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Respiratory Equipment & Products:
Wheelchairs
and Components:
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Health Issues:
Mobility
Products:
Other
Home Medical Equipment:
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Respiratory
Equipment & Products
Bi-Level - Bi-Level system makes breathing easier and more
natural for adult patients with Obstructive Sleep Apnea (OSA) who are having
difficulty complying with continuous positive airway pressure therapy.
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.
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.
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.
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 moves the person to
a standing, seating, or reclined position.
Patient
Lifts – (power or hydraulic) for assistance with patient transferring.
Lift/commode is a FDA registered medical device, ideal for people with
musculo-skeletal 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 breathing disorder characterized by brief
interruptions of breathing during sleep.
a.
Central Sleep Apnea: Occurs when the brain fails to send the appropriate
signals to the breathing muscles to initiate respirations.
b.
Obstructive Sleep Apnea: Occurs when air cannot flow into or out of the
person’s nose or mouth, although efforts to breath continue.
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): is 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: is 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: is 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: is 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 - 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. 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 -
are 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--people with milder forms of cerebral palsy, multiple
sclerosis, post-polio syndrome, stroke survivors, 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
is 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 wheel 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
travelling 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 elctro-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 affect 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 musculo-skeletal 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 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 - permits 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
– allows 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
– allows 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 – allows for the raising and
lowering functions of the head and knee break, along with 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 where 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/products/vac/index.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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