Child passenger safety has dramatically evolved over the past decade; however, motor vehicle crashes continue to be the leading cause of death for children 4 years and older. This policy statement provides 4 evidence-based recommendations for best practices in the choice of a child restraint system to optimize safety in passenger vehicles for children from birth through adolescence: (1) rear-facing car safety seats as long as possible; (2) forward-facing car safety seats from the time they outgrow rear-facing seats for most children through at least 4 years of age; (3) belt-positioning booster seats from the time they outgrow forward-facing seats for most children through at least 8 years of age; and (4) lap and shoulder seat belts for all who have outgrown booster seats. In addition, a fifth evidence-based recommendation is for all children younger than 13 years to ride in the rear seats of vehicles. It is important to note that every transition is associated with some decrease in protection; therefore, parents should be encouraged to delay these transitions for as long as possible. These recommendations are presented in the form of an algorithm that is intended to facilitate implementation of the recommendations by pediatricians to their patients and families and should cover most situations that pediatricians will encounter in practice. The American Academy of Pediatrics urges all pediatricians to know and promote these recommendations as part of child passenger safety anticipatory guidance at every health supervision visit.
In a sample of children aged O through 14 years who were treated for injuries incurred in a motor vehicle accident, a large proportion of those involved in noncrash events fell or were ejected from the vehicle. This study was designed to describe the patterns of passenger travel, precipitating causes, and severity of injury in noncrash falls or ejections. The data were obtained from a larger ongoing hospital-based monitoring system. The Abbreviated Injury Scale was used to grade injuries. Over 50% of those ejected sustained serious injuries compared with 5% of those who remained in the vehicle. Two high-risk patterns emerged: (1) the young child traveling in a passenger seat falling out of the vehicle, and (2) the older child riding on the exterior of the vehicle and falling off during a vehicle maneuver. Door locks, restraint use, and prohibition of travel in nonpassenger locations would prevent these serious noncrash injuries. (JAMA1985;253:2530-2533)
This study was designed as a preliminary investigation aimed at exploring variations in costs within a specific AIS category and to secondarily discuss the applicability of this type of cost analysis in assessing the ffectiveness of a mandatory restraint use law. Data from 1982 (the year prior to implementation of the Child Passenger Protection Act) and 1983 (the first year after implementation) were used. The data were obtained from a larger ongoing data collection effort in emergency rooms and the Coroner's Office in a large urban California county. Variation of costs within the minor injury category were found. The specific injury method of cost calculation was found to be more precise than use of an average AIS-1 cost. This study also demonstrated that costs associated with emergency room evaluation of those who are in fact uninjured must be included in cost analyses of a public policy measure, e.g. a mandatory restraint use law. Language: en
Historically, research on pediatric pedestrian injuries has analyzed children younger than 5 years of age as a single group. However, in this study, these children were divided into two age groups which were reflective of differences in behavior and development. The data demonstrate differences in the circumstances of the pedestrian injury events between toddlers (0 through 2 years and ambulatory) and preschoolers (3- and 4-year-olds). Toddlers were more likely to be injured in nontraffic events whereas preschoolers were more frequently injured in traffic situations. A high proportion of toddler injuries occurred in residential driveways and were caused by vehicles backing up. The majority of preschoolers, often without supervision, were injured while crossing/darting midblock on residential streets near their homes. Reflecting these differences in circumstances and also developmental differences between toddlers and preschool children, there is a need for age-specific interventions to reduce pedestrian injuries in children younger than 5 years of age.
Children with special health care needs should have access to proper resources for safe transportation as do typical children. This policy statement reviews important considerations for transporting children with special health care needs and provides current guidance for the protection of children with specific health care needs, including those with airway obstruction, orthopedic conditions or procedures, developmental delays, muscle tone abnormalities, challenging behaviors, and gastrointestinal disorders.
To compare child pedestrian injury events occurring in driveways and parking lots and at midblock and intersections with respect to characteristics and activity of the child, injury outcome measures, and characteristics of the vehicle and roadway.Descriptive case series.Data were obtained from a multihospital/coroner monitoring system, during 2 years in an urban county, by record review and interviews.The sample consisted of 345 pedestrians 0 through 14 years of age treated for injuries at one of the participating facilities.Eleven percent were injured in driveways, 8% in parking lots, 53% at midblock, and 28% at intersections. Median age was 2 years for driveways, 4 years for parking lots, 6 years for midblock, and 10 years for intersection. Events in driveways and parking lots had significantly more vehicles backing up, fewer automobiles, and more pedestrians with adults. Events at intersections occurred more often on streets with more than two lanes, with speed limits > 25 mph, and with moderate or heavy traffic than events at midblock. Sixteen percent of those injured in driveways and parking lots sustained head injury of moderate or greater severity versus 35% injured in the street.Interventions to prevent child pedestrian injuries must consider normal child behavior and driver awareness as it relates to location of the events. Driveway events involve small children, larger vehicles, and backing up. Midblock events involve children too young to cross even quiet residential streets safely. Traffic controls and safe street crossing skills are measures to consider for intersection events involving older children.
National observational studies indicate that infants who are not restrained in child safety seats (CSSs) in motor vehicles are usually riding on the lap of another occupant. This study was undertaken to determine the conditions under which children travel on-lap. The extent to which injuries would be reduced if these children were restrained in CSSs was also examined. Data were taken from a multihospital monitoring system for pediatric occupant injuries and from the coroner's office in a single urban county (1980 through 1989). One hundred ten children younger than 1 year of age evaluated in the monitored emergency departments after involvement in a crash had been traveling on-lap. On-lap travel did not appear to result from overcrowding. Eighty-eight percent were riding in vehicles with five or fewer occupants; 83% were in the front seat; 58% sustained injury; 22% of those evaluated were hospitalized; and 15% sustained intracranial injury. A 30% reduction in overall injury, a 75% reduction in hospitalization, and a 69% reduction in intracranial injury were projected for those riding on-lap, had they been restrained in CSSs. Applying national rates of on-lap travel (16.8%) to National Highway Traffic Safety Administration estimates of the number of infants injured in crashes each year indicates that approximately 2218 of these children would be on the lap of another passenger. Substantial savings in terms of injury and associated costs can be realized if children traveling on-lap were in CSSs. Parent education as well as strict enforcement of CSS laws must be implemented. Parents must be convinced that this practice of travel in vehicles is not protective and, in fact, poses a significant risk for injury.
'%3e%3cg id='b'%3e%3cpath id='a' d='M0-8v8h4z' transform='rotate(18 0 -8)'/%3e%3cuse xlink:href='%23a' transform='scale(-1 1)'/%3e%3c/g%3e%3cuse xlink:href='%23b' transform='rotate(72)'/%3e%3cuse xlink:href='%23b' transform='rotate(144)'/%3e%3cuse xlink:href='%23b' transform='rotate(216)'/%3e%3cuse xlink:href='%23b' transform='rotate(288)'/%3e%3c/g%3e%3c/svg%3e)