In addition, the PT should be part of the team that helps to determine where and how to tie down the wheelchair so that school bus drivers and/or monitors don’t injure themselves. In one day, the driver or monitor secures a wheelchair 16 times. If these people do not move correctly, they have the potential to hurt their back 16 times. Some people are able to squat to tie down the wheelchair correctly; those of us who cannot squat need to go down onto one knee. The staff should never bend over with their trunk and keep their knees straight. With time, this could cause a serious back injury.
Assistance in proper loading and unloading, evacuations
Another area where drivers and monitors could injure their back is in the process of loading and unloading the students. Staff should never carry a child up and down the steps. They could slip and fall with the student, or the student could have a seizure. The employee should stand behind the student as they go up the steps and in front of the child as they go down the steps. In this way, the child is well protected should he or she start to fall, and the staff is also well protected. The therapist should teach the team how to place a student onto a school bus seat correctly as well.
PTs will also teach drivers and monitors how to protect their back and lift students safely when evacuating them and using evacuation equipment. They will discuss the use of a belt cutter and the quickest way to use it.
In addition, PTs will review how to lift a student and how to “drag” a student out of the bus, and they will help decide the best way to evacuate the student. PTs should be involved in the design of the written evacuation plan and participate in the evacuation drills.
Head Start children
In February 1999, the National Highway Traffic Safety Administration developed guidelines for the safe transportation of preschool age children in school buses. The Head Start program decided that it would follow these guidelines in regard to child passenger restraint systems, so all students in a Head Start program must be in some type of child safety restraint system. PTs can assist a transportation staff in deciding what restraint is the best for each student.
A student in a Head Start program will most likely be in a baby car seat. As the student becomes older, the options become greater, i.e., a larger car seat, an integrated seat, an add-on system or a safety vest. The PT needs to ride the school bus and help decide what system provides the student with the most support. Should there be a problem with head control, then the student may need a soft cervical collar.
Summary
As PTs, there is a tremendous amount of information we can provide to a school district’s transportation team. Listed above are just some of the ways. Ask your therapist any questions you have. Call on the PT — this is part of his or her job, and we need to work together for the safe transportation of our students.
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Jean Zimmerman is supervisor of occupational and physical therapy for the School District of Palm Beach County (Fla.).
