Wheelchair Parts and Safety Checks

A wheelchair is a complex piece of medical equipment — not a simple chair on wheels. Understanding its parts and performing safety checks before every use protects both the client and you.

Section 01

Key Wheelchair Components

🔒

Wheel locks (brakes)

The most critical safety feature. Must be engaged before any transfer — getting in or out of the wheelchair. Test both brakes at every use. A brake that does not lock is a fall hazard that must be reported immediately before the chair is used.

🦶

Footrests

Swing away or remove before transfers so the client can place feet on the floor. Must be in the down position and feet placed before propelling. A client whose feet hang without support develops pressure on the back of the thighs.

💪

Armrests

Some armrests are removable (desk-style) to allow closer seating at tables and facilitate lateral transfers. Know which type the client has. Missing or damaged armrests affect transfers significantly.

🪑

Seat and back

The seat and back cushion significantly affect pressure distribution and posture. A flat sling-seat wheelchair without cushioning can cause pressure injuries within hours. Pressure relief cushions are essential for clients who sit for extended periods.

🔧

Anti-tip bars

Small wheels at the rear base that prevent the wheelchair from tipping backward. Must be in place for any client at risk of backward tipping. Check that they are not bent or missing.

Section 02

Pre-Use Safety Check

💡 Check before every use

Before placing a client in any wheelchair:

Test both brakes — lock and apply sideways pressure to confirm they hold
Check both tires — properly inflated (firm, not soft), no visible damage
Check footrests — swing properly, lock in position, equal height
Check armrests — secure, not damaged
Check seat cushion — in place, not worn through to the base
Check anti-tip bars — present and in correct position

This takes 60 seconds and prevents equipment failures during transfers.

Section 03

Wheelchair Sizing

Seat width: 1 inch of clearance on each side. Too wide: the client slumps to one side and cannot propel effectively. Too narrow: pressure on the thighs and difficulty with transfers.
Seat depth: 2–3 inches between the back of the knee and the seat edge. Too deep: presses on the popliteal area (behind the knee), reducing circulation. Too shallow: reduced thigh support, instability.
Seat height: Feet flat on footrests with approximately 90-degree hip angle. Hips should not be higher than knees.
Back height: Should not be so high that it pushes the shoulders forward.

Section 04

What to Report About Wheelchair Condition

⚠ Report immediately and do not use until repaired

Brake that does not lock securely
Flat or significantly soft tire
Footrest that does not lock in position
Missing or damaged anti-tip bar
Cracked or bent frame
Seat cushion worn through

Do not use a wheelchair with any of these defects. Document and report to the supervising nurse before the next use.

Section 05

The Tilt-in-Space and Reclining Wheelchair

✓ Specialized wheelchair types

Tilt-in-space: The entire seat tilts backward while maintaining hip angle — redistributes pressure without changing body position. Used for clients at high pressure injury risk or with tone issues. Tilting schedule is prescribed — follow it.
Reclining: The back reclines while the seat remains in place — useful for pressure relief, rest, or clients who cannot maintain upright position. Can cause shear force on the skin if the client slides during reclining.

If a client has a specialized wheelchair, ask the supervising nurse for specific management instructions before use.