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Prescription for Your Childs Safety: Best Practices Educational Conference Call February 22, 2006 Child Passenger Safety Hospital Project Maryland EMSC in partnership with Maryland KISS & Maryland Highway Safety Office This conference call is sponsored in part by a grant from the Maryland Highway Safety Office/ State Highway Administration Slide 2 Rx for your childs safety pads & posters can be ordered online www.miemss.org/EMSCwww/CPSHome.htm Slide 3 Crash Dynamics Debbi Baer, RN BSN Child Passenger Safety Instructor Maryland Child Passenger Safety Board CPS Conference Call 2006 Slide 4 4-994 Crash Dynamics National Standardized Child Passenger Safety Training Program May 2004 Slide 5 Newtons Law Of Motion An object in motion remains in motion at the original speed until acted on by an outside force. The outside force Can be harmful (e.g., the steering wheel, windshield, pavement, etc.) Can be designed to protect (e.g., safety belt or CRS) Crash Dynamics - 4 Slide 6 Crash Forces Approximation For Parents: Weight X Speed = Restraining Force Crash Dynamics - 5 Slide 7 Three Collisions in a Crash 1st: Vehicle Collision 2nd: Human Collision 3rd: Internal Collision Crash Dynamics - 6 3 rd 2 nd 1 st Slide 8 Types of Crashes Frontal Lateral (Side Impact) Rear-end Rollover Crash Dynamics - 7 Slide 9 Frontal Crashes Most frequent type, but not necessarily most severe Common injuries to unrestrained occupants: Fractures of the skull, spine, & ribs Cuts and bruises to the head & face Injuries to larynx, liver, & spleen Crash Dynamics - 8 Slide 10 Lateral (Side Impact) Crashes Typically the most deadly type of crash due to less crush space Minor differences in # of fatalities between left & right side Common injuries include: Chest & pelvic injuries Facial and skull fractures Crash Dynamics - 9 Slide 11 Rear-end Crashes Usually less severe Common injuries include Cervical fractures Stretching/tearing of neck ligaments and tendons (whiplash) Properly set head restraint can decrease risk of injury Crash Dynamics - 10 Slide 12 Rollovers Rollovers = Side to side & vaults Severity of injury depends upon number of rotations etc. Often cause ejection Ejected occupants are 4 times more likely to be killed Crash Dynamics - 11 Slide 13 4-9913 Selecting & Securing Children In Vehicle Safety Restraint Systems Slide 14 Childs Body Proportions Selecting & Securing - 5 Slide 15 Effectiveness of Child Restraints 71% effective in reducing infant deaths 54% effective in reducing toddler deaths 69% effective in reducing hospitalization need Children = 37% less likely to be fatally injured riding in the rear seat Selecting & Securing - 8 Slide 16 Rear Facing Only (Infant Seat) Rear facing ONLY Birth/5pounds to 17 - 22 pounds (most models) or when head is 1 below top of shell Selecting & Securing - 28 Slide 17 Rear Facing Only (Infant Seat) Supports entire head, neck & back, reducing stress to neck and spine in crash May have 5-point or V-harness Some have a detachable base Selecting & Securing - 29 Slide 18 Rear Facing Convertible Rear-facing until 20 to 30/35 lbs and at least one year old Use in reclined position T Shield Selecting & Securing - 30 5 Point Harness Tray Shield Slide 19 Forward Facing Seats Tracy Whitman, B.S., CHES Coordinator, Maryland Kids in Safety Seats Maryland Department of Health & Mental Hygiene CPS Conference Call 2006 Slide 20 Anatomy of a Toddler Large, heavy heads Weak neck/back muscles Immature skeletal system Flexible, narrow shoulders Small, round pelvis Slide 21 Why Forward-Facing Seats? The harness system: Dissipates crash forces over the stronger parts of the body Lessens the crash force on weaker bones/muscles of the childs body Keeps them in position Also, car seats are child-sized Slide 22 Types of Harness Systems 5 Point HarnessTray ShieldT Shield Slide 23 5 Point 1. Straps snug against pelvis/ across shoulders and rib cage 2. Crash forces are absorbed by strongest parts of body 3. Fit can be adjusted- limiting momentum 4. Nothing in front of head 5. Easy access to buckle Expert Statements listed on http://www.cpsafety.com/articles/fivepointshield.aspx Tray-Shield (3 point) 1. Straps pulled away from body to buckle 2. Crash force may transfer to abdomen 3. Fit can not be adjusted too much momentum 4. Head may contact shield 5. Limits access to buckle Which Harness is Best? Slide 24 How Long Should Children Ride in a Harness System? To maximum weight limit: 40 pounds (or more on select seats) To maximum height limit: Move to Combination or Forward-facing only seat for taller shoulder slots Do not advise premature graduation into a booster seat or seat belt Slide 25 Special Circumstances 1. Young/heavy children 2. Children restrained by lap-only belt 3. Behaviorally challenging children Best protected by full harness system past 40 pounds Slide 26 Regent (80 lbs) Husky (80 lbs) Marathon (65 lbs) Decathlon (65 lbs) Boulevard (65 lbs) Current Options-Britax Slide 27 Nania Airway (50 lbs) Cosco Apex (65 lbs) Current Options-Other Slide 28 STS Ride Safer Travel Vest Small 35-60 lbs Large 50-80 lb E-Z On Adjustable Vests 2 Styles lbs vary E-Z On 86 Y Harness 40-168 lbs Current Options-Other Slide 29 Sunshine Kids Radian Car Seat Current Options-Other Rear-facing children 5 to 33 lbs. Forward-facing children up to 65 lbs. Maximum child height of 49 in. Slide 30 Current Options-Other Slide 31 Special Needs Children Traveler Plus 20-105 # Gorilla 20-105 # Columbia Positioning Seat 20-102 # Slide 32 Booster SeatsWhy and How? Meg Miller, BS Occupant Protection Coordinator Maryland Highway Safety Office at SHA CPS Conference Call 2006 Slide 33 Why booster seats? Many caregivers believe that once a child has grown out of a traditional child safety seat with harness straps, s/he is ready to go right into a seat belt. Safety belts are designed for adult comfort and safety, not childrens. Kids 4-8 = the forgotten children Slide 34 What happens when kids are placed into adult seat belts too soon? Discomfort and lack of proper belt fit can lead to: Child putting shoulder harness behind back or under arm Lap belt riding too highlap belt syndrome Submarining Ejection Slide 35 Slide 36 Whats the solution? A booster seat! Belt positioning booster seats boost the child up so the vehicle safety belt fits better Using a belt positioning booster reduces a childs risk of injury by 59% (JAMA, June 2003) Slide 37 Belt positioning booster seats (BPB) High back provide head and neck support in vehicles that have no head restraints. No back only use in vehicles with high seat backs and/or head restraints. Slide 38 Slide 39 Benefits of boosters Better comfort AND safety for the child Helps the shoulder belt fit properly across the childs chest, away from the face and neck Holds the lap belt low and snug over the upper thighs. Studies have even shown that raising the childs sight-line can help improve carsickness! Slide 40 When are children ready to use the seat belt without boosters? Its not an age or a weight, or even a height. Its Slide 41 When they pass the 5-Step Test!! Remember, putting children in an adult seat belt too soon is the equivalent of giving them an adult dosage of medicineits just not safe. Slide 42 The Five-Step Test Does the child sit all the way back against the auto seat? Do the childs knees bend comfortably at the edge of the auto seat? Does the belt cross the shoulder between the neck and arm? Is the lap belt as low as possible, touching the thighs? Can the child stay seated like this for the whole trip? Slide 43 The Five Step Test Slide 44 Five Step Test contd If you answered no to any of these questions, the child needs a booster seat to make both the shoulder belt and the lap belt fit right for the best crash protection. And, they will be more comfortable too! This test should be done in every vehicle in which the child rides. ( Source for 5-Step Test: SafetyBeltSafe USA, a national advocacy group, with the support of the Allstate Foundation) Slide 45 How to tell proper seat belt fit on adults and kids!! Lap belts should be worn below the waistline, against the hips and thighsnever across the abdomen. Shoulder belts should be snug across the chest and against the collarbonenever under your arm or behind your back! Slide 46 Copyright 2002 American Academy of Pediatrics Committee on Injury and Poison Prevention, Pediatrics 2002;109:550-553 Car safety seats: selecting the appropriate type Slide 47 Slide 48 Additional Resources Slide 49 CPS Information & Resource Guide Maryland Kids in Safety Seats for statewide CPS technical support/info, consumer helpline, e- mail updates, training and seat check-up event schedules, educational materials, Maryland CPS Advisory Board Co-chair www.mdkiss.orgwww.mdkiss.orgE-mail: kiss@dhmh.state.md.uskiss@dhmh.state.md.us 1-800-370-SEAT (7328)Newsletter:NewsNotes Maryland Highway Safety Office Occupant Protection Information including county Community Traffic Safety Program coordinators, educational materials and Maryland CPS Advisory Board Co-chair Meg Miller, Occupant Protection Coordinator E-mail: mgobrecht@sha.state.md.usmgobrecht@sha.state.md.us 410-787-4077 Safe Kids Maryland State Coalition Occupant Protection educational materials, information on local Safe Kids coalition coordinators and programs, and other unintentional injury prevention information Barbara BeckettE-mail: bbeckett@sha.state.md.usbbeckett@sha.state.md.us Safe Kids Maryland State Coalition Coordinator410-787-5893 Maryland EMSC Child Passenger Safety Project Promotes child passenger safety discharge policies for Maryland hospitals and health care professionals. Resources available through Web site. Mary Ellen Wilson, CPS Hospital Project Coordinator E-mail: cps@miemss.orgcps@miemss.org www.miemss.org/EMSCwww/CPSHome.htmwww.miemss.org/EMSCwww/CPSHome.htm410-706-8647 Slide 50 Maryland KISS Slide 51 CPS Information & Resource Guide Safe Kids Worldwide (formerly National SAFE KIDS Campaign) for CPS Certification Information including your personal profile and contact info, logging seat-check activity, finding update or certification courses, re-certification, questions/concerns www.usa.safekids.orgwww.usa.safekids.orgE-mail: cps.certification@safekids.orgcps.certification@safekids.org 1-877-366-8154 (customer service line through PES) Newsletter: CPS Express! National Child Passenger Safety Board information and updates regarding standardized curriculum, certification/re-certification, national issues/concerns, download CPS tech manual, list of child restraint manufacturers www.cpsboard.org Newsletter: Tech Update Partners for Child Passenger Safety (PCPS)- Child Passenger Safety research conducted in collaboration with State Farm Insurance Companies, The Childrens Hospital of Philadelphia and American Academy of Pediatrics. Research focuses on injury patterns among children, crash and air bag data. Consumer information includes research reports and interactive videos of car and booster seat and LATCH installation. www.chop.edu/carseatwww.chop.edu/carseat www.traumalink.chop.eduwww.traumalink.chop.edu Copies of article abstracts authored by PCPS researchers Publications: CPS Issue Report (archived issues available on-line) Slide 52 CPS for Children Slide 53 CPS Information & Resource Guide Safe Ride News Publications most current CPS resource information, educational materials (fee charged) www.saferidenews.comwww.saferidenews.com800-403-1424 Publications: Safe Ride News Fact Sheets (updated annually) Safe Ride News (bi-monthly CPS publication) LATCH Manual University of North Carolina Highway Safety Research Center free recall list and notification service www.hsrc.unc.edu/pubinfo/child recall1 pdf.htmwww.hsrc.unc.edu/pubinfo/child recall1 pdf.htmE-mail: cps@hsrc.unc.educps@hsrc.unc.edu Safety Restraint Coalition 4 page recall list with updates as needed (fee charged) www.800bucklup.orgwww.800bucklup.org425-828-8975 Slide 54 CHOP Slide 55 CPSPList an informative web list-serve related to Child Passenger Safety. To subscribe, send an E-mail to the list administrator. E-mail: CPSPList-subscribe@yahoogroups.comCPSPList-subscribe@yahoogroups.com Automotive Safety Program:- National leader and expert in transportation of children with special health care needs. http://www.preventinjury.org/specNeeds.asphttp://www.preventinjury.org/specNeeds.asp 800-543-6227 American Academy of Pediatrics: Professional education and resource for pediatricians and families http://aap.org/ National Highway Traffic Safety Administration (NHTSA) CPS and automotive safety information, safety seat and vehicle recalls, auto safety hotline (report defects), free educational materials www.nhtsa.dot.gov 1-888-DASH-2-DOT CPS Information & Resource Guide Slide 56 AAP Slide 57 Questions and Answers Slide 58 Thank you for your time and your interest in Child Passenger Safety ! Feedback Form & Order Form can be downloaded from: www.miemss.org/EMSCwww/CPSConferenceFeb22.htm or email cps@miemss.orgcps@miemss.org