Ehsanullah Khan et al.

/ International Journal of Engineering Science and Technology (IJEST)

SYSTHESIS OF TROLLEY CUM

WHEELCHAIR FOR PATIENT
HANDLING
Ehsanullah Khan

Dr. C.C.Handa

Dr. R.D.Askhedkar

ABSTRACT
Handling of patient from hospital bed to CT-Scan, MR Scan, X-Ray, Sonography centre etc is a
cumbersome and tedious job. Generally from bed, the patient is moved to trolley manually. Three to four
persons lift the patient and keep him on the stretcher. The trolley is moved to lift if necessary. If the lift cannot
accommodate, the trolley, the patient is transferred to the ground floor by a nursing staff on a stretcher, and the
stretcher is kept on the trolley. Again the trolley takes the patient to ambulance but patient is to be lifted
manually with stretcher and put on ambulance platform. Again at the CT scan centre the patient with stretcher
has to be lifted manually for X-Ray or CT scan. The procedure is repeated for moving the patient back to the
hospital bed.
The manual handling of patient is injurious to the patient as stresses are produced in the body of the
patient, especially in neck, back bone, limb joints etc along with the basic medical problem he has. Improper
handling may cause injuries to the patient. Also the nursing staffs who handles patients, faces some health
problems like pain in the shoulder, back bone etc.
For safety of the patient, the manual handling of patient should be totally eliminated. If trolley cum
wheelchair ,with adjustable height is available, once the patient is transferred to the trolley-cum-wheelchair
from hospital bed, the patient will not be required to be handled manually till he reaches the CT Scan / X-Ray
centre.
The paper presents a schematic design of trolley cum wheelchair and discusses its salient features and
applications

INTRODUCTION
Generally a person who is suffering from some kinds of medical problem and requires continues
monitoring by doctor and may require external aids like oxygen, blood transformation, saline etc. is known as s
patient. He is generally admitted in a hospital. The patient is confined to bed in hospital and is required to be
moved to other places for taking X-ray or undergoing sonography or CT scan procedure.
The handling of the patient is rather difficult and is required to be planed meticulously. In patient
handling, a lot of problems are being faced by nursing staff, the people who handle the patient at home, and the
patient himself. These problems consist of pain to patient, in various portions of body like shoulder, back, legs,
etc; while moving him from one place to another. In the hospitals, the nursing staffs are also facing some
health problems like pain in their shoulders and backbone, as they have to do the work of patient handling
repeatedly.

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According to a recent survey, it is found that, 38% of nursing staffs suffer work-related back
injuries requiring time away from work,12% of nursing staffs consider leaving nursing due to low back pain at
average age 39, Nursing staff aides have also experienced significant injury.
The main objective of this research work is to reduce problems of patient handling by developing
Trolley-cum-Wheelchair. [3]

PRESENT METHOD OF PATIENT HANDLING

Fig. No.1 shows the present method of handling the patient to move into or to transfer to
CT scans, MRI scans, X-ray, Sonography etc.

Patient Bed

Manually Lifted
Trolley

Manually Lifted
Lift/elevator

Manually Lifted
Ground Floor

Manually Lifted
Ambulance
Manually Lifted
CT scans, MRI scans, Sonography, X-ray

Manually Lifted
Back to Bed

Fig. No. 1Flow chart for Present method of patient handling

Various stages of patient handling to transfer patient from hospital bed to CT scan/MR
machine/Sonography/X-ray centre, as shown in flow chart, are.
1) Patient bed to trolley- The patient is moved from bed to trolley with the help of three to four persons.
They simply lift the patient and keep him on trolley

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2) Trolley to lift- The trolley with patient is then moved to lift whose size is appropriate to accommodate
the trolley.
3) Trolley to ground floor- The trolley inside lift is then transferred to ground floor.
4) Ground floor to Ambulance platform-The stretcher along with patient is moved inside the
ambulance and pushed on the guide ways provided inside the ambulance for stretcher. The trolley is
lifted and put in ambulance.
5) Hospital to CT scan centre- The ambulance takes the patient from hospital to CT scan centre
6) Ambulance to CT scan machine- From the ambulance, the patient lying on stretcher, is lifted
manually by four persons and put it on the trolley.
7) Movement of trolley to CT scan machine- The trolley with patient is moved to the CT scan machine.
8) Back to patient bed- The above procedure is repeated while moving the patient back to the hospital
bed in reverse sequence.
THE PROBLEMS ASSOCIATED WITH HANDLING OF THE PATIENT
The patient is required to move manually on a canvas bed sheet from hospital bed to trolley, trolley to
ambulance bed then ambulance bed to trolley, trolley to CT scan machine. Backward patient journey from CT
scan bed to the hospital bed is similar.
The various problems associated with patient handling are
1) When the patient is required to be moved on the same floor is wrapped in a canvas or cotton bed sheet and
lifted and moved by three to four person / nursing staff. Due to this handling, stresses are produced, in the body
of the patient as well as the nursing staff. This may result in injuries to the patient and cramps may be produced
in backbone and other parts of the body.
2) During the manual handling of the patient various accessories like oxygen supply, blood transmission facility,
saline facility, are not available and this may create serious problem if the patient is serious.
3) When the patient is to be moved from trolley to ambulance bed or to be move on staircase at CT scan or Xray centre .The movement of the patient is on inclined plane. During this handling there is a chance that the
patient may slip/slide down on stretcher. The nursing staff handling the patient has to be very causes to such an
eventuality.
The problems of manual handling of patient can be eliminated or minimized by using trolley-cumwheelchair for patient handling.
CONCEPTUAL DEVELOPMENT OF TROLLEY CUM WHEELCHAIR

This paper presents the synthesis of trolley cum wheelchair Fig. No. 2 and Fig. No 3 shows the
photograph of trolley cum wheelchair in wheelchair position and trolley position respectively.

WORKING OF TROLLEY CUM WHEELCHAIR

The trolley cum wheelchair consists of backrest, hip rest and leg rest (as shown in fig. No. 4),
connected together by a four bar mechanism OABC. [1, 2]OA is a fixed link of four bar mechanism and AC and
OB are movable links and BC is a coupler in form of a lever which is used for changing trolley cum wheelchair
from trolley position to chair position and vice versa. Link AC is connected to Backrest while link OB is
connected to leg rest. The hip rest is immovable and is parallel to the ground always. The backrest and leg rest
are moved by lever operated by the coupler of four bar mechanism to change trolley cum wheelchair from
trolley position to wheelchair position and vice versa. The design of Trolley cum wheelchair will be based on

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ergonomic considerations. The schematic drawing of trolley cum wheelchair in chair position and trolley
position are shown in Fig. No. 2 and Fig. No. 3 respectively
In wheelchair position, the backrest will be inclined perpendicular to hip rest to provide comfort to
the patients. The hip rest will be parallel to the ground. To convert the wheelchair into trolley (stretcher), the
lever is rotated in clockwise direction. When the lever is rotated in the clockwise direction, backrest slides
backward (downward direction) and leg rest slides upward and the wheelchair is converted into trolley. To
convert the trolley into wheelchair the lever is rotated in anticlockwise direction. When the lever is rotated in the
anticlockwise direction, backrest slides upward and leg rest downward and the trolley is converted to
wheelchair.

Fig 2 chair position of trolley cum

Fig 3 trolley position of trolley cum wheelchair

Wheelchair

SIMULATION OF TROLLEY CUM WHEELCHAIR

The dimensions of the trolley cum wheelchair are assumed on the basis of dimensions of trolley
cum wheelchair reported in literature [4]. The CAD model of the trolley cum wheelchair of these dimensions is
prepared by using Pro-E software. Figure 5 shows the CAD Model of trolley cum wheelchair.
To verify the dimensions of trolley cum wheelchair, it is simulated from wheelchair position to
trolley position and trolley position to wheelchair position by using Pro-E. It is observed that there is an
interference with backrest and link (AC). To remove the interference, the length of link AC is changed to 40cm
from its original length of 25cm. Fig. No.6 shows the wheelchair cum trolley with new dimensions.
To verify the modified dimensions of trolley cum wheelchair, it is simulated from wheelchair
position to trolley position and trolley position to wheelchair position by using Pro-E the When the simulation
was carried out it was observed that there is no interference. Therefore the final dimensions of trolley cum
wheelchair are accepted as final dimension of trolley cum wheelchair.

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Fig. No. 4 CAD Model of trolley cum wheelchair with links

Fig. No. 5 CAD Model of trolley cum wheelchair with original dimensions

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Fig. No. 6 CAD Model of trolley cum wheelchair with modified dimensions

CONCLUSION
The research work reported in this paper is an attempt to synthesize a trolley cum wheelchair.
The production of this trolley cum wheelchair will help hospitals to improve the comfort of patient during their
required movement for CT scan, X-ray etc. Trolley cum wheelchair is generally available in developed countries
for patient handling but such trolley are not available even in modern hospital in our country.
It is expected that production of low cost trolley cum wheelchairs for patient handling will
relive patient and nursing staff from a lots of physical discomfort.
REFRENCES
1.
2.
3.
4.

Rao J.S.Mechanism and Machine Theory-(New Age International (p) limited Publishers) Edition 2.
Sandor N.George & Erdman G.Arthur ADVANCE MECHANISM DESIGN Analysis and Synthesis (Tata Mc-Grew hills) 2002,
fifth Edition.
Tiernan John, Leonard Conor,Gilchrist Michael & de Paor Annraoi," A Survey of the Wheelchair and Seating Market in Ireland"
Assistive Technology shaping the future: AAATE conference proceedings ,Vol. 11, No. 1, pp. 105-111, Publication 2003.
www.esurgicals.com/hospital-furniture

Ehsanullah khan, Lecturer,

Mechanical Engg, Dean,
Nagpur

ISSN : 0975-5462

Prof & Head Dept of Mech Engg

Dr. R.D.Askhedkar Prof of
Central India Institute of Polytechnic Nagpur.
KDK collage of Engg,
(Academic),
KDK collage of
Engineering, Nagpur.

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