unit, but accessories
should be evaluated in light of their capacity to create a mobility aid which
provides maximum user independence. At the same time, it should be kept in
mind that some options may decrease battery life, maneuverability, and/or
travel range.
Other
Home Medical Equipment
Bariatric
products are designed to have a weight capacity of 300 pounds
(or more) for those who need that extra support. Bariatric chairs
maximize the patient's ability to sit and stand with reduced effort, and
lessens the chance of lifting injury to the caregiver.
Bariatric beds have extra bracing integrated into the home care bed frame,
along with a wider surface and truss assembly, in order to provide maximum
support.
Portable
lifting cushions - provide that extra lift needed to help you
get in and out of any armchair on your own by shifting your weight forward
and pushing off gently with your arms and/or legs. The pneumatic lift will
help to gently raise you up to an almost standing position. The cushion is
portable and weighs approximately 9 pounds and flattens quickly for easy
transport.
Commodes
- 3-in-1 Commodes are adjustable and include back, pail
w/lid, toilet seat, and cover. Some can be used as a free-standing commode or
a raised toilet seat. Lift/commode is a FDA registered medical device, ideal
for people with musculoskeletal or neuromuscular limitations. It is motorized
and designed to operate as a lift system and as an adjustable height commode.
It can be used as a bedside commode (helps reduce bedpan use) or as a
transfer system to move a person from a bed to a seated or standing position.
Compression
Stockings - Problems with the veins of the leg occur in both
men and women of all ages but certain factors increase the risk of venous
problems. Health conditions, lifestyle habits, heredity, injury, surgery,
age, and pregnancy all play a role. A broad range of compression hosiery from
knee, thigh high, waist chaps, open toe and closed toe are manufactured to
meet your needs. For more information: http://www.jobst-usa.com/
Continuous
Passive Motion (CPM) - devices are available for synovial
joints (hip, knee, ankle, shoulder, elbow, wrist, and TMJ) following surgery
or trauma (including fracture, infection, etc). The device moves the affected
joint continuously on a 24-hour basis, without patient assistance. The device
is held in place across the affected joint by Velcro straps. An electrical
power unit is used to set the variable range of motion and speed. The speed
and range of motion can be adjusted depending on joint stability, patient
comfort level, and other factors assessed intraoperatively.
Diabetic
Supplies – Blood glucose monitoring – there are a variety of
systems available that allow testing on arms, fingers or thighs, with fast
and accurate results and minimal cleaning required.
Environmental
Control Units - Permit remote control of electronic devices
in the immediate surroundings. A person can independently turn lights, radio,
and television on and off, answer or initiate phone calls, and unlock a door.
Essentially any aspect of the environment can be controlled depending upon
the system's complexity. For more information and products: http://www.makoa.org/ecu.htm
Hospital
Beds - allow for positioning and safety not possible with
standard beds. There are basically three (3) types of hospital beds available
for home use: Semi-Electric Beds – allow for raising and lowering the head
and the knee break through the use of an automatic hand-held control. Raising
the entire bed height is accomplished through use of a manual crank. Manual
Beds – allow for raising and lowering the head of the bed and the knee break
through the use of a manual crank. Full or half-side rails are available.
Full-Electric Beds – allow for the raising and lowering functions of the head
and knee break, and the entire bed height adjustment is operated by a
hand-held control.
T.E.N.S.
dual channel units – a transcutaneous
electro-nerve stimulator; pain control that goes where you do. A small
medical device slightly larger than a beeper, attaches to your pants or belt
and helps alleviate pain while you wear it.
T.E.N.S.
units have been dispensed by doctors to their patients for
home use. They operate on a 9v. transistor battery
and have small wires and pads that adhere to a painful area and alleviate
pain. Tiny free nerve endings secrete a chemical called "substance
P" that transmits pain signals to our brain. T.E.N.S. units artificially
stimulate free nerve endings, thereby depleting them of substance P,
literally stopping the pain signal in its tracks.
Wound
V.A.C Therapy - or negative pressure wound therapy uses
negative pressure through a controlled suction device
to close large wounds and promote faster healing. This patented,
FDA-approved device is composed of a sophisticated pump, hoses, and
monitoring system held within a portable compact case weighing less than 20
pounds. It is recognized as an advanced line therapy alternative for patients
when traditional dressing changes are not effective. It is a method that is considered among recovering patients in hospitals,
nursing homes, and other home health care settings. It meets the needs of
most cost-effective modalities and an estimated 5 million American patients
suffering from chronic or acute wounds.
For more information on Wound V.A.C Therapy & wound care management
reference –
http://www.kci1.com/87.asp
Ostomy Supplies – Pouching
system s- may include a one-piece or two-piece system. Both kinds include a
faceplate/flange (barrier or wafer) and a collection pouch. The pouch
(one-piece or two-piece) attaches to the abdomen by the faceplate/flange and
is fitted over and around the stoma to collect the diverted output, either
stool or urine. The barrier is designed to protect the skin from the stoma
output and to be as neutral to the skin as possible
- One-piece pouching system - the ostomy pouch
and skin barrier are joined together permanently. The pouch and skin barrier
are applied and removed together—in one piece. Easy to apply and remove and
more flexible than a two-piece pouching system.
- Two-piece pouching system, the ostomy pouch
and skin barrier are separate . The pouch can be
removed without removing the skin barrier. Because it is separate from the
pouch, the skin barrier can be more easily positioned around the stoma.
Pediatric pouching systems
are available as either one-piece products or two-piece products and are
designed for premature babies, infants, and children. These systems can also
be used to manage adult conditions such as small wounds, drain sites, and
fistulas. Irrigation systems - Some colostomates
can "irrigate," using a procedure analogous to an enema. This is done to clean stool directly out of the
colon through the stoma. This requires a special irrigation system,
consisting of an irrigation bag with a connecting tube (or catheter), a stoma
cone, and an irrigation sleeve. A special lubricant is sometimes used on the
stoma in preparation for irrigation. Following irrigation, some colostomates can use a stoma cap, a one- or two-piece
system which simply covers and protects the stoma. This procedure is usually
done to avoid the need to wear a pouch.
Urinary pouching
systems - urostomates can use
either one or two-piece systems. However, these systems also contain a
special valve or spout which adapts to either a leg bag or to a night drain
tube connecting to a special drainable bag or bottle.
For more information on ostomy and ostomy supplies:
http://www.uoa.org/ostomy_main.htm
http://www.hollister.com/us/
Bili Lights - (phototherapy)
used to help infants with jaundice, a yellow coloring of the skin and eyes
related to abnormal liver function.
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