Pediatric Seat Belt Use in Motor Vehicle Collisions: The Need for Driver Education Programs

BACKGROUND By statute, pediatric passengers transported in motor vehicles need to be appropriately restrained. The National Highway Traffic Safety Administration (NHTSA) estimates that currently only 2% of children do not wear safety restraints. This study aimed primarily to evaluate the use of pediatric restraints (seat belts) in motor vehicle collisions (MVCs) transported to our Level I pediatric trauma center (PTC) compared with historical NHTSA controls. METHODS A 4-year review utilized our Level I PTC registry for patients younger than 16 years, involved in an MVC. Appropriate booster seat/child restraints were verified by EMS, fire rescue, and patient/family. Odds ratios were used to compare occurrences and χ for categorical values with significance defined as p <.05. RESULTS A total of 685 pediatric patients in MVCs were admitted to our PTC during the study period. Only 39 of 685 (5.7%) pediatric patients were in restraints. Based on the NHTSA historical controls, 671 of 685 (98%) children would have been expected to be using restraints (5.7% vs. 98%, p < .01). The odds ratio of lack of use of child restraints or seat belts in pediatric trauma population was markedly higher compared with NHTSA historical controls (odds ratio 793.9, 95% confidence interval: 427.02-1475.98, p < .0001). CONCLUSION Astonishingly low rates of child restraints and seat belt use in pediatric patients in MVCs, requiring admission to a PTC, indicate the need for better injury prevention programs, and parental or driver education on risks associated with lack of restraints.