Recommendations on Standards for the Design of Medical Diagnostic Equipment for Adults with Disabilities, Advisory Committee Final Report

M301.2.1, M302.2.1 Transfer Height

Proposed requirement:

The height of the transfer surface during patient transfer shall be 17 inches (430 mm) minimum and 19 inches (485 mm) maximum measured from the floor to the top of the transfer surface.

• Sub-Committee Recommendation: 17 inches with exceptions.

Exception: During patient transfer, the height of the transfer surface shall have a lower height of 21" maximum and adjustable to a higher height of 25" minimum, measured from the floor to the uncompressed height of the patient support surface.

Rationale: Early studies are showing that achieving a low height for stretchers in the 17"-19" range to be very difficult due to the various roles of stretchers being not only diagnostic pieces of equipment, but as that they are used for transport. The very nature of the mobility systems and components of the stretcher configuration, including wheels, brakes and steering systems as well as their ability to carry portable equipment such as IV's, infusion pumps, monitors, oxygen, foley catheter bags, etc. all of which create serious packaging constraints that limit the low height of the patient support surface.

Patients may utilize stretchers for long periods of time – e.g. emergency room (primary equipment used) or while waiting to have their diagnostic tests performed. Stretchers are also widely used in outpatient surgery centers. Other considerations for stretchers are the surfaces (mattress) that is purchased separate from the stretcher deck. The Standard of Care for healthcare organizations is to have a pressure-relieving surface on the stretcher to help prevent pressure ulcers. These surfaces may range between 4” to 5” in thickness - this will add to the vertical height of a stretcher when measuring from the floor to the top of the surface (uncompressed). The Committee acknowledges this Standard of Care and feels it is important to maintain when measuring overall the height. Stretchers currently have a low deck of 20” – 23”.
This is also coupled with the complication of a 6" tall lift clearance window that forces foot operated controls up. These elements are all competing for the same vertical space and it will take full development of the stretcher to confirm or deny the ability to meet the desired range of 17"-19". Until that time, it is proposed we take a more conservative position and push the low height slightly higher for stretchers until the technology can catch up with the regulations and full feasibility studies can be researched. The recommendation for exception is 21" (with a oxygen holder). When access is unachievable, a portable floor or ceiling lift shall be utilized.

Figure 1: Stretcher Vertical Height Constraints – Configuration of Features
(Picture provided by Hill-Rom)

Note: In the healthcare setting having a single stretcher type that services a majority of patient conditions is desired. Patients may use stretchers for transport only, however many patients may also require supporting oxygen during transport to and from diagnostic procedures.

Figure 2: View of Stretcher with Oxygen Tank
Note: Oxygen tanks require a minimum of 5” of vertical height in stretcher configuration
(Picture provided by Stryker)