emergency preparedness series- evacuation chairs

Emergency Preparedness Series-Evacuation ChairsMarch 27, 2014 1

“Evacuation Chairs: Recent Research and New Performance Standards”

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Evacuation Chairs: Recent Research and New Performance Standards

Steve Lavender, PhD, Associate Professor, Department of Integrated Systems Engineering and the Department of Orthopedics, Ohio State University

Glenn Hedman,MS, PE, ATP, RET, Clinical Associate Professor, Department of Disability & Human Development and the Director, Assistive Technology Unit at the University of Illinois at Chicago

How Can we Evacuate Individuals withDisabilities from High Rise Buildings

Safely and Efficiently?Steve Lavender, PhD1

Glenn Hedman, MS2

Jay Mehta, MS1

Sanghyun Park, MS1

Paul Reichelt, PhD2

Karen Conrad, PhD2

1The Ohio State University2The University of Illinois at Chicago


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Evacuation Needs

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EMS – An occupation with Significant MSD Risks

• Maguire, B.J., Hunting, K.L., Guidotti, T.L., & Smith, G.S. (2005). Occupational injuries among emergency medical services personnel. Prehospital Emergency Care, 9, 405-411.– Relative risk: 5.8 relative to health services

• Gershon RR, Vlahov D, Kelen G, Conrad B, Murphy L. (1995) Review of accidents/injuries among emergency medical services workers in Baltimore, Maryland. Prehosp Disaster Med., 10:14-18.– 43% Strains/Spains, 20% of injuries to the back

• Hogya PT, Ellis L. (1990). Evaluation of the injury profile of personnel in a busy urban EMS system. Am J Emerg Med.8:308-11.– Back strain accounted for 78% of lost days.

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EMS – An occupation with Significant MSD Risks

• Furber, S., Moore, H., Williamson, M., Barry, J. (1997). Injuries to ambulance officers caused by patient handling tasks. J. Occup Health Safety, 13, 259-265.– Most common location – private residence where stairs and

heavy patients are contributing factors.– 63% of injuries were back injuries

• Karter, M.J., Jr., & Molis, J.L. (2011). Firefighter injuries: 2010. National Fire Protection Association. Quincy: MA.– Musculoskeletal injuries account for over half of the injuries

suffered by firefighters (FF) as they perform non-fire emergency tasks, such as emergency medical services (EMS) and rescue operations.


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Study Objective

• To evaluate different types of stair descent devices that can be used to evacuate individuals with motor disabilities from high-rise buildings.

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Prior Work• Adams and Galea (2010)

– Decreased task performance times when using a track-type device vs:

• manually carried stair-chair, • an ambulance cot, • or a drag mattress

• The physical demands on the responders were not quantified.

Adams and Galea, 2010, Pedestrian and Evacuation Dynamics Conference, NIST, Maryland USA

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Track-Chair Comparison Study• Fredricks et al., 2006

– Compared two track chairs– Modeled with the 3DSSPP – Substantial differences between two

track-type chairs• Spine Compression• Spine Shear

– Used two operators (leader/follower)• Load sharing

Fredericks, T.K. et al. (2006). Proceedings of the 11th annual international conference on industrial engineering- Theory, applications, and practices, Nagoya, Japan


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Study Aims

1.To quantify the differences among types of existing evacuation devices with regards to the physical demands placed on firefighters.

2.To quantify the variation in evacuation times, including occupant preparation for transport and the stair descent process, across different evacuation devices.

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Study Aims (Continued)

3. To determine the impact of environmental factors including:

• the width of the stairs, • the sense of urgency,

4. To assess usability issues with each of the evaluated devices through video analysis and a structured interview process.

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Approach• Evaluate physical demands

experienced by seasoned FF as they roll/slide stair descent devices down flights of stairs.

• Physical Demands are measured using:

• Electromyography (EMG)• Heart Rate• Self Report


Task

• Secure occupant in device

• Transport the occupant down three flights of stairs.– Through two

landings

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Experimental Design

• Factors considered– Device Design – Staircase Width– Urgency

Device Type• 3 Main Categories

– Hand-carried devices– Devices with stair

descent tracks– Sled type evices


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Track-Type Devices

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Sled-Type Devices


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Hurricane Sandy Hits NYC

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Staircase Width• Based on NFPA 101-2009 describing

staircase widths based on occupant load:

Category Width (inches)

Capacity (persons)

Code

Narrow 36 < 50 7.2.2.2.1.2 (A)

Medium 44 < 2000 7.2.2.2.1.2 (B)

Wide 56

(52)

>= 2000 7.2.2.2.1.2 (B)

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Staircase Width


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Staircase Width

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Urgency

• Controlled via instructions given to the subject prior to each run.– non-urgent - “you can take as much

time as you need during this descent”– urgent - “the situation requires you

leave the building as quickly as possible.”

• Repeating recorded message “This is an urgent condition”

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Participants-• Recruited from a population of

firefighters• Twelve subjects/study- male

– Height: 183 cm (175 – 196 cm)– Weight: 88 kg (71 – 111 kg)– Age: 36 yrs (24 – 61 years)– Experience: 9 yrs (1.5 – 23 years)

• Signed IRB approved consent documents


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Occupant

• Rescue Randy– Control

for size, shape, weight

– 73 kg (160 lbs)

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Measures• Duration of evacuation• Electromyography

– Erector Spinae, – Latissimus Dorsi, – Deltoid, – Biceps

• Heart Rate• Perceived exertion ratings• Spine motion• Usability information via

post study interview.

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Perceived Exertion Ratings• “How hard physically was this task for you?”

– 0 Not at All– 1 Very Easy– 2 Fairly Easy– 3 Moderate– 4 Somewhat Hard– 5 Hard– 6– 7 Very Hard– 8– 9– 10 Very, Very Hard


Descent Speed Results

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Looking Across Studies:Descent Speed as a function of

Staircase Width

0.0

0.1

0.2

0.3

0.4

0.5

0.6

44 52

Vertical Speed (m/s)

Stair Width (inches)

p<0.001

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Stair Descent Speeds: Hand-Carried Devices (44” Staircase Width)

Fruin, J.J. (1971). Pedestrian Planning and Design, All age average, pg 56.

Range based on samples obtained by Peacock, Hoskins, Kuligowski (2012) Safety Science 50, 1655–1664, table 3.


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Stair Descent Speed by Track-Type SDDs (44 & 52” staircase widths)

Fruin, J.J. (1971). Pedestrian Planning and Design, All age average, pg 56.

Range based on samples obtained by Peacock, Hoskins, Kuligowski (2012) Safety Science 50 1655–1664, table 3.

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Stair Descent Speed by Sled SDDs (44 and 52 inch Staircase Widths)

p values (Width <0.001 Device <0.001 Device x width = 0.553)

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Heart Rate Results


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Heart Rate – Percent Max –Hand Carried SDDs

Hand-Carried Stair Descent Device

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Heart Rate – Percent Max-Track-type SDDs

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Heart Rate – Percent Max Sled Type SDDs


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Results – Muscle Use

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Hand-Carried SDDs –Stair Data Mean*time, (44” Width)

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Track Type SDDs: Stair Data Mean*time (1.12 and 1.32m):


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Track Type SDDs: Landing (1.12 and 1.32m): Arm Muscles - 90th percentile

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Sled-Type SDDs: Stair DataErector Spine (Back) Muscles

Sled-Type SDDs: Landing DataLatissimus Dorsi Muscles

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Sled-Type SDDs: Landing DataBicep Muscles


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Objective Measures - Analysis Summary

Device Positives NegativesHand-Carried

Less Expensive Higher Physical DemandsSlower – Unless lead person can face forward

Track-type Reduced Back muscle use –Faster

Latissimus use – on stairs, landings

Sled-type Low muscle demands on stairs.

Transfer in/out, High demands on Landing

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Hand-Carried SDDs-InterviewsDevice: Basic Stair Chair Extended Handle Stair

Chair Fabric Seat Manual Carry

Positive Comments

• Lighter • Smaller • Easy operation • More Portable • Works in narrow

spaces • Can keep arms

straight

• Easier to set up • All components lock • Wider • Natural position • Foot spacing better • Hands shoulder-width

apart • Synchronizing better • Can go faster

• Handy • Easy to have in small

bag • Easy operation • Occupant torso up,

away from body • Can keep arms

straight • Less room required to

turn

• Easy, quick, gets job done • Can hold weight against

chest • No rocking • Arms around occupant • Less anxiety • More secure • Requires less room to

make turn • OK for 1-2 floors

Negative Comments

• Too narrow • Hard to lift • Footing a problem • Synchronizing with

partner a problem • Unstable – side to

side • Rear handles too

short • Rear handles do not

lock

• Width makes it difficult to turn corners in tight spaces

• Handle height • Difficult to lift higher • Difficult clearing steps

during urgent condition (arms are at 90-degrees)

• Cumbersome to get occupant on it

• Straps get in the way • Handles hurt hands • Need to use wider

stance • Not sturdy enough • Cannot stop on steps or

landing to rest

• Difficult to grip occupant, especially larger individuals

• Stressful, especially for operators in turnout gear

• Limits dexterity • Cannot see stairs • Cannot stop on stair to

rest

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Track-type SDDs - InterviewsDevice Narrow 2-Wheel Standard Long Track Rear Facing

Pros Works well in narrow space

Easy to move from track to wheel

4 wheels (available when on landing)

Liked tracks Easy to pull back

(easy to prepare for the stairs)

Brakes (has a brake system)

Smooth ride Easy (to get) around

corners

Simple, Fast ,Little effort to operate: maneuverability, and steering

Good wheel placement - patient weight is between you and the wheels

Moved easily on stairs

Good for apt building and for lay people to use

Handle bar with curve Didn’t have to bend

over as much

Easier to operate 4 wheels on landing Easy to use –

(tracks) caught (gripped) stairs well

Sturdy, Wider Easy to steer Easy to turn on

landing Doesn’t take off on

you

Liked brake Tracks can stop

device More controlled

speed Strap easy to put

on but a little cumbersome

Descent was smooth Had control on stairs Liked patient facing me –

can observe patient When tilt patient back,

(their) legs don’t get in way so (I) can make a tighter turn

Treads easy to control

Cons Narrow device Rocks a lot with

larger patient Tended to tilt

sideways Slides sideways No place to kick it

back like on hand truck

Hand position limits balance

Takes a little time to get used to

Hard to maneuver corner on narrow staircase

Can’t put (rear) wheels down at end of stairs (when on landing)

(Rear) Wheels not in fixed down position

On landing, bar in front of wheels got in way

More difficult to set up

Noisy – minor issue

Lap swivel belt hard to use

Most difficult to use

Rough (difficult) transition from stairs to landing

Braking system is counter intuitive

Handle too low Operator’s foot

got caught on back bar with weight of patient on his toes

Hard to maneuver because of length

Have to change hand position while in motion

Requires large radius for turning

Required a lot of lifting at turns and therefore more energy

No second set of wheels to put device down (during turn)

Patient faces you – may be uncomfortable for patient


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Sled Type SDDs– InterviewsDevice Corrugated Fabric Mat Hard Shell Inflatable Roll‐up Wheeled

Positive Design Features

2‐Handle straps – good lengthEasy to get around cornerLow profile

Wide Strap‐Good lengthGood FrictionEasy to get around corner

None None More rigid – less lateral swingEasy to get around corner

Friction from material

Negative Design Features

Length makes getting around corner tough

None Lack of controlHard to turnStrap to longStrap could slip

Top heavy‐tendency to tipHard to get around cornerBulky

Could slide to fastLong thin strap difficult to grip*

Position of single operator in front of patient / BendingHead‐end swing on landing,Awkward to push down on patient’s legs

% that would Recommend*

Fire service / Building owners

42% / 67% 50% / 58% 0% / 25% 0% / 25% 58% / 58% 8% / 25%

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Limitations

• Weight of the occupant• Perspective -- Experience of the

occupant

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Summary• Track-type devices preferred

– Evacuation speed– Physical Demands– Ingress / Egress for occupant

• If a hand-carried device is used - device width and handles should support lead person descending facing forwards.

• Sled-type devices – acceptable for evacuator but getting in/out is a concern for the occupant.


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Acknowledgement

• Federal Emergency Management Agency Assistance to Firefighters Grant Program– 2009-EMW-FP-01944

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Questions?

• Further contact: – Steve Lavender: [email protected]

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Consumer Opinion Study


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• Conducted at the Access Living facility in downtown Chicago.

• July 2013

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• Participants –Those with a disability that would require assistance should they need to evacuate a multi-story building without the use of an elevator.

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• 2 Components– First Impressions

• Collect initial perceptions of the 13 devices used in the prior studies

• Asked which, if any, devices they would like to try

– Post descent impressions• Participants will be taken down 2 flights of

stairs in up to 5 different devices.


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Initial Impression Survey

Transfers

Safety

Security

Nervousness

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Initial Impression Survey1. How easy would it be for you to transfer into the

device?very difficult / difficult / somewhat difficult/ somewhat easy / easy / very easy

2. How easy would it be for you to transfer out of the device? very difficult / difficult / somewhat difficult/ somewhat easy / easy / very easy

3. How safe would you feel riding in this device?very unsafe / unsafe / somewhat unsafe / somewhat safe / safe / very safe

4. How securely do you think the straps would hold you?very unsecurely / unsecurely / somewhat unsecurely / somewhat securely / securely / very securely

5.How nervous would you be about riding in the device?

very nervous / nervous / a little nervous / not at all nervous

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Initial Impression Survey (cont.)Which of these devices would be acceptable to you

for emergency evacuation from a multi-story building?

• Fabric Seat• Basic Stair Chair• Extended-Handle Stair Chair• Track-Type Stair Chair - Standard• Track-Type Stair Chair – Narrow• Track-Type Stair Chair – 2-wheel• Track-Type Stair Chair – Speed Governor• Track Chair – Rear-Facing• Sled – Corrugated• Sled – Fabric Mat• Sled – Hard Shell• Sled - Inflatable• Sled – Roll-up• Sled - Wheeled


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Post-Ride Survey1. How easy was it for you to transfer into the device?

very difficult / difficult / somewhat difficult/ somewhat easy / easy / very easy

2. How easy was it for you to transfer out of the device? very difficult / difficult / somewhat difficult/ somewhat easy / easy / very easy

3. How safe did you feel riding in this device?very unsafe / unsafe / somewhat unsafe / somewhat safe / safe / very safe

4. How securely did the straps would hold you in the device?very unsecurely / unsecurely / somewhat unsecurely / somewhat securely / securely / very securely

5. After having ridden in this device, how nervous would you be if we asked you to repeat the ride in the device?very nervous / nervous / a little nervous / not at all nervous

6. For an emergency evacuation, were you sufficiently comfortable riding in the device? (Y/N)

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After the completion of all rides selected by a participant…

• Which of these devices would be acceptable to you for emergency evacuation from a multi-story building?

• Are there any specific design features you liked or disliked about the devices you rode in today? Please explain.

• Is there anything else you would like to tell us about the devices you have seen today?

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Preliminary results – Participants

• Total– 14 participants

• 8 male

• 6 female

• Age range• 29 – 63 years (avg. 49.2 years)

• Weight• 106 – 365 lb (avg. 208.6 lb)


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Preliminary results – Participants

• Disabilities

– Amputation, arthritis, CVA, diabetes, hearing impairment, low back pain, low vision, paraplegia, quadriplegia, post‐polio, spina bifida

• Mobility aids– Cane, walker, manual

wheelchair, powered wheelchair, prostheses

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Preliminary results – Initial Impression

• Transfers

– Easiest for Carry‐Type

• Safety

– Concern over carrying full weight in Fabric Seat

– Raised edges of Hardshell and Inflatable added to safety

• Security

– More straps, more secure

• Nervousness

– >50% of participants

– Least nervous about Standard Track‐Type

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• Transfers


• Safety

– Concern over carrying full weight


• Security


• Nervousness




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• Transfers


• Safety



• Security


• Nervousness



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• Transfers


• Safety



• Security


• Nervousness



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Preliminary results – Post‐Viewing

• Acceptable– Carry‐Type, extended handle (10)

– Track‐type, standard (8)

– Sled‐type, inflatable (8)

• No other device viewed as acceptable by at least half of the participants.


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Preliminary results – Post‐Ride

• Transfer in and out– Same or improved

• Nervousness– Same or improved

• Security– Same or improved

• Safety– Less safe (2)

– Unchanged (5)

– More safe (2)

• Trial use– Opinion changed in half of instances

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ANSI / RESNA ED-1 : 2013Emergency Stair Travel Devices

used by Individuals with Disabilities

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ED‐1:2013

• Background

• ANSI / RESNA ED‐1:2013 elements

• Key points of Draft RESNA Position Paper on Evacuation Chairs


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• Past interest

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• Rehabilitation Engineering and Assistive Technology Society of North America

• Professional membership society

• Approximately 1400 members

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• Rehabilitation Engineering and Assistive Technology Society of North America

• Board of Directors (11 members)• Standing Committees (10)• Operating Boards (4)

– Journal Board– Professional Standards Board (ATP, SMS, RET credentials)

– Development Board– AT Standards Board (ANSI‐accredited standards development organization)


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AT Standards Committees

– Wheelchairs

– Wheelchairs & Transportation

– Wheelchair & Related Seating

– Support Surfaces

– Adaptive Sports Equipment

– Adaptive Golf Cars

– Cognitive Technologies

– Emergency Stair Travel Devices used by Individuals with Disabilities (ESTD)

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ESTD Committee

• Approved by RESNA AT Standards Board

– June 2009

• Recruitment of members

– Sept 2009 – Feb 2010

• First meeting

– Feb 2010

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ESTD Interest Categories– Consumers

– Manufacturers & Suppliers

– Consultants (e.g., emergency management professionals)

– Code Development / Code Enforcement professionals

– Building Owners & Managers

– Insurance Industry professionals

– Testing Organizations & Facilities

– Researchers

– General or Other


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• Important aspects of evacuation chairs

– Description

• Device type covered

• Terminology

• Measurement

– Occupant features

– Performance

– Maintenance

– Inspection

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• Terminology

– Occupant

– Operator

– Type

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Device Types

• Carry‐type


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Device Types

• Track‐type

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Device Types

• Track‐type

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Device Types

• Track‐type

– Controlled descent

– Manual ascent


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• Track‐type

– Powered descent

– Powered ascent

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Device Types

• Sled‐type

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• Terminology

– Occupant

– Operator

– Type (Volume 1)• Track‐Type

• Controlled descent

• Manual ascent


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• Occupant features

– Weight capacity

– Safety straps

– Support surfaces

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– Weight capacity

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– Weight capacity


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– Weight capacity• 350 lb (159 kg), min.

• Use of RESNA WC‐1 mannequin

101


– Weight capacity• 350 lb (159 kg), min.

– Test method

• 1.5 x weight capacity

– Examples:

– 350 lb, test at 525 lb

– 400 lb, test at 600 lb

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Performance

• Maneuverability


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Performance

• Maneuverability

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Performance

• Stability

– Configuration for travel on Horizontal Surfaces

• Forward: 10 degrees

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Performance

• Stability

– Configuration for travel on Horizontal Surfaces

• Lateral: 10 degrees


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Performance

• Stability

– Configuration for travel Downward

• Forward: 40 degrees

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• Inspection

– Location of device

– Markings

– Components

– Frequency

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• Inspection

– Location of device

– Markings

– Component check

– Frequency of inspections


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ANSI/RESNA ED-1 : 2013• Approved February 27, 2013• Available April 2013

• Key elements of ED-1– Weight capacity– Measurements– Maneuverability on code-compliant stairways and

landings– Stability on horizontal and stair surfaces– Inspection

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Adoption

• NFPA 101 Life Safety Code

– 2015 Edition

• Annex entry

• ANSI/ICC A117

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What Next?

• Dissemination of information on the Standard

• Recommendations on selection


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• Standard

– Voluntary

– Focus on performance

– Does not specify design features

• Position Paper

– Guide for practitioners

– Tool for educators

– Material for justification of acquisition

– Evidence for policy change efforts

– Contribution toward standard of practice

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Position Paper Requirements

• Literature review

• Documented best practice

• Summary for use in justification

• Review of benefits

• Presentation of draft for feedback

• Consideration by RESNA BOD

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Draft Position Paper

• Recommendation 1

– For building occupants who can be in a seated position, track‐type evacuation chairs should be utilized.


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– When selecting a track‐type evacuation chair, preference should be given to devices which comply with the ANSI/RESNA ED‐1:2013 Standard.

COMPLIES WITH

ED - 1 : 2013Figure 1.

Sticker indicating compliance with ED-1:2013 Standard. Center element to be current RESNA logo.

QR code links to RESNA web page regarding ED-1.

QR CODE



– When outfitting a building accessed by the public for goods and services for stair descent devices, the allocation of at least one stair descent device at each floor of each stairway is recommended.

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– Where there are known additional building occupants who will need a stair descent device in an evacuation, the acquisition of one device for each should be considered.


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• Additional considerations

– Involvement of consumers in evacuation planning and device selection

– Trial use

– Mobility at floor of discharge

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Contact Info

• Glenn Hedman (UIC)

– 312‐413‐7784

– [email protected]

• Yvonne Meding (RESNA AT Standards Secretary)

– 703‐524‐6686

– [email protected]

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Questions?

• ANSI/RESNA ED‐1:2013 • Position Paper


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emergency preparedness series- evacuation chairs

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