Safety Seat Research Articles

Safety belt abdominal trauma associated with anthropometric characteristics of an injured person\u2014a case report

BackgroundThe aim of this report is to present a case of a blunt abdominal trauma with vascular and spinal involvements of an overweight man, caused by the front seat safety belt.Case presentationIt took place as a result of the car bonnet collision with a roadside pillar. During the primary inspection of the crash site, it was found that the car had collided with a roadside pillar. The driver was found dead in the driver’s seat with the seat belt on. The lower part of the belt was in the inguinal region and the upper part was high on the chest, separated by the bulky midriff. The autopsy revealed a transverse fracture of the body of tenth thoracic vertebra, complicated by a torn abdominal aorta, and severe bleeding into the abdominal cavity, which was the cause of the death. The complications of the abdominal trauma result from the atypical position of the seat belt holding the upper and lower part of the body to the seat at two very distant levels, while between them the bulky, heavy midriff continued to move forward, carrying with it the vertebral column and surrounding anatomical structures. On the other hand, the forceful contact between the abdominal wall and the instrumental panel of the car generates pressure which transmits force through the adjacent organs to the aortic wall. The specific anthropometric features of the victim had an impact on the mechanism of death. The improper position of the seat belt relative to the body affected the severity of abdominal injuries, instead of protecting from them.ConclusionsThe driver’s body disproportion, combined with the restraining effect of the seat belt, could increase the risk of a fatal outcome. It is incorrect to think that if the victim had not worn a seat belt, he would have survived. The safest seatbelt type for occupants with a similar anthropometric data would be the 4-point seat belt system, which is used in children’s car seats. This type of safety belt is crossed over the chest and abdomen and holds the entire trunk better at dynamic loads in all directions.

A Study on the Fire Safety of Seat Covers in Railway Vehicles

In this study, we performed the Cone Calorimeter test in accordance with ISO 5660-1 to verify the fire safety of seat covers in railway vehicles. All 16 samples that were tested satisfied the MARHE criteria. However, we found that there was a big difference in smoke production data from the mass loss for each sample. The ASTM E662 standard was used to evaluate the smoke production of these railway vehicle materials. There was a correlation between the ISO5660-1 test results and the ASTM E662 test results. If we use two different types of data at the same time in one test, heat release, and smoke production, we can evaluate fire safety correctly and effectively for these samples. Keywords: Heat Release, MARHE, Smoke Production, Fire Safety, Mass Loss, Seat Cover

Use of child safety seats during transportation of newborns

PurposeChild safety seats (CSS) are critical for the protection of children, in case of motor vehicle accidents. Although the national legislation mandates that all newborns must be placed in an appropriately installed CSS during transportation, people often do not perceive the importance of CSS and do not use it as recommended. The purpose of this survey was to understand the use of CSS for the safe transport of newborns from hospital to home. MethodsWe interviewed parents of newborn infants, using a structured questionnaire, at the time of their discharge from Cheil General Hospital & Women’s Health Care Center, between May 2014 and July 2014. ResultsA total of 403 participants were interviewed. The rate of CSS use was only 14.9%. Overall, 76.4% of the families interviewed were not aware about the recommendations on CSS use for newborns when travelling in a car. The provision of education on using CSS significantly influenced their rate of use. Parents who were educated about mounting the CSS in a car used it more as compared with others (25.7% vs. 12.2%) (P=0.002). Furthermore, if parents had heard about the importance or necessity of CSS, they used it more than others did (19.5% vs. 10.6%, P=0.032). ConclusionDespite the legal regulation, most parents transport their newborn infants without a CSS while traveling from hospital to their home. The rate of CSS use was influenced by parental education and their knowledge about its necessity. Education programs for parents must be reinforced to increase the CSS use.

Use of car beds for infant travel: a review of the literature.

Discharging neonates in a proper car safety seat is standard of care in the United States and many other countries. However, not every neonate can be safely positioned in a standard semi-upright car seat. In these cases, providers may opt for a travel device that allows the infant to lie flat, either supine or prone, known as a car bed. Minimal evidence exists to guide providers on car bed safety and help determine which infants would benefit from discharge in a car bed. In this article, we provide a comprehensive summary of existing literature on the safety of car beds for motor vehicle travel, car bed use in specific patient populations, and car beds vs. car seats for infants at risk of adverse cardiorespiratory events, including preterm infants with Hg-O2 desaturations in the car seat. We discuss recommendations for the follow-up of infants discharged in a car bed in order to safely transition back to a car seat.

Educating parents to support children’s road safety: a review of the literature

ABSTRACTThis narrative review synthesised the limited work that has been carried out into road safety education targeting parents. Parent education appeared to have a positive impact on child safety seat use and children’s bike helmet use, but results regarding the impact of parent education on pedestrian safety were mixed. The review highlighted important gaps in the literature. A key gap being identifying effective ways to engage parents of low socioeconomic and ethnic minority backgrounds. Further, another gap is understanding effective ways to engage and support parents of children with additional needs to build their children’s road safety skills. There is some evidence that parent education has a positive impact on these “at-risk” groups, but little work on how to engage with these groups and the type of parent education required.

Evaluation of give kids a boost: A school-based program to increase booster seat use among urban children in economically disadvantaged areas

ABSTRACTObjective: This study evaluated the effectiveness of a series of 1-year multifaceted school-based programs aimed at increasing booster seat use among urban children 4–7 years of age in economically disadvantaged areas.Methods: During 4 consecutive school years, 2011–2015, the Give Kids a Boost (GKB) program was implemented in a total of 8 schools with similar demographics in Dallas County. Observational surveys were conducted at project schools before project implementation (P0), 1–4 weeks after the completion of project implementation (P1), and 4–5 months later (P2). Changes in booster seat use for the 3 time periods were compared for the 8 project and 14 comparison schools that received no intervention using a nonrandomized trial process.The intervention included (1) train-the-trainer sessions with teachers and parents; (2) presentations about booster seat safety; (3) tailored communication to parents; (4) distribution of fact sheets/resources; (5) walk-around education; and (6) booster seat inspections.The association between the GKB intervention and proper booster seat use was determined initially using univariate analysis. The association was also estimated using a generalized linear mixed model predicting a binomial outcome (booster seat use) for those aged 4 to 7 years, adjusted for child-level variables (age, sex, race/ethnicity) and car-level variables (vehicle type). The model incorporated the effects of clustering by site and by collection date to account for the possibility of repeated sampling.Results: In the 8 project schools, booster seat use for children 4–7 years of age increased an average of 20.9 percentage points between P0 and P1 (P0 = 4.8%, P1 = 25.7%; odds ratio [OR] = 6.9; 95% confidence interval [CI], 5.5, 8.7; P < .001) and remained at that level in the P2 time period (P2 = 25.7%; P < .001, for P0 vs. P2) in the univariate analysis. The 14 comparison schools had minimal change in booster seat use. The multivariable model showed that children at the project schools were significantly more likely to be properly restrained in a booster seat after the intervention (OR = 2.7; 95% CI, 2.2, 3.3) compared to the P0 time period and compared to the comparison schools.Conclusion: Despite study limitations, the GKB program was positively associated with an increase in proper booster seat use for children 4–7 years of age in school settings among diverse populations in economically disadvantaged areas. These increases persisted into the following school year in a majority of the project schools. The GKB model may be a replicable strategy to increase booster seat use among school-age children in similar urban settings.

An Evaluation of Factors Influencing the Use of Child Car Safety Seats and Safety Belts By Families Presenting to the Pediatric Emergency Department

An Evaluation of Factors Influencing the Use of Child Car Safety Seats and Safety Belts By Families Presenting to the Pediatric Emergency Department

Preventive effects of car safety seat use on clinical outcomes in infants and young children with road traffic injuries: A 7-year observational study

IntroductionRoad traffic injury (RTI) is one of the major mechanisms of injury leading to high disability and case-fatality in infants and children. Proper car safety seat use can reduce fatal outcomes in pediatric patients with RTI; however, the use rate is still low. This study aimed to measure the preventive effects of car safety seat use on clinical outcomes among infants and young children injured from RTI. MethodsA multicenter cross-sectional study was conducted using the Emergency Department-based Injury In-depth Surveillance (EDIIS) registry from 23 EDs between Jan 2010 and Dec 2016. All pediatric patients who were under 6 years of age and who sustained RTI in a vehicle with fewer than 10-seats were eligible. Primary and secondary endpoints were intracranial injury and mortality. We calculated the adjusted odds ratio (AOR) of the car safety seat for related outcomes adjusting for potential confounders. ResultsAmong 5545 eligible patients, 1452 (26.2%) patients were in car safety seats at the time of the crash (12.5% in 2010 to 33.9% in 2016, p-for-trend <0.01), and 104 (1.9%) patients had intracranial injuries. The patients using car safety seats were less likely to have intracranial injuries compared with the patients not using car safety seats (0.8% vs. 2.2%, AOR: 0.31 (0.17–0.57)). However, there was no significant difference in mortality between the two groups (0.4% vs. 0.6%, AOR: 0.50 (0.20–1.25)). ConclusionUse of the car safety seat has significant preventive effects on intracranial injury. Public health efforts to increase use of car safety seats for infants and young children are needed to reduce the burden of RTI.

EVALUATING EXTREMELY LOW FREQUENCY MAGNETIC FIELDS IN THE REAR SEATS OF THE ELECTRIC VEHICLES.

In the electric vehicles (EVs), children can sit on a safety seat installed in the rear seats. Owing to their smaller physical dimensions, their heads, generally, are closer to the underfloor electrical systems where the magnetic field (MF) exposure is the greatest. In this study, the magnetic flux density (B) was measured in the rear seats of 10 different EVs, for different driving sessions. We used the measurement results from different heights corresponding to the locations of the heads of an adult and an infant to calculate the induced electric field (E-field) strength using anatomical human models. The results revealed that measured B fields in the rear seats were far below the reference levels by the International Commission on Non-Ionizing Radiation Protection. Although small children may be exposed to higher MF strength, induced E-field strengths were much lower than that of adults due to their particular physical dimensions.

Comparison of Self-reported and Observed Road Safety Performance Indicators

The first concept of road safety performance indicators was published by European Transport Safety Council, Brussels in 2001. Hungary has long and reliable time series of safety belt wearing and child safety seat usage rates in passenger cars. These rates are based on real roadside observations and representative sample, meeting the requirements of international road accident databases. The methodology of the data collection has been further developed during the recent years, but we paid attention to the possibility of comparison with the earlier data and consistent analysis of time series. Although the roadside observations could not have been organized in each year, the trends can be seen relatively well. Our initial hypothesis was that the self-reported data always show a bit "better" picture about the driving behaviour than the observed ones, since the people are not sure that their data will be handled in an anonym way. Based on these results we can say that the ESRA results are relatively good estimations of the real safety belt wearing rates.

Advising families on appropriate car seat safety

Car safety is an important health promotion consideration and, for health visitors, providing families with information on the appropriate use of car seats should be a priority.

Trends in child passenger safety practices in Indiana from 2009 to 2015

ABSTRACTObjective: This study reviews trends in rear-facing direction, top tether use, booster seat use, and seating position for children 12 years or younger among motor vehicle passengers in Indiana.Methods: This is an observational, cross-sectional survey of drivers transporting children 15 years and younger collected at 25 convenience locations randomly selected in Indiana during summers of 2009–2015. Observations were conducted by certified child passenger safety technicians (CPST). As the driver completed a written survey collecting demographic data on the driver, the CPST recorded the child demographic data, vehicle seating location, the type of restraint, direction the car safety seat (CSS) was facing, and use of the CSS harness or safety belt as appropriate. Data were analyzed for infants and toddlers younger than 24 months, children in forward-facing CSS, booster seat use, and seating position for children 12 years or younger.Results: During the study period, 4,876 drivers were queried, and 7,725 children 15 years and younger were observed in motor vehicles. Between 2009 and 2015, 1,115 infants and toddlers (age birth to 23 months) were observed in motor vehicles. For infants <1 year, rear-facing increased from 84% to 91%. During the study years the greatest increase in rear facing was for toddlers age 12–17 months (12–61%). Rear facing for those from 18–23 months did not significantly change. Of the 1,653 vehicles observed with a forward-facing car seat, using either the seat belt system or lower anchors, an average of 27% had the top tether attached. For installations of forward-facing seats using the lower anchor, 66% employed the top tether. Among children age 4–7 years observed booster seat use decreased from 72% to 65% during the observation period. Finally, for vehicle seating position, in our sample, more than 85% of children 12 years or younger were seated in a rear seat vehicle position. Unfortunately, 31% of 8- to 12-year-old children were observed in the front seat.Conclusions: Overall, these trends demonstrate an improvement in child passenger safety practices among Indiana drivers. However, this study illuminates areas to improve child passenger safety, such as rear facing for toddlers 18 to 23 months, increasing top tether use, booster seat use, and an emphasis on rear seat position for children 8 to 12 years. This information can be used by primary care providers and child passenger safety technicians and other child passenger safety advocates to develop counseling points and targeted educational campaigns.

Child Car Safety: A Parental Survey at a Tertiary Care Emergency Treatment Center in Greece.

This study aimed to assess parental behavior in terms of child restraint systems (CRS) use under emergency conditions while driving to the hospital's outpatient settings as well as their routine child car safety (CCS) practices. A cross-sectional survey of parents/caregivers transporting children 13 years or younger was conducted at the Emergency Treatment Center of a pediatric tertiary care center in Athens, Greece. Participants completed a questionnaire inquiring about the possession of CRS, and type and use of appropriate CRS while driving to the Emergency Treatment Center and under routine conditions. In addition, presence and type of parental education with regard to CCS and the use of seat belts among drivers were assessed. Of 444 participants, 51.4% children were carried restrained, although 48.6% were fastened in an improper seat for their age, in contrast with 23.7% who travel unrestrained on a daily basis. Forward-facing restraint seats were most popular, with 53.9% total use even in children younger than 2 years or older than 4 years, whereas booster seats (9.4%) and rear-facing restraint seats (18.2%) were inappropriately disfavored. Children younger than 4 years, male drivers, and drivers who had received information on CCS had higher odds of using CRS. The proportion of those had never been provided any CCS education was 38.5%. Child restraint systems use was inappropriately low under routine conditions and declined even further under emergency circumstances. Most children younger than 2 years and older than 4 years traveled inappropriately restrained in a forward-facing restraint seat. Parents should be more intensively educated on child car safety seat and the proper CRS use.

Analysis of Seat Belt Anchorage Strength for Vehicles

In order to improve the efficiency of seat design and enhance the safety of vehicle seats, it is necessary to carry out CAE analysis on seat safety before making physical tests. In this paper, the finite element analysis theory and HyperWorks finite element analysis software are applied in the pretreatment of vehicle seats, seat belts, as well as the upper limbs and buttocks of dummies. The loading time and load of the seat are set according to GB 14167-2013 of the People’s Republic of China, and CAE calculation is carried out based on LSDYNA software, obtaining the stress-strain nephogram of the corresponding vehicle seats. An improved scheme is proposed base on the analysis results, and CAE analysis is carried out on the improved seats again. The results of the analysis fully meet the national standard GB 14167-2013 and material strength requirements, which are of important guiding significance in reducing the development costs, shortening the development cycle and improving the passing rate of physical test.

Identifying Factors to Improve Safety Seat Use in Children

Identifying Factors to Improve Safety Seat Use in Children

Retraction: Car safety seats for children: rear facing for best protection

Henary B, Sherwood CP, Crandall JR, et al . Car safety seats for children: rear facing for best protection. Injury Prev 2007;13:398-402. DOI: 10.1136/ip.2006.015115 The manuscript ‘ Car safety seats...

The Impact of Child Safety Restraint Status and Age in Motor Vehicle Collisions in Predicting Type and Severity of Bone Fractures and Traumatic Injuries.

Although morbidity and mortality in children increases in motor vehicle collisions (MVC) if child restraints are not used, no data exist correlating specific injuries with proper or improper use of safety restraints or age. The purpose of this study was to evaluate correlations between childhood MVC injuries, age, and restraint status. A medical record search for pediatric patients involved in a MVC was conducted at a pediatric hospital (level 1 trauma). Charts were reviewed for demographics and injury-specific information. Patients were grouped by age, restraint use, and injuries. Nine hundred sixty-seven patients ≤12 years (average age 6.39 y) were identified. Being properly restrained was most common in all age groups except the 4- to 8-year age group in which being improperly restrained was most common. Unrestrained patients were most commonly found in the 9- to 12-year age group. A statistically significant difference was not observed for orthopaedic injuries among the restraint groups, but internal thoracic injuries, open head wound, and open upper extremity wounds were significantly more common in improperly or unrestrained patients. Improperly restrained infants had a significantly higher rate of intracranial bleeds and abrasions than those properly restrained. Unrestrained and improperly restrained 9- to 12-year olds had significantly more open head, open upper extremity, and vascular injuries. When comparing injury types with age groups, upper extremity fractures, femoral fractures, dislocations, and spinal fractures were found to be significantly higher in older children. Preventing orthopaedic injuries in older children may be accomplished by changes in regulations or automotive safety equipment. Rear-facing child safety seats could possibly be improved to prevent head trauma in the youngest patients. There is a continued need to reinforce the importance of proper use of child safety devices to parents. Knowledge of the patient's age, along with restraint status, might aid in diagnosis of less obvious MCV injuries. Level III.

Are Booster Seats More Effective than Child Safety Seats or Seat Belts at Reducing Traffic Fatalities among Children?

In an effort to increase booster seat use among children, the National Highway Traffic Safety Administration is encouraging state legislators to promote stricter booster seat laws, yet there is a p...

Discharge Criteria for the Late Preterm Infant: A Review of the Literature.

Standardized late preterm infant (LPI) discharge criteria ensure best practice and help guide the neonatal provider to determine the appropriate level of care following birth. However, the location can vary from the well newborn setting to the neonatal intensive care unit (NICU). The purpose of this review is to examine differences in LPI discharge criteria between the well newborn setting and the NICU by answering the clinical questions, "What are the recommended discharge criteria for the LPI and do they differ if admitted to the well newborn setting versus the NICU?" Databases searched include CINAHL, TRIP, PubMed, and the Cochrane Library. Focusing first on the highest level of evidence, position statements, policy statements, and clinical practice guidelines were reviewed, followed by original research. There were few differences shown between settings. Discharge criteria included physiological stability and completed screenings for hearing loss, hyperbilirubinemia, car seat safety, hypoglycemia, critical congenital heart disease, and sepsis. Parent education is provided on umbilical cord care, feeding, elimination, and weight gain norms. Recommended maternal assessment included screenings for depression, drug use, safe home environment, and presence of social support. In general, research supported protecting the mother-infant dyad. Developing a standardized approach for discharge criteria for LPIs may improve outcomes and reduce maternal stress. Research is needed to compare health and cost outcomes between settings.Video Abstract available at http://links.lww.com/ANC/A29.

Young females at risk while driving with a small child

IntroductionPrevious research suggests that young mothers with little driving experience are at risk when driving with a small child passenger. In this study we examined the prevalence, characteristics and risk of fatal motor vehicle crashes involving an infant passenger under the age of one among female drivers of different ages. MethodsWe used crash data from the US Fatality Analysis Reporting System for 1994–2013. The prevalence of fatal crashes involving infants was examined by age of female drivers and compared to the number of births among mothers of a similar age. The essential characteristics of the crashes were described, and the odds of being at fault were determined for young (16–24-year-olds) and older female drivers (25–39-year-olds) with an infant passenger or with no passengers. ResultsThe prevalence of fatal crashes involving infant passengers was higher among young female drivers in relation to the number of births among mothers of a similar age than among older females. Young female drivers with an infant passenger were more often at fault than older drivers (aOR=1.83, 95%, CI=1.52, 2.20). Their vehicles were older and smaller and they used proper safety seats for infants less often than the older drivers. In addition, young female drivers with an infant passenger but with no adult passenger in the vehicle were more often at fault than young female drivers with no passengers (aOR=1.27, 95% CI=1.06, 1.51).Both young and older female drivers’ crashes involving an infant passenger typically occurred in ordinary driving conditions, but these drivers with infant passengers were more often reported as having fallen asleep or inattentive than those with no passengers. The presence of an adult passenger in addition to an infant passenger lowered female drivers’ odds of being at fault, regardless of the driver’s age. ConclusionsYoung females driving with an infant passenger, probably most often mothers, are at an elevated risk of a fatal crash, especially when they drive alone with an infant. The protective effect of an adult passenger suggests that another adult in the vehicle can assist the driver by taking care of the infant and enabling the driver to focus on driving.