It’s hard enough to find a wheelchair or stroller that will work best for your child. But if your child also has medical equipment, you have to find a way to attach all the medical equipment to the chair as well. Too much equipment piled in one area can cause the chair to tip over. Too many machines mounted on the sides can make doorways difficult to navigate. And if the equipment is not mounted thoughtfully, it can be difficult to use, especially in an emergency.
There are several considerations you need to make when contemplating how to place medical equipment on chairs. First is the type of chair itself, as some chairs have built-in options for medical equipment, or can be adapted more easily. Second is determining the type of equipment your child needs while in the chair, and how easily it needs to be accessed. Third is coming up with a layout for mounting the equipment, and powering it if necessary.
I highly recommend that all families requiring a chair with medical equipment consult a trained mobility specialist. These individuals are more likely to know what is available on the market, and what types of equipment will work together. However, some may have never needed to set up a chair with extensive equipment, and you may need to point them toward some resources.
A small stroller, with ample storage below, on the back,
using an IV pole, and under the footrest
Choosing the Wheelchair or Stroller
The choice of chair can make all the difference in setting up and mounting equipment. Some chairs have equipment trays or baskets included or available, while others cannot be adapted as easily.
In general, most adaptive positioning strollers for toddlers and preschoolers can accommodate medical equipment quite well. Since the child is still tiny, the seating system required for the child is also very small, leaving considerable space for medical equipment.
Many adaptive strollers, especially those that can support children requiring extensive positioning, have equipment trays or baskets built-in or available. For example, the three strollers made by Zippie, the Voyage, Xpress, and TLC, all have either a built-in basket or an available tray. Ottobock, SnugSeat, and Thomashilfen strollers also may be purchased with an equipment tray. Many Convaid strollers are available with a storage basket.
Wheelchair with equipment tray underneath, holding a large Go bag and a nebulizer
Power chairs and larger manual wheelchairs for older children and teens also tend to have a considerable amount of real estate available for medical equipment. Power chairs tend to have large bases, creating plenty of extra room for storing equipment. The battery can also be used to power medical equipment. Similarly, larger manual wheelchairs have wider seats and are set high, allowing for many areas to store equipment.
The most difficult chairs for attaching medical equipment are small, manual wheelchairs for younger school-age children. These tend to be lower to the ground and narrow, with fewer areas for medical equipment. Also difficult are manual wheelchairs that tilt and recline, as the mechanisms required to achieve variable recline often take up a lot of valuable real estate on the chair.
One final option for babies and young children is adapting a regular stroller for use with medical equipment. Many parents have used a double stroller, with one seat for the child and the other for medical equipment.
General Mounting Options
Whenever you receive a new piece of medical equipment, ask for two things: a bag to carry it in, and a pole clamp. With these two items, you can attach many smaller items to a wheelchair or stroller with ease.
Bags are of course the simplest to attach. Suction machines, pulse oximeters, feeding and IV pumps, and even ventilators should all come in a bag. Oxygen bags for A, B, D, and even E tanks are also available. Sometimes the bag can simply be hung over the chair handles. Other options for attaching bags include bag clips and carabiners. Bag clips are small clips that attach to chair handles or poles and hold the handle of a bag securely in place so it will not slip. These are available commercially at a low cost, such as the Mighty Buggy Hook, which is about $15, or from your mobility dealer. Carbiners, such as the Mommy Hook Stroller Hanger and many other types of simple carabiners, are available in all sizes and colors very inexpensively, typically from $1-10. Even infant ring links can be used to hold equipment.
Infant links used to hold IV fluids
Pole clamps are available for many medical devices, including pulse oximeters, feeding pumps, and IV pumps. These pole clamps can be attached to any metal tube on the chair, and the item can simply be clamped on and off the chair as needed.
If you only have smaller items, you may have success mounting a commercial stroller boogie or buddy board to the back of your child’s chair. These devices are sturdy enough to hold a child, and holes can often be drilled into them to attach medical devices.
Other options for mounting require adaptations to the chair. There are several areas that are typically usable and can be adapted. These include:
- The back of the chair – best for ventilators or oxygen tanks
- Under the foot rest – best for smaller items like pulse oximeters or suction machines
- Under the seat – best for smaller items like pulse oximeters or suction machines
- Underneath the chair – appropriate for all items and batteries
- On the side of the chair – best for oxygen tanks and bags
- Above the chair – best for feeding or IV pumps
Side storage on a wheelchair
Types of Equipment
There are many different types of medical equipment you may need to mount on chair, including oxygen tanks, ventilators, pulse oximeters, IV or feeding pumps and bags, airway clearance devices, nebulizers, and suction machines. In general, it is best to mount larger and heavier devices directly to the chair, as these are the most cumbersome. Ventilators should be mounted if at all possible, and larger oxygen tanks should be well secured for safety reasons. Smaller items can be clipped, clamped, or hung on the chair in a bag.
The following are brief descriptions of specialized mounting equipment for the most commonly used medical devices:
Ventilators – The two most common types of home ventilators, the Trilogy and the LTV, both have multiple third-party wheelchair mounting systems available. Since the LTV is long and thin, it can be mounted to the back of the chair or placed on a tray underneath. The Trilogy is boxier, and can either be mounted on the back of the chair or on platform below or behind the chair.
Third party Trilogy vent holder, in this case used with a CoughAssist device,
and a suction machine hung underneath it
Third-party holder for the LTV vent
Oxygen Tanks – Small oxygen tanks can be hung in a bag behind the chair. Larger tanks are typically mounted on the side of the chair, though some can be mounted diagonally above the wheel. Because tanks are long and thin, they can be difficult to mount to chairs where there is a significant tilt and recline. Some oxygen mounts combine a tank holder with an IV pole to accommodate multiple forms of equipment.
Pulse Oximeters – Pulse oximeters come in many shapes and sizes. Those that are long and thin may be able to be mounted under the seat or below the child’s footrest. Some boxier models, such as the Nonin, can be mounted on the handles using a pole clamp. They can also be carried in bags if needed.
Standard side-mounted oxygen tank holder,
with pulse oximeter hanging on the other side
IV and Feeding Pumps – Many families prefer to carry these small pumps and IV fluids or formula in small backpacks that can simply be hung on the chair. Virtually all IV and feeding pumps have a pole clamp or holder available that can be mounted either directly to the chair or to an IV pole on the chair. Chair IV poles tend to be very simple clamp-on devices, though combination IV pole and oxygen holders are widely used as well. IV poles may be difficult to mount on chairs that are significantly reclined and tilted.
Airway Clearance Devices – Airway clearance devices can be very challenging to mount on wheelchairs due to their large size. The newer version of the CoughAssist is identical in size to a Trilogy ventilator and can be mounted using the same equipment. The larger, older version of the CoughAssist is very heavy and typically must be placed on an equipment tray under the chair. Oscillating vest systems are also very heavy, and typically must be placed on an equipment tray under the chair.
Nebulizers – Some nebulizers, such as the Pari Trek, are extremely small and can simply be hung in a small bag on the back of the chair. Larger nebulizers can be mounted below the seat, below the footrest, or underneath the chair.
Suction Machines – Many families need suction available at all times and keep it in a bag on the back of the chair. Most portable suction machines can be mounted easily below the seat, below the footrest, or underneath the chair. Some families keep the device below the chair, but create an attachment to hold the suction tubing near the top of the chair so it is readily available.
Batteries and Power Sources – It is possible to use a power chair battery to power medical equipment. There are commercial devices designed specifically for ventilators to attach your devices to the wheelchair battery, or your DME may create a system using cables and an inverter. Many vent users also carry a marine or other long-life battery in a tray below or behind the chair, and some use an inverter that can be mounted below the seat or below the footrest.
Go bags – In addition to medical devices, many families also need to carry bags of medical supplies and emergency equipment. There are wheelchair bags available that fit between the handles of the chair. Backpacks and messenger bags also fit well on wheelchair handles. Larger bags may be stored underneath the chair on an equipment tray.
Setting up a chair for medical equipment takes great creativity and imagination. The best option is to contact an experienced mobility dealer for assistance. Families who use similar technologies are often goldmines of information, with many suggestions on which chairs to choose and how to set them up. Clinics such as MDA neuromuscular clinics may also be helpful in setting up a creative workable system.