Transcript TM TM Prepared for your next patient. The Best Advice for Every Ride Update on the New Guidelines for Child Passenger Safety Benjamin Hoffman, MD, FAAP Associate Professor.

TM
TM
Prepared for your next patient.
The Best Advice for
Every Ride
Update on the New Guidelines for Child
Passenger Safety
Benjamin Hoffman, MD, FAAP
Associate Professor of Pediatrics/
Certified Child Passenger Safety Technician
Instructor
University of New Mexico
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Disclaimers
 Statements and opinions expressed are those of the authors and not
necessarily those of the American Academy of Pediatrics.
 Mead Johnson sponsors programs such as this to give healthcare
professionals access to scientific and educational information provided by
experts. The presenter has complete and independent control over the
planning and content of the presentation, and is not receiving any
compensation from Mead Johnson for this presentation. The presenter’s
comments and opinions are not necessarily those of Mead Johnson. In the
event that the presentation contains statements about uses of drugs that
are not within the drugs' approved indications, Mead Johnson does not
promote the use of any drug for indications outside the FDA-approved
product label.
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Objectives
 By the end of this presentation you should be
able to:
- Discuss new best practice guidelines for child
safety seat use
- Describe the data behind the new guidelines
- Counsel families to follow the best practice
guidelines for child passenger safety
What’s Killing Children?
Top 5 Causes: Ages 1 to 15 from 2001-2007
MV Traffic
Ages 1-15
N = 54,900
4.3 Child Occupants were Killed EACH DAY in 2007
Source: CDC
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Source: CDC
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THERE IS GOOD NEWS!
Number of Passenger Fatalities 0-16 years of age
Source: CDC
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THE TAKE HOME MESSAGE:
Just because you can,
doesn’t mean you should…
Delay Car Safety Seat
transitions as long as you
can!
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REAR FACING CAR SAFETY SEATS
 “All infants and toddlers
should ride in a Rear
Facing Car Safety Seat
until they are 2 years of
age, or until they reach
the highest weight or
height allowed by their
car safety seat’s
manufacturer”
AAP
Source: CDC
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REAR FACING CAR SAFETY SEATS ARE SAFER!
 Injury Risk Forward vs Rear Facing:
 0-23 months old
o 1.8x increased injury risk forward
vs. rear-facing
 12-23 months
o 5x increased injury risk
Courtesy of Bonnie Kozial, AAP
 Why?
o Spread crash energy over entire
back of child
o Protection for head and neck
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TYPES OF REAR FACING SEATS
 Birth to 2 years
 5-40 lb REAR FACING
o Infant Carriers
• Rear only
• Lower limit birth, 4, 5 lb
• 22-40 lb weight limit
o Convertible
• Rear as long as possible
• Lower limit birth, 5 lb
• 30-45 lb weight limit
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BUT WAIT… WHAT ABOUT THE LEGS?
3 years, 32 lbs., 36 in.
Courtesy of Michelle Cisweski, Safe NM
Arms and legs are safer rear facing!
Rear-Facing
86%
Forward-Facing
57%
Spine – 7%
8%
Percentage of AIS
2+ injuries
7%
25%
NASS-CDS
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FORWARD FACING CAR SAFETY SEAT
 All children 2 years or
older, or those younger
than 2 who have
outgrown the rear facing
limit of their car safety
seat, should use a
Forward Facing Car
Safety Seat with a
harness for as long as
possible, up to the
highest weight or height
allowed by their car
safety seat’s
manufacturer
AAP
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FORWARD FACING CAR SAFETY SEAT
20-50 lb Forward Facing
 >40 models >40 pounds
 Many 65 or 80 lb
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BELT POSITIONING BOOSTER SEAT
 “All children whose weight
or height is above the
forward-facing limit of their
car safety seat should use a
Belt-Positioning Booster
Seat until the vehicle seat
belt fits properly, typically
when they have reached 4
feet 9 inches tall and are
between 8 and 12 years of
age.”
AAP
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BELT POSITIONING BOOSTER SEAT
 Children 4-8 years old
o 45% decreased injury risk
• Compared to seat belt
Courtesy of Benjamin Hoffman, MD, University of New Mexico
o ~60% decreased injury risk
• Compared to unrestrained
Courtesy of Benjamin Hoffman, MD, University of New Mexico
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SEAT BELTS
Courtesy of Benjamin Hoffman, MD, University of New Mexico
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SEAT BELTS
 4’9” and taller
 Correct Fit:
o Sitting upright with back
against vehicle seat
o Legs bend comfortably on
vehicle seat
o Shoulder belt across clavicle
and sternum
o Lap belt low across hips
• Not resting on abdomen
o Child can sit that way the
entire ride
Courtesy of Benjamin Hoffman, MD, University of New Mexico
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WHERE TO SIT IN THE CAR
 “All children younger than
13 years should be
restrained in the rear seats
of vehicles for optimal
protection”
Courtesy of Benjamin Hoffman, MD, University of New Mexico
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FIND EXPERT RESOURCES IN YOUR COMMUNITY!
Certified Child
Passenger Safety
Technicians can be
identified by state on
the NHTSA website.
www.seatcheck.org
www.nhtsa.gov
1-866-Seat-Check
NHTSA.gov
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SUMMARY
 Moving from one child restraint mode to the next is not
necessarily a good thing
o Lose relative protection every step
 Rear facing to weight/height limit of seat
o Rear facing until at least 2 years
 Forward facing until weight/height limit of seat
o Forward facing in a harness until at least age 4
 Belt positioning booster seat until seat belt fits correctly
o Generally 4 years to 8-12 years
• Depends on child and vehicle
 Rear seat until at least 13 years of age
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IT IS UP TO US!
 Families look to their
pediatricians for the best
possible advice
 Follow the algorithm
o http://aappolicy.aappublications.
org/cgi/content/full/pediatrics;
127/4/788#F1
 Access community
resources
AAP
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