An Intro to Safely Transporting Native Children

Bridget Canniff & Luella AzuleNPAIHB Injury Prevention Program

Why SNAP?

• Low AI/AN restraint use

• Crashes can happen at any time

• Can help prevent injuries

• Can make a difference

SNAP ≠ certification training

• Today’s presentation: introduction to SNAP

• Even with full SNAP course, you will NOT be able to:• Serve as a technical expert• Teach SNAP• Only certified CPS technicians can teach SNAP

course

Guiding Principles

Learn

Practice

Explain

Best Practices & Tough Choices

• Best practices• Explain best practice options

• Tough Choices• Sometimes, no clear answers• Give options• Vehicles not designed for child restraints• Safer choices

Tough choices should always be made by the parent/caregiver

The Cradleboard

• Important part of Native culture

• Fine for general use• Always use child

safety seat for transporting children

NHTSA• Keep children in appropriate restraint as

long as possible before moving them up to the next type

American Academy of Pediatrics • Keep kids in rear-facing restraints until age

2 or highest weight/height allowed by seat manufacturer

Car Seat Recommendations

• Read child seat manufacturers' instructions & vehicle owner's manual• Important info on height & weight limits, how

to install using seat belt or LATCH system• All children under 13 should ride in back

seat• Children in rear-facing car seats should

never ride in front of active passenger airbag

Car Seat Recommendations

Motor Vehicle Crash Injuries

• Leading cause of death for American Indians & Alaska Natives

• More children ages 1-16 die from crashes than any other cause

Challenges to Crash Survival

• Non-use• Misuse• Use decreases as

children get older• Outdated or incorrect

educational materials

• Larger heads• Smaller bodies• Soft skull bones• Rounded hip bones• Weak stomach muscles• Vehicles built for adults

Why Restrain Children?

• Keep people in the vehicle • Hold where body is strongest• Spread out crash forces• Help body to slow down• Protect head & spine

How Restraints Prevent Injury

• Some crashes too violent to survive

• Many factors determine outcome

• Restraints & airbags give best chance of survival

You Can’t Survive Every Crash

Common Myths

“I’m not driving very far”

“It’s better to be thrown clear”

“I can hold my baby in a crash”

“Restraints are uncomfortable”

“I’m a good driver, so I won’t get into a crash”

• 33 states have primary seatbelt laws, 16 have secondary laws

• All 50 states have child restraint laws

• Some Reservations have their own Passenger Transportation Safety laws

Seat Belt & Child Safety Seat Laws

What’s the seat belt law in your tribal community?

A) Tribal law: primaryB) Tribal law: secondaryC) Community follows state lawD) No lawE) Unsure / Don’t Know

Local Laws: Seat Belts

Does your tribal community have a child safety seat law?

A) Yes: tribal lawB) No: follows state lawC) Unsure / Don’t Know

Local Laws: Child Safety Seats

• Studies show restraints reduce: Injury severity by 60% Hospital admissions by 69% Treatment costs by 66%

• Use seatbelts! • Use child restraints! • You could save lives!

Why Use Restraints?

Types of Child Restraints

• Infant (rear-facing only)• Convertible (rear-facing & forward-

facing)• Forward-facing only (harness &

combination)• Boosters (belt-positioning)• Special needs restraints • Seat belts

• Fits the child

• Fits the vehicle

• Used correctly every time

What’s the Best Child Restraint?

• Selection: right seat?

• Direction: front or rear-facing?

• Location: where is the child safest?

• Installation: right belt path/LATCH?

Elements of Correct Installation

• Select correct child seat for weight & height• Place in back seat of vehicle• Use only one method to install car seat• Install car seat• Tighten vehicle belt or lower anchor

attachment (LATCH)• Buckle child into car seat

Installation Check List

• Easy install

• Vehicles since 2000

• Read the vehicle & CR manuals

LATCH System

Post 2/27/14 LATCH

• After February 2014, car seats installed with LATCH should have MAXIMUM combined weight limit of seat + child = 65 lbs

• Requirement only apply to lower anchors, doesn’t include top tethers

• Belt positioning booster seats using LATCH are not included in the new requirements because:• The seat belt is what is restraining child in booster• LATCH only keeps seat in place when unoccupied, to

protect other passengers

Seat Belt Components

Anchor

Webbing

Latchplate

Buckle

Retractors

• Reduce injury• For use with seatbelts• Children <13 in back seat• Turn OFF airbag if CR

must be used in front seat

Airbag Systems

Consider These CR Issues

• Safety Label Expiration History Recall

• Compatibility• Convenience• Comfort

• Read instruction book & vehicle owner’s manual for proper installation instructions• Mail in seat

registration card

Important!

Harness straps

Harness slots

Retainer clip

Belt path

Harness adjuster

Buckle

Shell/ frame

Seat Parts & Functions

Harness adjuster plate Labels

Harness slots

Seat Parts & Functions

Rear-Facing Seats

• 3-point or 5-point harness at or below shoulder

• Best Practice: Until 2+ years

OR• Until upper limit of

CR’s height & weight recommendations

• Large, heavy heads• Small, flexible

shoulders• Bones not fully

developed

Why Rear-Facing Until Age 2?

Rear-Facing Convertible

• Rear-facing up to 30 pounds or more, then forward-facing

• Reclined position• Harness at or

below shoulder level

• 2+ years or when child reaches height & weight limits of rear-facing seat

• Weight limits between 22-85+ pounds, depending on manufacturer

• Use until child’s ears reach top of seat

Forward-Facing Seats

Belt Positioning Boosters

• Use with lap/ shoulder belt only

• Head restraint needed

• Shoulder belt positioners

• Use the 5 Step Test

The 5-Step Test

1. Child against the vehicle seat? 2. Knees bend at the edge? 3. Belt crosses shoulder between neck & arm? 4. Lap belt low across hips? 5. Child can stay seated for whole trip? If No to any Booster seat is neededIf Yes to all Ready for adult seat belt

Reasons for Incorrect Installation

• Don’t understand dangers

• Don’t take time• Instructions missing• Don’t read instructions• Restraints don’t fit

vehicle

Misuse: Child Safety Seats

Misuse: Child Safety Seats

• Retainer clip not at armpit level

• Loose harness• Twisted harness or

frayed/damaged webbing

• Restraint has been in a crash

• In seat belt too soon

Misuse: Seat Belts

Shoulder belt under arm

Misuse: Seat Belts

Misuse: Seat Belts

Shoulder belt under arm

Shoulder belt behind back

Lap belt too highBelt too loose

Shoulder belt under arm

Shoulder belt behind back

Misuse: Seat Belts

• Low restraint use in AI/AN communities• Everyone should buckle up• Selection, direction, location & installation

important• Best CR fits child, fits vehicle, used

correctly every time• Learn correct use, recognize misuse• Practice = confidence

Wrap-Up: What We’ve Learned

Additional Resources

• www.nhtsa.gov

• www.safekids.org

• www.nsc.org

• www.carseat.org

QUESTIONS?

THANK YOU!

Luella Azule (Yakima Nation/Umatilla)Injury Prevention Coordinator

lazule@npaihb.org503-416-3263