Hospitals encouraged to provide child passenger safety training

Volume 35 • Number 7
July 2014
Hospitals encouraged to provide
child passenger safety training, resources
by Marilyn J. Bull, M.D., FAAP, and
Michelle L. Chappelow, R.N., B.S.N., CPN
Guidelines to help hospitals develop programs to ensure
all children are transported safely on every trip recently
were developed by the Academy in collaboration with the
National Highway Transportation Safety Administration
(NHTSA), Children’s Hospital Association and the
National Safety Council.
Motor vehicle crashes remain a leading cause of death
and injury among U.S. children. Car seats reduce the risk
of fatal injury by 71% for infants and by 54% for toddlers.
Pediatricians play an important role as they advocate for
hospitals to develop comprehensive child passenger safety
An RN at Riley Hospital for Children at Indiana University teaches a father how
The new guidelines, Hospital Discharge Recommendations
to install the convertible car seat in the rear-facing position. His child had outgrown
for Safe Transportation of Children, emphasize that an effecher rear-facing-only car seat and needed to be moved to the convertible seat,
which has a maximum weight of 40 pounds and maximum height of 40 inches
tive hospital-based program should include physicians,
nurses, therapists, administrators, risk management staff
and community outreach team members. A successful program requires planning, identifying staff and their roles,
ensuring appropriate training, providing a plan for continuous assess- to developing a hospital-based child passenger safety program will
increase the likelihood of success.
ment of competency, and securing funds and resources.
The hospital should have access to conventional car seats as well
as child passenger safety restraints or large medical car seats for children Guidelines in action
One long recognized example of a comprehensive safe transportawith special transportation needs related to their medical condition.
program for children is centered at Riley Hospital for Children
Car seats and other restraint devices, including car beds and special
University Health in Indianapolis. The program has been
seats or vests, may be sold, loaned or given to families depending on
resources. Staff members with special training need to be responsible developed incrementally to provide resources and training on safe
for determining the appropriate car seat or restraint device needed transportation for all children, including those with special needs.
The program coordinator is a pediatric nurse who also is an instrucand for educating parents on proper use.
of the National Child Passenger Safety Certification Training
A coordinator, who is a certified child passenger safety technician,
should be responsible for policy development and revisions; staff Program.
One hundred child passenger safety technicians work throughout
training and ongoing competency assessments; and maintenance of
hospital. Most are registered nurses, but the hospital has started
written educational materials based on current best practice recomtraining
nursing assistants as well. The program coordinator mentors
mendations and state child passenger safety laws.
Development of standardized documentation in the medical record, new technicians as they develop knowledge and expertise.
In addition, more than 60 registered nurses have completed the
maintenance of car seat and restraint inventory, obtaining grants and
Kids: Next Generation Child Passenger Safety Basic
donations as well as program evaluation also are critical for the proAwareness
and can provide basic child passenger safety inforgram’s success.
Policies, based on best practice recommendations of the Academy mation to parents. They also refer families to inspection stations
and NHTSA, should be developed to establish the hospital’s standard throughout the state, where parents can have their child’s car seat
of care for the safe transportation of children. An incremental approach checked for proper installation in their vehicle.
© 2014 AAP News
All of the registered nurses working in the neonatal intensive care
unit (NICU) receive training and annual updates on passenger safety
for newborns and how to complete the car seat evaluation for premature and other high-risk infants. Hospital policy calls for evaluating
newborns born at less than 37 weeks’ gestation and others at risk for
apnea, bradycardia and oxygen desaturation when positioned semireclined in the car seat based on the manufacturer’s instructions.
Twenty of the nurses are child passenger safety technicians. Although
not required, the technicians teach proper car seat installation at the
family vehicle for every patient leaving the NICU.
Additionally, the program is expanding training and services across
its 18-hospital network.
Dr. Bull
Dr. Bull is a member of the AAP Council
on Injury, Violence and Poison Prevention
and chair of District V. Ms. Chappelow is
the child passenger safety program coordinator at Riley Hospital for Children at
Indiana University Health and IU Health
Methodist Hospital.
• Hospital Discharge Recommendations for Safe Transportation of Children are available at www.cps
• For more information on child passenger safety, visit, and www.
• For more information on the child passenger safety program at Riley Hospital for Children, email Michelle Chappelow at