OBJECTIVE. We compared observed and reported practice among children with special health care needs transported in wheelchairs with the recommendations from the American National Standards Institute/Rehabilitation Engineering and Assistive Technology Society of North America Committee on Wheelchairs and Transportation voluntary standards for best practice for using wheelchairs in vehicles.
METHOD. A convenience sample of vehicles exiting the garage of a children’s hospital was observed. Certified child passenger safety technicians gathered driver demographics and the child’s reported medical condition, weight, age, clinic visited, and relation to the driver. Technicians observed how the wheelchair and occupant were secured.
RESULTS. A sample of 20 vehicles showed that 90% used four-point tie-down systems to secure the wheelchairs. A total of 88% of drivers tied the wheelchairs down correctly; only 20% used a separate lap–shoulder belts to secure the occupants. Twenty-five percent used lap trays, which are not recommended. Fifteen participants traveled with medical equipment secured inappropriately.
CONCLUSION. Many deviations from best practice were observed and highlight areas for increased awareness, education, and resources for caregivers.