How to weight a patient in a wheelchair?

According to the Administration for Community Living, the Americans with Disabilities Act (ADA) requires medical providers to have accessible scales to ensure accurate weight tracking for all patients. To properly and safely weight a patient in a wheelchair, you need the right equipment and a clear, methodical process.

Quick Summary

Use a specialized wheelchair scale or a tare weight method to accurately measure a non-ambulatory patient's weight while ensuring their comfort and safety. This involves weighing the empty wheelchair, recording its weight, and then subtracting it from the total weight of the patient and chair combined. Always confirm the patient is stable and on a level surface throughout the process.

Key Points

• Use a Wheelchair Scale: The most accurate method involves a specialized wheelchair scale with ramps and a tare function.

• Employ the Tare Function: Weigh the empty wheelchair first, press 'TARE' to zero the scale, then weigh the patient to get their net weight.

• Use the Subtraction Method: Alternatively, weigh the empty wheelchair, weigh the patient and chair together, then subtract the wheelchair's weight.

• Prioritize Safety: Always lock wheelchair brakes, clear the path, and never leave the patient unattended on the scale.

• Ensure Accuracy: Perform measurements on a hard, level surface and remove all extra items from the wheelchair before weighing.

• Know the Alternatives: Consider bed scales or mechanical lift scales for patients who cannot be weighed in a wheelchair.

• Follow Protocol: Adhere to safety guidelines and proper transfer techniques to prevent injury during the weighing process.

Importance of Accurate Patient Weight

Accurate weight measurements are a critical part of patient care, influencing medical assessments, medication dosages, nutritional planning, and monitoring overall health status. For non-ambulatory patients, obtaining this data can be challenging without the correct tools and procedures. Improper techniques not only lead to inaccurate readings but also increase the risk of injury for both the patient and the caregiver.

Method 1: Using a Wheelchair Scale with a Tare Function

The most straightforward and recommended method for weighing a patient in a wheelchair is using a specialized scale with a built-in tare function. These scales are designed with a large, low-profile platform and ramps, allowing easy access for wheelchairs.

Step-by-Step Procedure

1. Prepare the Scale: Place the wheelchair scale on a hard, flat, and level surface, ensuring there are no obstructions. Turn the scale on and allow it to zero out. This confirms the scale is calibrated correctly before use.
2. Tare the Empty Wheelchair: Push the empty wheelchair onto the scale's platform, making sure it is fully centered and stable. Press the 'TARE' button on the scale's display. This function electronically zeroes out the weight of the wheelchair, so the subsequent measurement will only show the patient's weight. Some advanced scales allow you to enter a known, pre-recorded wheelchair weight using a numeric keypad.
3. Position the Patient: Carefully and gently roll the patient in their wheelchair onto the scale. Ensure the wheelchair is centered on the platform and engage the wheel brakes to prevent any movement. The patient's feet should be on the footrests, not touching the ground.
4. Record the Weight: Wait for the scale's reading to stabilize. The displayed number will be the patient's net weight, as the wheelchair's weight has already been tared. Record the reading immediately and, once complete, roll the patient off the scale. Disengage the brakes once they are safely off.

Method 2: The Two-Step Subtraction Method

If a scale with a tare function is unavailable, the subtraction method provides a reliable alternative. This process is more manual but can be just as accurate if performed carefully.

Step-by-Step Procedure

1. Weigh the Empty Wheelchair: First, roll the empty wheelchair onto the scale and record its exact weight. It is crucial to use the same wheelchair for this entire process. For future visits, you can use this recorded weight, provided the same equipment is used. Remove any extra items, like bags or blankets, before weighing.
2. Weigh Patient and Wheelchair Combined: Assist the patient into the wheelchair, ensuring they are positioned securely. Roll the patient and wheelchair together onto the scale. Record this total combined weight after the scale has stabilized.

3. Calculate the Patient's Weight: Subtract the weight of the empty wheelchair from the combined weight. The formula is:

   • Patient Weight = (Total Weight of Patient + Wheelchair) - (Weight of Empty Wheelchair)

Best Practices for the Subtraction Method

• Use the same scale for both measurements to ensure consistency.
• Always double-check your subtraction calculation to avoid errors.
• If the patient is regularly weighed, consider marking the wheelchair with its empty weight for easy reference.

Comparing Weighing Methods

Feature	Wheelchair Scale with Tare	Two-Step Subtraction Method
Accuracy	High, automated calculation	High, but relies on manual subtraction
Speed	Faster; tare function saves time	Slower; requires two separate weighings
Convenience	Most convenient; single measurement once tared	Less convenient, requires more steps and math
Equipment	Specialized, accessible wheelchair scale	Can be used with a standard floor scale, if large enough
Safety	Safer for patient; less manual transfer needed	Safe if done carefully, but higher potential for human error in calculation

Safety Precautions for Weighing a Wheelchair Patient

Patient safety is the top priority during any weighing procedure. Adhering to these precautions minimizes risks:

• Secure the Brakes: Always engage the wheelchair's brakes as soon as it is on the scale and before the patient is moved. This prevents rolling and stabilizes the patient.
• Use Proper Transfer Techniques: Use safe and approved techniques for transferring patients, especially if moving them to a different chair scale. This includes proper lifting mechanics to protect both the patient and the caregiver.
• Clear the Area: Ensure the path to and from the scale is free of any obstacles, wires, or uneven surfaces that could cause a trip or fall.
• Never Leave Unattended: A patient should never be left alone on a scale. Remain by their side to provide support and reassurance throughout the process.
• Maintain Equipment: Regularly check the scale for proper function and calibration. A damaged or uncalibrated scale can give inaccurate readings and pose a safety risk.
• Footrests and Armrests: Ensure the patient's feet are completely on the footrests and not touching the floor. For chair scales, use armrests and footrests as intended to secure the patient.

Other Weighing Alternatives

For patients who are bedbound or have complex medical needs, other options exist. Some hospital beds are equipped with built-in scales that allow for continuous weight monitoring without any patient transfer. Additionally, mechanical lifts with integrated scales, or 'sling scales,' can be used to weigh patients who cannot use a wheelchair or chair scale. These methods are typically reserved for hospital settings due to their specialized nature.

Conclusion

Knowing how to weight a patient in a wheelchair accurately and safely is a fundamental skill for healthcare providers and caregivers. By utilizing a dedicated wheelchair scale with a tare function or employing the careful two-step subtraction method, you can obtain precise weight measurements essential for medical care. Always prioritize patient safety by following established protocols and maintaining clear communication throughout the process. Proper practice ensures reliable data while providing dignity and security for the patient. For more information on safe patient handling, consult official medical and caregiving resources, like the guidance available from the Occupational Safety and Health Administration (OSHA).

Frequently Asked Questions

Can I use a standard floor scale to weigh a patient in a wheelchair?

Yes, but with limitations. The two-step subtraction method can be used with a standard scale, provided the scale's capacity is not exceeded and the wheelchair can be safely maneuvered onto it. A specialized wheelchair scale is always preferable for safety and convenience.

What is the tare function on a wheelchair scale?

The tare function allows you to subtract the weight of an object, in this case, the empty wheelchair. When you place the empty wheelchair on the scale and press 'TARE,' the display resets to zero, so the next measurement will only show the patient's weight.

How do I ensure the most accurate reading when weighing a patient?

To ensure accuracy, use a calibrated scale on a hard, level surface. Make sure the patient is centered and still, with their feet on the footrests. Remove any extra items from the wheelchair, like blankets or bags, before weighing.

What should I do if the patient is unable to transfer to a chair scale?

For patients unable to transfer, use the specialized wheelchair scale or explore alternatives. Many hospitals have beds with built-in scales, or you can use a mechanical lift with an integrated scale for bed-bound patients.

Are there different types of wheelchair scales?

Yes, there are several types, including platform scales with ramps, weigh beams that can be placed apart to accommodate various wheelchair sizes, and even chair scales for patients who can transfer but have difficulty standing.

How often should I weigh a patient in a wheelchair?

The frequency of weighing depends on the patient's medical needs and the care plan prescribed by their doctor. Always follow the specific instructions of the patient's healthcare provider.

What if the patient's wheelchair is not always the same?

If the patient uses different wheelchairs, you must use the two-step subtraction method each time. Weigh the specific empty wheelchair used for that measurement and record its weight before calculating the patient's net weight.