rear-facing child restraint systems do not distribute
TRANSCRIPT
Rear-facing Child
Restraint Systems
DO NOT DISTRIBUTE.
Do not distribute.
Objectives: LEARN• Why children should travel rear-facing• Why rear-facing CRS should not be used with frontal
airbags• How to teach parents to correctly secure and install a
child in a rear-facing CRS
Selecting & Securing - 2
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Objective: PRACTICE• Identifying parts of a RF CRS• Selection, direction, location and installation of a child
in a rear-facing CRS• Using check list form• Identifying misuse
Selecting & Securing - 3
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Objective: EXPLAIN• Proper use with caregivers• Misuse errors with caregivers• Best practice and tough choices with caregivers
Selecting & Securing - 3
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4 steps
• Rear facing
• Forward facing with harness
• Booster
• Seat belt
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Why Children Should Travel Rear-facing• Physical development
- Babies have big heads
- Bones, tendons and muscles not fully developed
• Increased crash protection- CR absorbs forces of the crash
- Spreads crash forces along the entire head, neck and back
- Protects head and spinal cord
Correct Installation - 3
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Child’s Body Proportions
Update to infant
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Types of Rear-facing CRS
• Infant-only CRS with or without base
• Convertible CRS used rear-facing
Correct Installation - 3
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Rear-facing Infant Only CRS• Rear-facing ONLY • Use rear-facing to the highest weight and
height allowed by the manufacturer’s instructions
• Head must be 1” below the top of the shell
• Use in semi-reclined position• Use harness straps at or below shoulder
level
Selecting & Securing - 28
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Low Birth Weight and Premature Infants• AAP recommends testing
in CSS before discharge to monitor baby’s heart rate, levels of oxygen and breathing
• Testing completed in a car safety seat positioned at appropriate angle
• Results may show child should use a car bed
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Breathing Problems
Add pict in veh – diff car bed – on back
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Low Birth Weight and Premature Infants• Avoid trays or shields• Rear facing child safety seat with
small internal harness dimensions• CSS that meets child’s low weight• Center in seat with rolled receiving
blankets and crotch roll if necessary
• Angle for testing should be same as angle in car
• Use CSS only for transportation
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Low Birth Weight and Premature Infants
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Breathing Problems
• Apnea (breathing stops for more than 20 seconds)
• Tracheostomies (breathing tube in trachea): Avoid seats with shields or trays
• Upright position in CSS may make breathing problems worse.
• Children may travel with apnea monitors, ventilators, oxygen
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Rear-facing Convertible CRS• Use when babies outgrow infant-only seat• Use rear-facing to the highest weight/height allowed by the
manufacturer’s instructions • Use in semi-reclined position• Use harness slots at or below shoulder level
Selecting & Securing - 30
5 Point Harness
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These seats not appropriate for young infants
Selecting & Securing - 30
Tray Shield
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CRS Parts & Functions
Selecting & Securing - 20
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Other CRS – (Infant Seats)
Baby Safe Companion
Foot Prop
Anti-Rebound Bar
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Hands-on Activity: Using Rear-facing CRS
• Locate instruction manual and CRS seat labels- Wt and ht limits- Use with or without base
• Check if on recall list• Practice harness adjustments (pull tab, O-ring, metal rod and A-lock)• Change harness slots• Adjust harness clip• Adjust recline mechanism• Adjust handle (when present)• Locate safety belt or LATCH belt paths• Locate locking clip or built-in lock-off
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FOUR STEPS To Remember • SELECTION• DIRECTION• LOCATION• INSTALLATION
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SELECTION
Correct Installation - 7
• Fits your child- Appropriate for weight and height
of child according to CRS instructions
- Harness straps must be at or below the shoulders
- Harness snug (pinch test)- Crotch strap that fits best
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SELECTION
Correct Installation - 7
• Fits your vehicle– Consult vehicle owner’s manual– Vehicle seat type and size (contoured, bench, captain)– Works with safety belt or LATCH system
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SELECTION
Correct Installation - 7
• Ease of use- Physical problems for caregivers
(arthritis, limb deficiency, bad back, etc.)
- With CRS (front vs. back harness adjustment)
- Works with safety belt or LATCH system
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SELECTION – Securing into Rear-facing CRS
• Back & bottom are flat into CRS
• Rolled cloth at crotch strap if necessary
• Blankets at sides for positioning
• Harness at or below shoulders• Harness snug• Harness retainer clip at armpit
level
Selecting & Securing - 31
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Selection - Low Birth Weight and Premature Infants• Avoid trays or shields• Rear facing child safety seat with
small internal harness dimensions• CR that meets child’s low weight• Center in seat with rolled receiving
blankets and crotch roll if necessary
• Use CR only for transportation
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Types of Special Needs Restraints: Car Beds
Source: Automotive Safety Program
Dream Ride SE
5-20 pounds and 26 inches; 3-point harness
Angel Ride
Birth-9 pounds and 20 inches; 3-point harness
Snug Seat
Birth to 21 pounds and 29 ½ inches; sleeping bag instead of harness
Car beds:•Infants who must lie down
•Head placed toward center of vehicle in all beds
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Selection: Conventional Restraints
• First option if meets child’s needs
• Less expensive• Usually easier to find, use
and install• Often meets needs of
children with special health care needs
Insert age/weight
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DIRECTION
Correct Installation - 7
• For optimal protection, use rear-facing to highest weight and/or height according to the CRS instructions
• Rear-facing until at least 1 year old AND at least 20 pounds
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LOCATION• A back seat is the safest location• If available, use center back seat of vehicle (away from
front, side, rear-end crashes)• Consider position of other passengers• Consider safety belt versus LATCH system• Airbag implications
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LOCATION - Airbags and Rear-facing CRS
• NEVER place a rear-facing CRS in front of an active passenger air bag
• If no back seat airbag = off!
• Very high forces hit child’s head during inflation
• Follow vehicle and CR instructions for side-airbag interactions
Misuse and Compatibility - 23
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INSTALLATION
• Appropriate recline angle• Correct belt path• Tight and locked in place
- Using safety beltOR- Using LATCH System
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INSTALLATION - Angle
• Spread crash forces along the entire head, neck and back
• Helps keep airway open• Angle according to
manufacturer’s instructions• More upright as child grows• Car bed option for special needs
Courtesy of Kathleen WeberChild Passenger Protection Research Program
University of Michigan Medical School
Correct Installation - 8
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INSTALLATION - Angle
Special considerations for rear-facing seats:
- Space requirements- Seat slope
Correct Installation - 13
NO
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INSTALLATION - Angle
• Follow CRS manufacturer’s instructions
• Use recline adjuster as needed
Correct Installation - 14
YES
NO!
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INSTALLATION - Angle
• Pool noodles or a rolled towel may help to recline CRS
• Avoid too much recline• Do not allow pool noodles or
towel to get in the way of safety belt or LATCH system
Correct Installation - 14
YES
NO!
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INSTALLATION - Safety Belt or LATCH System
Tightly Securing the CRS:- Install tightly using safety
belt or LATCH system- Grip CRS at belt path to
check - CRS should not move
forward or side to side more than one inch
- Parent or caregiver must be able to repeat installation
Correct Installation - 21
Tech pulling on belt to tighten (not knee)
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INSTALLATION - Special Situations
CRS with a switchable
retractor:• Tension in shoulder portion may
lift up CRS- Keep in ELR mode and- Use locking clip or - Try another seating position
Correct Installation - 32
NO
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INSTALLATION – Rear-facing CRS and Tethers
• Unless allowed by CRS and vehicle manufacturer, do not tether a CRS rear-facing
• Read CRS/vehicle instructions
Correct Installation – 49
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Rear-facing Tethering Provides...
Correct Installation - 50
Swedish Method = Toward Front of Vehicle
Australian Method = Toward Rear of Vehicle
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INSTALLATION – Safety Belt or LATCH System DEMO
• Tightly securing the CRS− Install tightly using (1) safety belt or (2) LATCH
system− Grip CRS at belt path to check− CRS should not move forward or side to side
more than one inch− Parent/caregiver must be able to repeat
installation
Misuse and Compatibility - 24
Insert RF CRS installation with Safety Belt and LATCH/Tether
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PRACTICE - Hands-On Exercise
Using the information known about “your child”:
- Configure CRS correctly for child, including different harness systems
- Install in vehicle: Rear-facing convertible, infant only
» Lap only» Lap/shoulder» Flexible/Rigid LATCH/Tether
- Teach a parent to do these things
Selecting & Securing - 59
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EXPLAIN - Best Practice and Tough Choices
Role Play• I have 2 kids. Which one should go in the middle?• It is easier if I leave the handle up. Is that okay?• Should I use LATCH or the safety belt? Which is
safer?• Should I use a tether on my RF convertible seat?• I want to see my baby. Can I turn him around?
Selecting & Securing - 9
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EXPLAIN - Common Selection Errors
1. Using outgrown CRS2. Child too small/young for CRS3. Using non-213 certified device4. Using a CRS that is more than 6 years old5. Using a CRS with unknown history6. Using a CRS that has been involved in a crash7. Using a CRS under current recall
Misuse and Compatibility - 9
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EXPLAIN - Harnessing Errors
1. Too loose2. Not used3. Retainer clip not at armpit level4. Routed through wrong slots5. Not doubled back, if needed6. Knotted, pinned or otherwise incorrectly secured 7. Not placed on child correctly8. Frayed or damaged9. Metal adjuster not flush with slot or out of position10. Crotch strap too long or wrong position11. Using "add-ons" not approved by the CRS manufacturer
Misuse and Compatibility - 10
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EXPLAIN - Installation Errors
1. Safety belt or LATCH too loose or not locked2. CRS facing wrong way3. Using wrong belt path4. Incorrect recline angle5. CRS installed using both safety belt and LATCH system6. Incorrect LATCH use7. Incorrect tether use8. Carrying handle not used as specified in the instructions
Misuse and Compatibility - 10
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PRACTICE - Classroom Activity
• Determine what is correct or incorrect with the CRS installation
• How would you explain to a parent or caregiver?
Misuse and Compatibility - 27
“What’s Wrong With This Picture?”
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Misuse -What’s Wrong With This Picture?
Misuse and Compatibility - 28 Standardized CPS Training Program - Winter 2004
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SHARE with Parent or Caregiver-
• Child too upright• Needs some type of support
under front of CRS• Possibly too big for CRS
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 29 Standardized CPS Training Program - Winter 2004
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Misuse-
“What’sWrong
With This Picture?”
Misuse and Compatibility - 48 Standardized CPS Training Program - Winter 2004
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SHARE with Parent or Caregiver-
• Harness adjuster bar missing
• Using rope or cords to hold straps in place
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 49
Standardized CPS Training Program - Winter 2004
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Misuse- What’s Wrong With This Picture?
Misuse and Compatibility - 50 Standardized CPS Training Program - Winter 2004
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SHARE with Parent or Caregiver-
• Rear-facing seat is forward facing
• CRS too small for child• Bulky clothing means
harness is too loose
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 51 Standardized CPS Training Program - Winter 2004
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Misuse- What’s Wrong With This Picture?
Misuse and Compatibility - 54 Standardized CPS Training Program - Winter 2004
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SHARE with Parent or Caregiver-
• This is a household carrier• No CRS labels (but a very small
sticker stating it is not to be used in a vehicle)
• No belt paths for vehicle use • No harness straps• No harness retainer clip
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 55 Standardized CPS Training Program - Winter 2004
Do not distribute.
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 56 Standardized CPS Training Program - Winter 2004
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SHARE with Parent or Caregiver-• CRS reclined too far in rear seat• Wedged into vehicle seat
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 57 Standardized CPS Training Program - Winter 2004
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Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 58 Standardized CPS Training Program - Winter 2004
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SHARE with PARENT or Caregiver-
• Cargo tie down used in addition to safety belt
• Tie down secured to vehicle seat frame
• Too upright
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 59 Standardized CPS Training Program - Winter 2004
Do not distribute.
Misuse-
“What’sWrong
With This Picture?”
Misuse and Compatibility - 60 Standardized CPS Training Program - Winter 2004
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SHARE with Parent or Caregiver-• Wood added under rear-facing CRS to obtain correct angle for infant
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 61 Standardized CPS Training Program - Winter 2004
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Misuse-
“What’sWrong
With This Picture?”
Misuse and Compatibility - 72 Standardized CPS Training Program - Winter 2004
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SHARE with Parent or Caregiver-
• Front- facing only CRS used rear- facing
• Too upright for rear-facing• Harness too loose• Safety belt used for installation is
threaded though the wrong belt path and is too loose
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 73 Standardized CPS Training Program - Winter 2004
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Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 74 Standardized CPS Training Program - Winter 2004
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SHARE with Parent or Caregiver-
• Infant is facing the front• Rear-facing only CRS installed is
installed facing forward• Handle left up• Harness too loose and off the
shoulders• No retainer clip used
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 75 Standardized CPS Training Program - Winter 2004
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Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 78 Standardized CPS Training Program - Winter 2004
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SHARE with Parent or Caregiver-
• Handle left up• Harness may be too loose if infant
can turn around• Note: Shoulder belt around back of
CRS is allowed on this model
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 79 Standardized CPS Training Program - Winter 2004
Do not distribute.
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 80 Standardized CPS Training Program - Winter 2004
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SHARE with Parent or Caregiver-
• CRS is not semi-reclined• Harness on edge of shoulders
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 81 Standardized CPS Training Program - Winter 2004
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Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 82 Standardized CPS Training Program - Winter 2004
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SHARE with Parent or Caregiver-
• Infant bundled before harnessing• Harness retained clip is not at
armpit level
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 83 Standardized CPS Training Program - Winter 2004
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Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 86 Standardized CPS Training Program - Winter 2004
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SHARE with Parent or Caregiver-
• Too upright for infant• Harness too loose• Harness retainer clip twisted and
out of position• Safety belt not through belt path
slots• Safety Belt too loose
Misuse-What’s Wrong With This Picture?
Misuse and Compatibility - 87 Standardized CPS Training Program - Winter 2004
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Objectives – A REVIEW
• Describe an infant’s physical characteristics that require added protection during travel.
• Describe ways that rear-facing CRS provide additional protection during travel.
• Identify all CRS parts on a:- rear-facing infant CRS (with and without a base) - rear-facing convertible CRS.
• Identify correct CRS installation techniques - tight fit, appropriate angle, harness use, and seat selection
• Describe correct placement of harness straps, harness retainer clip, carrying handle, etc.
Selecting & Securing - 2
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Core elements
• Why RF (phys char)?
• Selection IO and RFC
• Harness adjustment
• Install – angle, belt path, tightness
• location
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Hands-on Activity:Identifying Labeling
• Participants will locate labels re: weight and height requirements on infant-only CRS and convertible CRS
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CRS Parts & Functions
Adjustment Foot
Detachable Base
Selecting & Securing - 20
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CRS Parts & Functions
ADD – RF Convertible
Selecting & Securing - 20
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CRS Parts & Functions
ADD – RF Convertible
Selecting & Securing - 20
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CRS Parts & Functions
ADD – RF Convertible
Selecting & Securing - 20
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LOCATION
• Airbags- Passenger
» NEVER place a rear-facing CRS in front of an active passenger air bag
» If no back seat airbag = off!
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INSTALLATION – ID Safety Belt Path HANDS ON
- Read CRS manufacturer’s instructions
- Identify belt path on » Infant seat (with and without
base)» Rear-facing Convertible
Seat
Correct Installation - 19
Update to RF seat – safety belt RF only
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I INSTALLATION – Identify LATCH System
- Read CRS manufacturer’s instructions
- Identify LATCH belt path » Infant seat (with and without
base)» Rear-facing Convertible Seat
Correct Installation - 19
Update to RF seat – LATCH system
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INSTALLATION - Safety Belt or LATCH System
Tightly Securing the CRS:- Install tightly using safety
belt or LATCH system- Grip CRS at belt path to
check - CRS should not move
forward or side to side more than one inch
- Parent or caregiver must be able to repeat installation
Correct Installation - 21
Tech pulling on belt to tighten (not knee)
Do not distribute.
INSTALLATION – Rear-facing CRS and Tethers
Correct Installation - 50
• Currently, ONLY the Britax CRS is designed to be tethered rear-facing
• Rear-facing tethering with Britax provides…..
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Best Practices
• Suggested option for the safest way to travel • May conflict with the real world
Selecting & Securing - 10
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LATCH - Best Practices
Situation for rear-facing infant CRS or rear-facingconvertible CRS:• If CRS has LATCH attachments but vehicle has no LATCH anchors.• Vehicle has LATCH anchors but CRS does not have LATCH
attachments.• Both CRS and Vehicle have user-ready LATCH hardware but the system
is not used.• Both CRS and vehicle have LATCH hardware but no tether is used.• LATCH components used incorrectly.
Correct Installation - 42
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EXPLAIN - Most Common Misuses
• Selection• Harness• Installation
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Child’s Body Proportions
Update to infant