A Smooth Ride: Keeping Any Child Safe in Any Vehicle Ayesha Ahmad, MPH CHES Mary E. Jones, MSPT

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1 A Smooth Ride: Keeping Any Child Safe in Any Vehicle Ayesha Ahmad, MPH CHES Mary E. Jones, MSPT Led By 1

2 Objectives Provide education on appropriate child passenger safety restraint systems. Equip clinical professionals with resources and educational materials on child passenger safety. Understand the unique challenges associated with properly restraining children with special needs and become familiar with resources available for them. 2

3 Global Overview The UN Decade of Action for Road Safety was officially launched by the United Nations General Assembly in May Its goal is to stabilize and reduce the projected level of road traffic deaths around the world. It is estimated that the measures taken during the Decade could save five million lives on the world s roads by : We ve arrived at the half way mark. Yet, across the globe, more than 500 children are killed every day as a result of road traffic collisions and tens of thousands are injured, often suffering lifelong disabilities. Source: Safe Kids Worldwide Safe Road/Safe Kids Global Road Safety Report 3

4 Global Overview Global road safety is not getting the priority it deserves. Unless we take action now, the global toll of traffic injuries is will explode. By 2030, road traffic injuries among both children and adults is set to surpass HIV/AIDS, malaria and tuberculosis. Only 7 percent of the world s population is covered by laws that address all give key risk factors (speed, drinking and driving, helmets, seat belts and child restraints). 4

5 National Scope of the Problem In the United States during 2011, more than 650 children ages 12 years and younger died as occupants in motor vehicle crashes, and more than 148,000 were injured. One CDC study found that, in one year, more than 618,000 children ages 0-12 rode in vehicles without the use of a child safety seat or booster seat or a seat belt at least some of the time. Only 2 out of every 100 children live in states that require car seat or booster seat use for children age 8 and under. Of the children who died in a crash in 2011, 33% were not buckled up. Source: 5

6 South Carolina Statistics Children s Trust of South Carolina reports: Motor vehicle accidents (MVA) are the Number 1 cause of childhood injury fatality for 0-19 years of age. 1,598 children have died from MVAs from More children die on S.C. roads than their peers across the U.S. Source: Centers for Disease Control and Prevention, CDC Vital Signs - Child Injury Infographic Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) 6

7 Is Your Child Always Buckled Up? A survey of 1,000 parents yielded surprising results: 1 in 3 affluent ( $100K) parents say it is acceptable to leave their child unrestrained if they aren t driving a far difference compared to 15% of parents making less than $35K. 60% of crashes involving children occur 10 minutes or less from home. 23% of younger parents (18-29) said it would be acceptable for children to ride unrestrained when traveling overnight compared to 13% of older parents (30-49). Children are most likely to be injured in a crash at this time period. Parents with graduate degrees are twice as likely to drive without buckling up their children compared to parents with a high school education, particularly when they are in a rush. Drivers in a rush may not be as careful when they are fully attentive. 7

8 SC Child Passenger Safety Law Children from birth to 1 year old, or who weigh less than 20 pounds, must be secured in a rear-facing child safety seat. 8

9 SC Child Passenger Safety Law Children 1 through 5 years old weighing 20 to 40 pounds must be restrained in a forward facing child seat. 9

10 SC Child Passenger Safety Law Children 1 through 5 years old weighing 40 to 80 pounds must be secured in a belt-positioning booster seat. 10

11 SC Child Passenger Safety Law Children under 6 may not sit in the front passenger seat. However, this restriction does not apply if the vehicle has no rear passenger seats or if all rear passenger seats are occupied by children less than 6 years old. Violators are subject to a $150 fine. 11

12 Best Practice According to American Academy of Pediatricians: The AAP recommends that all infants should ride rear facing starting with their first ride home from the hospital. All infants and toddlers should ride in a rear-facing car seat until they are at least 2 years of age or until they reach the highest weight or height allowed by their car seat's manufacturer. All children younger than 13 years should ride in the back seat. Booster seats are for older children who have outgrown their forward-facing car seats. All children whose weight or height is above the forward-facing limit for their car seat should use a belt-positioning booster seat until the vehicle seat belt fits properly, typically when they have reached 4 feet 9 inches in height and weigh between pounds. This is usually between 8 and 12 years of age. 12

13 Common Mistakes Getting a car seat without knowing its history. Placing in the wrong spot. Loose harness, loose base. Using as a replacement crib. Reclining at the incorrect angle. Transitioning too quickly. Dressing child in bulky outerwear. 13

14 Common Mistakes 14

15 Common Mistakes 15

16 Common Mistakes 16

17 Common Mistakes 17

18 Buckle Up: Every Ride, Every Time Safe Kids and the GM Foundation are working together to raise awareness about child passenger safety and encourage parents and caregivers to use the right seat for their child s height and weight to prevent tragedies. 18

19 Special Needs Child Restraints Many children with special needs are unable to sit safely in a booster seat or with the vehicle seat belt. Need 5-point harness to higher weights Traditional seats with higher harness weights Specialized restraints ordered through equipment vendor Limited options because of funding sources, despite wide variety on the market 19

20 Commonly Used Special Needs Seats in SC Traveller Plus by Snug Seat (Britax) Harness up to 105 pounds Many children outgrow height before weight 20

21 Commonly Used Special Needs Seats in SC Snug Seat Pilot Booster seat with a positioning harness Fits children up to 120 pounds Fits taller children than Traveller Plus 21

22 Commonly Used Special Needs Seats in SC Churchill Booster seat with trunk support vest and other positioning options Up to 175 pounds Difficulty with funding in SC 22

23 Commonly Used Special Needs Seats in SC EZ-on vest Zipper in back Behavioral concerns/ Houdini Family responsible for installation of hardware in vehicle 23

24 Car Beds 24

25 Spica Casts Casts typically applied for femur fractures or after hip dysplasia repair Hippo car seat Low cut sides to allow for cast Additional padding that has been crash tested with the seat for more positioning options 25

26 Other Vehicles: School Buses Why aren t there seatbelts on school buses? Large school buses are heavier and distribute crash forces differently than passenger cars and light trucks. Compartmentalization States and school districts not prohibited from purchasing large buses with seat belts. 26

27 Other Vehicles: Ambulances Providing appropriate occupant protection for child passengers presents multiple challenges. Specific guidelines child occupants on cots are based on research and available at: Children who weigh up to 40 pounds and can tolerate sitting in a semi-up right position can be placed into a convertible seat with a 5 point harness. To center small infants, rolled receiving blankets or towels can be placed on either side of the child. 27

28 Safe Kids Upstate Efforts Safe Kids Upstate (SKU) has trained over 100 Child Passenger Safety Technicians. We will begin to offer technician training classes once per quarter and will have a special needs class once a year. In 2014, our technicians have helped approximately 3,500 children and their families. SKU manages 6 Child Safety Seat Inspection Sites, with 2 additional sites set to come online in late spring of CSSI sites offer Spanish speaking interpreter services once per month. In the Upstate, there are several Child Safety Seat Inspection (CSSI) sites. 28

29 Special Needs Car Seat Program Partnership between Kidnetics and Safe Kids Upstate Two components: Loaner program for children in spica casts Outpatient evaluations for children with special needs 29

30 Referring for a Car Seat Evaluation Prescriptions Physical therapy evaluation Vehicle Positioning Seat Important information to include Family contact info Insurance info Patient s height, weight Concerns with current seat Type of car/other children traveling in car 30

31 31

32 Car Seat Check-Up Right Place. Kids are VIPs, just ask them. We know all VIPs ride in the back seat, so keep all children in the back seat until they are 13. Right Direction. You want to keep your child in a rear-facing car seat for as long as possible, usually until around age 2. When he or she outgrows the seat, move your child to a forward-facing car seat. Make sure to attach the top tether after you tighten and lock the seat belt or lower anchors. Inch Test. Once your car seat is installed, give it a good shake at the base. Can you move it more than an inch side to side or front to back? A properly installed seat will not move more than an inch. Pinch Test. Make sure the harness is tightly buckled and coming from the correct slots (check car seat manual). Now, with the chest clip placed at armpit level, pinch the strap at your child s shoulder. If you are unable to pinch any excess webbing, you re good to go! 32

33 Contact Information: Ayesha Ahmad Program Coordinator-Child Passenger Safety (864) Mary E. Jones Physical Therapy Supervisor, Kidnetics Children's Hospital, Greenville Health System Greenville (864) Spartanburg (864)

34 Thank You for Your Participation! Led By 34

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