Child Car Seats Research Articles

Analysis of Child Passenger Safety Restraint Use at a Pediatric Emergency Department

The objectives of the study were to determine the number of children properly restrained during transit to a pediatric emergency department for care and to ascertain parental knowledge of Alabama laws and American Academy of Pediatrics (AAP) guidelines and where they obtain this information. An emergency department (patient care rooms) waiting area, convenience sample of Alabama parents who have children younger than or 13 years of age were surveyed over a 5-week period. Appropriate use of child passenger safety (CPS) restraints was determined using Alabama law and AAP recommendations. Use of Car Seat Checks provided by Children's Hospital and Safe Kids, knowledge of Alabama laws and CPS guidelines, and the source of information used by parents were ascertained. Among 525 patients identified, 520 (99.0%) participated. Appropriate use per Alabama law and AAP guidelines was 72.3% and 60.6%, respectively; 5.0% were unrestrained. Booster seats were the most commonly misused restraint. Car seats were reportedly used correctly by 81.9%. Parents who had used the Car Seat Checks program had correct booster seat and car seat use rates of 95.8% and 61.5%, respectively. Unfortunately, only 31.2% of patients had knowledge of the Car Seat Checks program, and only 40.6% knew the current law. Most often, parents stated that the hospital where their child was born was the primary (and sometimes only) source of CPS information. This study illustrates the need for improving parental knowledge of appropriate child passenger restraint use (especially booster seats) and Car Seat Checks programs. Car seat program assistance is associated with high levels of appropriate use.

Pediatric Obesity in Motor Vehicle Collisions

This article discusses the consequences of childhood obesity as it relates to motor vehicle collisions (MVCs) and injuries sustained therein. The authors note that there is no question that child age- and weight-appropriate restraints are effective in reducing fatal or serious injuries to children in MVCs. In adults there appears to be a linear decrease in seatbelt use with increasing body mass index, suggesting that seatbelts may not be large enough to accommodate larger sizes or are simply too uncomfortable for overweight adults to use regularly. Research on this topic has found correlations with obesity and degree of injury in adults. However, there is not much research in the literature that addresses the potential risks for injury of improperly-restrained obese children in a MVC. The authors briefly comment on some of the studies, noting that children may move directly from child car seats to adult seatbelts, without interim use of a booster seat, putting them at greater risk of injury. The authors conclude with a set of three questions for future research to address: are obese children at greater risk for serious injury in a MVC compared with their non-obese counterparts; injury severity, length of hospital stay, mental health, and residual disability in MVC-injured obese children compared with non-obese children; and whether obese children are at greater risk for post-traumatic stress syndrome.

Effectiveness of hands-on education for correct child restraint use by parents

This study evaluates whether a hands-on educational intervention makes a significant difference in the proper use of a child passenger restraint by a parent. The clinical trial design included a sample of 111 parents who were at least seven months pregnant and who were randomly assigned to one of two groups (56 intervention and 55 control). All participants received a free car seat and a standardized education session on the safety and use of child passenger restraints. The experimental group received an additional component consisting of a hands-on demonstration and return demonstration of correct installation and use in their own vehicle. Follow-up observation for correctness of use was done after birth using a standardized tool. A total of 24 (22%) parents correctly used the car seat; of these, 18 (32%) were in the intervention group and 6 (11%) were in the control group. The intervention group was four times more likely to have correct use than the control group (odds ratio 4.3, p-value = 0.0074). The range for the number of errors per person was 0–7, with the majority (70%) having 0–2. The rate of errors was 33% less in the intervention group (ratio of 0.67). There were few serious errors in either group. No secondary variable (age, education, income, or help from others) had a significant effect on the outcome. The hands-on educational intervention made a significant difference in the proper use of a child passenger restraint by a parent. This study demonstrates the value of hands-on teaching for learning how to install and use a child car seat.

Thalassotherapy

Envying binges on unbandaged waves ‘tumultuous come,’ I'm all ‘qu'est-ce que c'est?’ when the jellyfish ride out, the brainless meninges. What remains of the rue. Like the 5-point harness on child car seats made of the same foam as life jackets, the starfish arches. What remains of the crabgrass. The life jackets made of the same foam as the bicycle helmet – qu'est-ce que c'est? – cracked in two in your hands. What remains of the butter-and-eggs. The head unscathed emerging from foam as from a shell game when a shell – qu'est-ce que c'est? – explodes. Same foam as the bicycle helmet, the car seat, the life jacket. What remains of bog sage.

428: Child Car Seat Safety Knowledge Among Caregivers in Puerto Rico: Is More Education Needed?

428: Child Car Seat Safety Knowledge Among Caregivers in Puerto Rico: Is More Education Needed?

Casting Technique and Restraint Choice Influence Child Safety During Transport of Body Casted Children Subjected to a Simulated Frontal MVA

Hip spica casts (or body casts) are commonly applied to young pediatric trauma and hip dysplasia patients. The greatest hip stability in the cast is achieved via fixed hip flexion or abduction and fixed knee flexion. Unfortunately, this fixed position causes difficulties in restraining children for transport because the child cannot typically accommodate their body to the child car seat geometry. The objectives of the current study were to identify a range of reasonable seating options for casted children. These positions were then studied in frontal crash tests to identify the relative injury exposure for the different positions. A revised casting technique was also investigated in an effort to address head-to-cast contact identified during the course of the study. The current study assessed the ability for different child seats and the vehicle seat belts to accommodate casted 1-year-old and 3-year-old crash test dummies. The restrained dummies were then subjected to frontal 30-mph crash tests with uncasted dummies serving as a control. In general, traditional child seats were able to accommodate both children; however, the child's body shifted anteriorly in the cast when the belts were tightened. This shift produced concerns for pulmonary function and the potential for elevated pressure on the superior mesenteric artery. This anterior shift of the chest was reduced when the dummies were restrained by a special hip spica child seat or solely by the vehicle seat belts. When considering all restraint types, the addition of the cast increased the majority of the injury metric magnitudes. For the 3-year-old dummy these increases were determined to be related to the casting technique; an alternative technique significantly reduced the injury metrics. This study demonstrates that there are anticipated variable effects on basic physiologic function for body-casted children based on the method of restraint. Restraint modalities which place the child forward facing with the face in proximity to the anterosuperior cast overlying the chest should be avoided.

Product design evaluation model of child car seat using gray relational analysis

This paper attempts to explore a design evaluation system dealing with the ergonomic comfort problems for the child car seat designers. The new product design evaluation (abbreviated as PDE) model is developed through two stages. The first stage is to perform an ergonomic experiment to find out the relations between the comfort and the interface pressures on the child subjects. The second stage is to construct a PDE model by applying the method of gray relational analysis with programming languages. Final results show that the new PDE model is very effective for the car safety seat designers to solve the complex problems of ergonomic comfort. Therefore, the new model can provide designers a scientific method supporting decisions on the new product design of child car seats. Some suggestions by using this model for the reference of future researchers are also provided.

Utilização de automóveis familiares para o transporte de crianças: um estudo preliminar sobre o uso de dispositivos de retenção infantil

OBJETIVOS: determinar a freqüência de utilização de automóveis familiares por usuários de creches na cidade de Maringá, Paraná, Brasil. MÉTODOS: a cidade foi agrupada em seis estratos, de acordo com características sócio-ocupacionais da população e tipo de creches. Utilizando breves entrevistas com os coordenadores das creches foi mensurada a freqüência de utilização de automóveis para o transporte de crianças às creches em cada estrato. RESULTADOS: 62,4% dos usuários de automóveis familiares para o transporte de crianças concentram-se em 32 creches, de quatro estratos. CONCLUSÕES: os quatro estratos que contém a maioria dos usuários de automóveis serão exploradas por estudo futuro para determinar a freqüência de utilização de dispositivos de retenção infantil.

Evidence to support changes to child restraint legislation

from 14–26 kg”, and that they are not to be used if the child’s eye level is above the top of the booster back, or above the top of the car seat back or headrest when restrained in the booster seat. The matter of children exceeding the maximum weight threshold of 26 kg while failing to meet the transition height to adult seatbelts is far from trivial. Previous research published in the Journal found that about 50% of 7-year-olds whose height fell between 100 cm (the upper recommended height for child car seats) and 145 cm (the recommended seatbelt transition height) exceeded 26 kg, with only 27% having an ageand sex-adjusted body mass index > 25 kg/m. Consequently, due to the current range of approved booster seats available in Australia, children may be placed at some unquantified risk in the event of a crash, as optimal protection above this weight threshold cannot be guaranteed. Further compounding this scenario is that pursuant to r266 of the Australian Road Rules, if a child “cannot safely be restrained as required . . . because of his or her height or weight”, the use of a seatbelt may be deemed acceptable. To avoid this scenario, it is essential that booster seats with a higher maximum weight threshold be made available in Australia as soon as practicable.

Using a Focus Group to Determine Car Seat Use Among Mothers of Children Aged 3 to 7 Years

This study built on prior research and examined the beliefs, behaviors, barriers and motivating factors for use of child car seats with children aged 3 to 7 years. Two focus groups of eight mothers each were conducted using a structured interview guide. One group consisted of African American and Latina women, the other of White women. All of the mothers believed that properly restraining their children while riding in a car protected the children from injury. Most also reported that they have used car seats for their children. African American and Latina mothers, however, reported more inconsistent use of the seats, particularly with older children of this age group. They were also more likely to report greater resistance by their children to use car seats. In this small study, there were ethnic disparities in differences in use of child car seats for children aged 3 to 7; this subject requires more research. In the meantime, public health programs on child car seats are needed and should take into account differing beliefs and behaviors of various cultural groups.

Child restraint misuse: a case example and strategies for injury prevention

Motor vehicle crashes are a leading cause of death and serious injury for children. Emergency nurses can play a key role in encouraging parents and caregivers to use child restraints consistently and correctly. This article will discuss a case scenario where a young child is seriously injured in a motor vehicle crash where his child car seat was not used correctly. Injury prevention strategies for emergency nurses will be reviewed.

Health problems and health behaviors of preschoolers

This study was conducted to understand the health status and health behaviors of preschoolers to provide baseline data for developing health promotion programs. Parents of children attending day-care centers were recruited for the study. Participating day-care centers were selected using a stratified sampling method. Data was collected from June to August 2002 using a questionnaire. Among 754 preschoolers, 17.3% were overweight, while 18.2% were underweight. The most frequent infectious diseases that children have had previously were hand-foot-mouth disease (20.2%) and chicken pox (18.7%). Current health conditions that children have frequently are respiratory disease (28%) and atopic dermatitis (23.8%). Only 61% brush their teeth everyday at bedtime, 54.3% wash their hands every time after returning home, 8.8% wear bicycle helmets, 9.3% use a child car seat, and 8.1% eat fruits and vegetables five times a day. Children residing in the metropolitan area were more likely to have positive health behaviors, and children of parents with an advanced college level education were more likely to have positive health behaviors than those with only a high school level education. Based on the study results, health professionals could plan and develop health promotion programs to change unhealthy behaviors of preschoolers targeting high-risk groups.

When Smoke Alarms Are a Nuisance

There is a clear analogy between smoke detectors and child car seats. Both technologies have been enthusiastically embraced, and their widespread distribution has saved many thousands of lives. However, the issue of car seat misuse has led to a reevaluation of engineering and educational approaches for child occupant protection. 1 It is time for a similar comprehensive reevaluation of smoke detectors for home fire safety.

Recommending Bicycle Helmets Is Not Enough: Fit Is Important

Injury and Poison Prevention| February 01 2000 Recommending Bicycle Helmets Is Not Enough: Fit Is Important AAP Grand Rounds (2000) 3 (2): 17. https://doi.org/10.1542/gr.3-2-17 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Recommending Bicycle Helmets Is Not Enough: Fit Is Important. AAP Grand Rounds February 2000; 3 (2): 17. https://doi.org/10.1542/gr.3-2-17 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: protective helmet, craniocerebral trauma Source: Rivara F, Astley S, Clarren S, et al. Fit of bicycle safety helmets and risk of head injuries in children. Injury Prevention. 1999;5:194–197. To understand why some helmeted individuals sustain head injury with cycling, these authors examined the relationship between helmet fit and risk of injury. A questionnaire was sent to 1,718 helmeted riders who had crashed and sought care for a related injury in 1 of 7 emergency rooms in the Puget Sound area of Washington State 7–14 days after their emergency room visit inquiring about the circumstances and helmet use. A sample of 28 children 2–14 years of age who sustained a head injury while wearing a bicycle helmet, and 98 helmeted individuals of the same age treated in the same hospital emergency departments for injuries other than to the head but who had hit their head, helmet, or face, underwent anthropometric measurements of helmet fit. Measurements were made of the child’s head, the helmet, and on a cast made of the child’s head using techniques developed to manufacture helmets used to treat positional cranial deformities.1 Individuals whose helmets were reported to fit poorly had a 2-fold increased risk of head injury compared with those whose helmets fit well (odds ratio 1.96; 95% CI, 1.10–3.75). Children with head injuries had helmets that were significantly wider than their heads compared with children without head injuries (p=.05). Significantly, more of the head-injured children (47.4%) had helmets 2 cm or more larger than the width of their head compared to controls (19.5%; odds ratio 3.72; 95% CI, 1.11–12.17). Helmet fit was poorer among males and younger children. The authors concluded that poor fit of helmets may be associated with an increased risk of head injury in children, especially in males. Just recommending use of helmets with cycling is not enough: like child car seats, helmets need to fit and be properly “installed.” Capitalizing on a large case control study of the effectiveness of helmets in preventing bicycle head injuries, the authors sought to determine if poor helmet fit could explain why some helmeted children sustain head injuries. Guided by a team skilled in cranial facial dysmorphology, they employed a creative method to measure head size and shape and to measure helmet fit.1 Not surprisingly, both the degree of self-reported helmet fit and measured helmet fit were inversely related to the presence and severity of head injury. They found that width was the critical dimension for misfit which was observed predominantly in males and was significantly greater in younger than in older children. Given the limitation that the investigators used a sub-sample of convenience that was small in size, we should anticipate replication in larger, systematic samples and a refinement of measurement methodology that is applicable for general use. However, it is safe to say that helmet manufacturers will need to address bicycle helmet fit much more carefully than they do now and that pediatric anticipatory guidance will need to add advice about the... You do not currently have access to this content.

Knowledge of child car seat safety in a tricultural Southern California emergency department

Knowledge of child car seat safety in a tricultural Southern California emergency department

Child passenger safety

Motor vehicle crashes are a leading cause of death and disability among children in the United States despite the fact that child safety seats and seat belts can provide effective protection against serious and fatal injuries. Many child car seats and safety restraints are being used incorrectly. In addition, recent fatalities associated with children and air bags have heightened awareness of child passenger safety issues. Pediatric nurse practitioners are in an excellent position to offer motor vehicle occupant prevention strategies to families through health education and anticipatory guidance.

Parental perception of injury prevention practices in a multicultural metropolitan area.

This study was conducted to survey parents of children seen in the emergency department regarding parent and child safety-related behaviors, parents' perceptions of their children's risks for injury, and educational needs. The descriptive design involved three questionnaires with age-specific items related to children in groups 0-4 years, 5-12 years, and 13-15 years. Parents voluntarily completed the questionnaires in the emergency department waiting area. Data were analyzed by descriptive statistics, parametric tests, and content analysis. The culturally diverse sample included 81% minority group representation. Parents tended to underestimate their children's risks for injury from motor vehicle crashes. Less than one half of caretakers believed that most injuries can be prevented. Only one third of parents listed needs for future learning, although parents of younger children listed more needs. High response rates were received for knowing how to call 911, use of child car seats and seat belts, and smoke detectors in the home. Survey results provide evidence that parents have misconceptions about childhood injury. Through strategic planning, we have expanded our community education programs to focus on cardiopulmonary resuscitation and activating the emergency medical system, water safety, use of safety helmets, and injury prevention in the home.

The Fort McMurray Demonstration Project in social marketing: health- and safety-related behaviour among oil sands workers.

This is the first round in a series of surveys conducted in Fort McMurray as part of the Fort McMurray Demonstration Project in social marketing. This component of the survey was intended to focus on the most prominent group of employed workers in the community and to compare their patterns of response with the community as a whole. Respondents to the survey were overwhelmingly male (96%), married (72.9%) and living in households of two to five persons (87.9%). They were predominantly aged 30-44 (55%) and graduates of high school (53.5%). Younger male workers (below age 30) were more likely to have a high school diploma (78.3%) or some additional technical or vocational training (21.7% compared to 12.5% overall) and to be unmarried or separated. Attitudes toward safety-related behaviours were stronger than for respondents from the community as a whole. Approximately 70-100% of all age groups and both sexes showed strong agreement with attitudes involving child car seats and the unacceptability of drinking and driving. These attitudes include strong advocacy of vigorous enforcement of occupational health and safety standards. However, they showed a variability similar to the community as a whole in behaviour at home compared to work, generally reporting more consistent use of personal protection on the job than in their own homes, particularly hearing protection. Even so, they were much less likely to perform stretching and warm-up exercises prior to exertion than community residents in general. The potential may exist to transfer the technology and attitudes from workplace health and safety to community safety. One possible strategy to accomplish this is to involve workers in this industry directly in community initiatives. This strategy may be generalizable to any community in which there are major employers who place a heavy emphasis on risk control and occupational health and safety.

Children in Car Crashes: Analysis of Data for Injury and Use of Restraints

To determine the effect of car restraints on motor vehicle injury rates for children aged 0 to 14 years. A probability sample of all police-reported car crashes in the United States in 1990 and 1991 was analyzed for injury rates of passengers aged less than 15 years in relation to restraint usage, age, and seating position. Optimal restraint usage (defined as car seats for children 0 to 4 years old and lap shoulder belts for children 5 to 14 years old) was 40%. The use of the car seat was 76% for infants (0 to 12 months old) and 41% for toddlers (1 to 4 year olds). The non use of a restraint was highest for 10 to 14 year olds (43%). The rate of involvement in car crashes for all children was 21.4 (per 1000/yr). The highest rate was the 14 year olds with 29.6 followed by 2 year olds with 26.5. Injury rates were 4.76 (per 1000/yr) for all children. The lowest rate was 2.91 for infants but increased to 4.78 for 3 year olds. The single strongest risk factor for injury was the non use of a restraint. (Adjusted odds ratio 2.7; 95% CI 2.4 to 3.0.) The risk factor for injury for the front seat was 1.5 (95% CI 1.4 to 1.7). Use of the car seat reduced injuries by 60% for 0 to 4 year olds, whereas the lap shoulder harness was only 38% effective for 5 to 14 year olds (P < or = .001) Injury rates of unrestrained 0 to 4 and 5 to 14 year olds were similar. Greater involvement in car crashes and less use of car restraints explains the 64% higher rate of injury for 3 year olds than for infants. It is time to target the toddlers. Restraints designed for adults are not as effective for the school age child as car seats are for the preschool child. A better restraint for the school age child should be designed and evaluated. Meanwhile, increased usage of current restraints must be encouraged, as they substantially reduce injuries.

School Bus Transportation of Children With Special Needs

Many school-aged children with handicaps are transported in school buses. A recent amendment to the Individuals with Disabilities Education Act has established requirements for infants and toddlers to have access to developmental and rehabilitation facilities. This amendment, to Part H of the Individuals with Disabilities Education Act (enacted as part of Public Law 102-119), however, does not specify how these children are to be transported to these facilities, a responsibility that will be faced by many school systems. FMVSS 222 (School Bus Passenger Seating and Crash Protection) established safety requirements for school bus interiors, but to date it only applied to able-bodied children. However, an amendment to FMVSS 222 becomes effective in January 1994 that applies to the securement of wheelchairs and their occupants in school buses. National recommended standards for special education school buses were revised in May 1990 by the Eleventh National Standards Conference on School Transportation.1 Wheelchairs are the primary mode of transport on the school bus for many children with special needs. They have not been developed as safety restraint devices, however, and are not currently subjected to any crash-testing requirements. Research,2-5 nevertheless, has provided a basis for recommendations concerning occupant securement for a wheelchair-dependent child and a child with special needs who is transported on a school bus: 1. Any child who can assist with transfer or be "reasonably" moved from a wheelchair, stroller, or special seating device to the original manufacturer's forward-facing vehicle seat equipped with dynamically tested occupant restraints or be "reasonably" moved to a child car seat complying with FMVSS 213 requirement should be so transferred for transportation to and from school.