Emergency Preparedness Series- Evacuation Chairs
Transcript of 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
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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
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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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Consumer Opinion Study
• Conducted at the Access Living facility in downtown Chicago.
• July 2013
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Consumer Opinion Study
• 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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Consumer Opinion Study
• 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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Preliminary results – Initial Impression
• Transfers
– Easiest for Carry‐Type
• Safety
– Concern over carrying full weight
– 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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Preliminary results – Initial Impression
• Transfers
– Easiest for Carry‐Type
• Safety
– Concern over carrying full weight
– 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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Preliminary results – Initial Impression
• Transfers
– Easiest for Carry‐Type
• Safety
– Concern over carrying full weight
– 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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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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• Occupant features
– Weight capacity
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• Occupant features
– Weight capacity
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• Occupant features
– Weight capacity• 350 lb (159 kg), min.
• Use of RESNA WC‐1 mannequin
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• Occupant features
– 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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Draft Position Paper
• Recommendation 2
– 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
Draft Position Paper
• Recommendation 3
– 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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Draft Position Paper
• Recommendation 4
– 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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Draft Position Paper
• 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
• Yvonne Meding (RESNA AT Standards Secretary)
– 703‐524‐6686
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Questions?
• ANSI/RESNA ED‐1:2013 • Position Paper
Emergency Preparedness Series-Evacuation ChairsMarch 27, 2014 41
Thank you for participating in today’s
Emergency Preparedness Webinar Series Session
This session was recorded and will be available for review at www.adaconferences.org/Emergency/Archives
within 24 hours of the completion of this session
Please watch the website www.adaconferences.org/Emergency
for future scheduled sessions
[email protected] 877‐232‐1990 (V/TTY) 121