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.
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 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.
- Central Sleep Apnea: Occurs when
the brain fails to send the appropriate signals to
the breathing muscles to initiate respirations.
- 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
- 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
- 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 togetherin 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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