Volume 35 • Number 7 July 2014 www.aapnews.org 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 programs. 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, rear-facing. 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. tion program for children is centered at Riley Hospital for Children Car seats and other restraint devices, including car beds and special at Indiana 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. tor 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 the 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 Operation Kids: Next Generation Child Passenger Safety Basic donations as well as program evaluation also are critical for the proAwareness Course 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 Chappelow 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. RESOURCES • Hospital Discharge Recommendations for Safe Transportation of Children are available at www.cps board.org. • For more information on child passenger safety, visit www.nhtsa.gov, www.preventinjury.org and www. healthychildren.org. • For more information on the child passenger safety program at Riley Hospital for Children, email Michelle Chappelow at email@example.com.