MDE - Radiologic Medical Equipment and the ADA
There are many types of radiologic technologies and medical equipment associated with them, including MRI, x-ray, CT scan, bone densitometry, mammography, and ultrasound. This specialized equipment presents unique challenges for use by individuals with disabilities. The Americans with Disabilities Act (ADA) mandates that medical service providers must provide access for handicapped individuals to receive medical care similar to that provided for individuals without disabilities.
Some of these technologies require the patient to lie on a flat surface that is part of the equipment. The accessibility issues related to transfer to the surface are similar to those addressed previously under Exam Tables and Chairs. However, because the radiology technology is often integrated into the table, the table may not be able to be lowered sufficiently. In these cases, use of a patient lift or another transfer and positioning technique is particularly important for access to this equipment. See the diagram below for a representation of transferring a patient using a sliding technique.
Assisted Transfer Using Sliding Technique
In the photo above the following features are highlighted.
Set stretcher height to be level with table surface for lateral transfer.
Adequate floor space to maneuver and position stretcher.
Stretcher locked in place to prevent movement during lateral transfer.
Slip/slide sheets, boards, or other aids assist with lateral transfers.
Many radiologic technologies also require the patient to keep still, which may be very difficult for some individuals with a mobility disability, including those with spasticity, tremor, or other condition. Patients may need a staff person to support them with pillows, rolled up towels, wedges, or by holding onto them.
A mammography exam typically requires the patient to stand up. Individuals who use wheelchairs will need to have an exam while staying in their wheelchair. The mammography machine will need to adjust to their height and accommodate the space of the wheelchair. People who walk with a mobility device or who cannot stand for prolonged periods of time may need to sit in a chair with adequate support, locking wheels, and an adjustable back and, like people who use wheelchairs, need the machine to adjust to their height once seated. Additionally, some patients may need support to lean forward. See the diagram below.
Accessible Mammography Machine
The items featured in the image above are discussed below.
Unit pivots to multiple angles and adjusts in height for seated patients.
It is best to position equipment to allow both front and side approaches; for some patients a side or angled approach may be better for positioning at the camera unit and plate.
Clearance is needed beneath the camera unit and plate to allow people using wheelchairs and other mobility devices to pull up to the equipment.
Other items included in the proposed standards for mammography machines include standing support on each side of the standing surface (M304.3), standing supports that do not rotate within their fittings (M305.3.3), vertical gripping surfaces 18 inches (455 mm) long minimum (M305.3.2), bottom of the vertical gripping surface 34 inches (865 mm) high minimum, and 37 inches high (940 mm) maximum above the standing surface (M305.3.2). Knee and toe space under the breast platform that is 25 inches (635 mm) deep (M303.2.4). The breast platform should be 30 inches (760 mm) high minimum and 42 inches (1065 mm) high maximum above the floor when used by a patient seated in a wheelchair (M303.4 and M303.4.1). Wheelchair space that is 36 inches (915 mm) wide minimum and 48 inches (1220 mm) deep minimum (M303.2.2 and M303.2.3). Finally, the wheelchair space surface slopes no more than 1:48 in any direction (M303.2.5). These proposed standards were presented by the Access Board and are usable guides but still not enforceable.
In summary, medical service providers must provide access for handicapped individuals to receive medical care similar to that provided for individuals without disabilities. This access goes from the site arrival point (accessible parking spaces) to the medical diagnostic equipment in the medical service facility. Failure to provide this access is a violation of ADA laws. Proposed standards for specialty machines like mammography will increase the requirements to comply with accessibility laws when the standards are adopted by enforcement agencies. For additional information please Accessible Medical Equipment.
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