Proper Installation of Convertible Carseat on an Ambulance Cot

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Convertible install ambulance cotSometimes, it’s the upside of a slow carseat check event – the opportunity to “play” with something new. On this particular warm, sunny, spring day – parents were obviously busy doing something other than coming to our well-publicized check event. That left us techs with a little free time. At one point, some of the volunteers from the local ambulance corp showed up and the conversation quickly turned to transport of non-critical pediatric patients in ambulances. I think I shocked a few of the techs when I admitted that I had never actually installed a carseat on an ambulance cot (What? Something involving carseats that Kecia has never done??? Alert the presses! Lol.) Yes, I understand how it’s supposed to be done. I’ve read the research papers and I’ve seen several presentations on the subject at various conferences over the years but I had never actually done it myself. Well, wouldn’t you know it – a short time later, an ambulance pulls up. Yes, boys and girls – it’s play time! 😀

It was actually a fairly simple install on this nice, new Stryker cot with this particular convertible (Cosco Scenera). For the record, the only type of conventional carseat that should be installed on an ambulance stretcher/cot is a convertible seat. You need to be able to secure the carseat on the cot using two different beltpaths and this is only possible if the carseat has separate beltpaths for the rear-facing and forward-facing positions – which convertible seats have. Obviously, this setup is only going to work if the child actually fits in the convertible (and that will vary depending on the specific convertible model being used) and if the child can tolerate being transported in the semi-upright position.

First they showed me how to raise the head of the cot until we had it flush against the back of the reclined Scenera. Then we routed the straps nearest the rear-facing beltpath thru that beltpath and routed the straps nearest the forward-facing beltpath thru that beltpath. We tightened everything up and Voila! Next, one of our local CPS techs strapped in our “non-critical pediatric patient” for good measure. Finally, the guys from the ambulance corps showed me how to load this particular stretcher into the ambulance and secure it.  I have to say, I was really impressed with this particular Stryker Powered Ambulance Cot. The hydraulic system was sweeeeet!

     

On this particular day, this exercise was all about learning something new in a relaxed and friendly environment. However, in reality, pediatric transport in an ambulance can range from “as safe as possible under difficult circumstances” to “downright scary for no good reason”. Why does it vary so much? Because currently there are no federal guidelines for pediatric transport in an ambulance. Therefore, EMS services are free to transport patients in any way they deem appropriate. Personally, I wouldn’t allow my children to be transported to the hospital in an ambulance unless they really needed to be attended to by a medic on the way there. Unconscious and not breathing? Massive head trauma? Aortic Rupture? Get my child into the ambulance fast and I’m not going to care or worry about how he’s restrained. Broken foot? Get in the car and I’m driving you to the hospital myself.

For more information on the subject see “Crash Protection for Children in Ambulances”: http://www.carseat.org/Resources/Bull_Ambulance.pdf

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Don’t Make Me Turn This Car Around

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no-cell-phone-clipart-nTBGkMGgcBy now we all know that talking on the phone while driving poses a great distraction. But did you know there’s something even more distracting, and you probably do it all the time?

An Australian study found that driving with children in the car is twelve times more distracting than using a cell phone while driving.

When you think about it, that’s not surprising. Besides the normal conversation that children engage us in, there’s also crying, yelling, nagging, whining, bickering, singing annoying songs, and endless games of I-spy. And those are just the audible components.

Add to it the toy-dropping, punching of siblings, and frantic waving of hands for no particular reason. Then add in the help opening the snack package, the handing-back of the snack package, and then your desperate contortions as you try to retrieve the empty packet before your child dumps the crumbs all over his or her car seat.

Those kids are kind of distracting, aren’t they?

2013TraverseBritaxParkwaySGLGracoAffixThe study found that during a 16-minute trip, parents’ eyes were off the road for almost 3.5 minutes, mainly from glancing in the rear-view mirror at their kids. Some even positioned the mirror to focus on their children rather than on the cars behind them.

I felt very smug reading the study and some articles about it. I hardly ever look back at my kids. Maybe I’m lucky in that they’re generally pretty well behaved in the car, or maybe I’m just really good at ignoring them, but that aspect just isn’t an issue for me.

They’re also at ages now where I can pretty much rely on them to hold onto their trash, and they know that if they drop a toy, they’re out of luck. Reaching for a dropped item is something I will not ever, ever do while I’m driving.

But then there’s the part about conversation…and I’m guilty of that one. Just as with the other party in a cell phone conversation, kids aren’t usually aware of what’s going on outside the car. They have constant comments and questions that need answering, and not always at the best times. I remember recently when I was trying to explain the history of child labor laws to an inquisitive 5-year-old while also navigating a tricky highway interchange. When things get too intense or distracting, I do sometimes tell my kids to wait a minute, then get back to them once I’m done backing out or merging or whatever I was doing.

One conclusion made by the researchers (that likely won’t come as a surprise to readers of this blog) is that properly restraining children probably leads to less distraction by the parents. This particular study showed that the children involved were incorrectly positioned 70% of the time, which could certainly lead to a need for increased attention by the parents. Chalk up another benefit to child restraints: Besides protecting kids in a crash, they can help prevent them in the first place.

Should You Toss Your Toxic Car Seat?

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coccoroEvery few years, HealthyStuff.org evaluates car seats based on the presence of flame retardants and certain heavy metals. They just came out with a new report, and you might be concerned about the findings. Let’s talk about what this all means.

First, let me say that I’m concerned about flame retardants, too. Some people brush it off as hippie-helicopter-parents-flipping-out-over-something-harmless. But some of the chemicals found in car seats have known detrimental effects, some have suspected detrimental effects, and at least one is slated to be phased out of use under the Stockholm Convention (a global treaty signed by over 150 countries who have vowed to reduce persistent organic pollutants).

I’ve written other posts about flame retardants for CarseatBlog, and I’m concerned about my own children’s exposure, so I’m not here to tell you the study doesn’t matter or should be ignored. But I’m not going to tell you to panic and throw away your seats, either.

This current study from HealthyStuff appears to be more thorough in some ways than past ones. This study looked for the presence of brominated, chlorinated, and phosphate-based flame retardants. They show which retardants were present in which seats, and they show the potential hazards of each of those compounds.

They do a much better job than in the past of explaining how these chemicals can enter a child’s body: through dermal (skin) contact, inhalation, or ingestion. The organization also provides a better explanation of their methodology and how they weighted the results to come up with their rankings.

Here are some things to keep in mind when looking at the rankings.

  • All car seats must meet federal flammability standards. The flammability standard is harsh, and there’s no way to meet the standard without the use of some kind of chemical flame retardant.
  • We don’t know the risks of all chemicals. We know that some are worse than others, but because fire retardants are largely unregulated, it often takes years before they’re fully tested and their impacts fully understood. A chemical that seems great now might turn out to be hazardous later. That means that we don’t necessarily know how “good” a seat with a “good” ranking really is. We also don’t know if a seat with a “bad” rating is really any worse. Especially because:
  • There’s no way to know how “safe” or how “dangerous” a car seat is. Even the FAQs on HealthyStuff.org’s report states:

    HealthyStuff.org ratings do not provide a measure of health risk or chemical exposure associated with any individual product, or any individual element or related chemical. HealthyStuff.org ratings provide only a relative measure of high, medium, and low levels of concern for several hazardous chemicals or chemical elements in an individual product in comparison to criteria established by our research team and informed by published research studies.

    We don’t know how—or even if—these car seats’ chemicals are having an actual impact on kids.

  • Not all seats were tested. HealthyStuff.org only tested 15 seats. There are a lot of seats that weren’t tested at all. Of the ones that were, we only have data for those particular samples. It’s possible that a company could switch vendors for certain components, meaning that foam that tested poorly (or well) might not even be used in other, seemingly identical seats manufactured at a different time. Basically: there’s just a lot we don’t know.
  • Car seats save lives. It’s okay to be concerned about chemicals in your children’s car seats, but it doesn’t mean the car seat itself is a bad thing. Just the opposite: It’s absolutely necessary and crucial. The chemicals in flame retardants pose a potential risk. Car crashes are a known, real, happening-everyday risk, and are a leading cause of death in children. Properly using an appropriate car seat is one of the best defenses against injury and death. Hands down.

With all that said, what can you do if you’re still concerned about potentially dangerous chemicals in your seats?

  • Don’t leave children in seats longer than necessary. For many reasons, car seats should be for the car, not for lounging or sleeping outside the car for long periods of time. Children left in car seats outside the car are at greater risk for other hazards, too, such as airway obstruction, falls, and strangulation.
  • Clean the cover. The cover isn’t the only part of the seat that contains fire retardants, but it’s the part in most direct contact with your child. Wash it (according to manufacturer instructions) to remove any excess chemicals. Remember that aftermarket covers and products are not recommended because they can interfere with the straps and with the ability to properly tighten the harness.
  • Avoid excess heat. This is sometimes easier said than done, especially during hot summer months, but heat can cause a greater dissipation of flame retardant chemicals. Park your car in the shade, crack windows, use sun shades, and air out the car before you get in it.
  • Vacuum regularly. Flame retardants can gather in dust, so vacuum out your car and your child’s car seat regularly.
  • Contact car seat manufacturers to express your concerns. Public pressure leads to results. Some companies have already abandoned the more-concerning chlorinated and brominated fire retardants in favor of the (seemingly and hopefully) less-concerning halogen-free phosphates. If some companies have done it, all of them can.

If, after all this, you’re still panicking over your particular seat, then by all means get a new one. I don’t think it’s necessary, though.

Remember, I don’t take this topic lightly at all, but guess what seat my youngest child is currently riding in? I won’t name names, but it’s among the seats listed as a “highest concern.” I’m not switching him out of it, though. For one, I have no way of knowing whether his particular seat has the same components as the one tested (nor do I know how any new seat I’d get him would compare to the samples they used). I do clean the seat regularly, and we try to keep windows cracked in the summer as long as there’s no threat of rain. I do my best to mitigate his exposure by avoiding flame retardants in other areas, especially in our mattresses and bedding, where my child currently spends about half his life.

I will definitely contact the manufacturer to encourage them to remove brominated fire retardants from all their products, but in the meantime I’m not going to sacrifice the seat in question, which fits well in my car, fits my child well, and is easy to use correctly each and every time.

Tweenbelt Safety

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aidenprotegewmI remember this one time when I was about six years old, my mom and some other parents were driving a big group of kids to swimming lessons at the YMCA. I didn’t know most of the kids—I think they were actually part of an after-school program at my friend’s school—but I remember that I sat in the back seat next to a big girl, who for some reason I remember was named Pam.

My mom told everyone to buckle their seatbelts, and Pam said, “I’m 13, so I don’t need to wear a seatbelt.” I was shocked that some other kid would a) not wear a seatbelt, and b) would talk back to my mom, but my mom handled it well. She said, “Well, I’m an adult and I wear one, so you will, too.”

I give my mom credit for being ahead of the curve (this was 30 years ago, after all, when it was common for kids to bounce around in cars, completely unrestrained). Times have changed a lot, in regard to car seats, booster seats, and universal seatbelt use, but all of us advocates know there’s still work to do.

Screen Shot 2015-05-27 at 12.16.17 PMRecently NHTSA launched a new campaign to help educate tweens (kids 8-14) and their parents about the importance of buckling up in the car. NHTSA found that as kids get older, they’re less likely to buckle up. During the past five years, half of children 8-14 years old who died in car crashes were unrestrained.

Reasons for this include a natural inclination to test boundaries, busy schedules (rushing to after-school activities), and peer pressure. Kids this age are typically responsible for their own buckling (as opposed to younger children in harnessed seats), so parents rely on their kids to get it right, and might not notice when they don’t. There are also still misconceptions about the importance of buckling up on every trip, Many people (kids and adults) think that short, familiar trips don’t require seatbelts. There’s also still a somewhat prevalent (and flawed) idea that people in the back seat don’t need seatbelts, so some parents might know their tweens aren’t buckling up but don’t see anything wrong with it.

Recaro Performance Booster - lap belt fitIt’s also important to remember that not all tweens are ready for the seatbelt alone. Until kids fit properly in the belt (usually not until between 8-12 years old, or when they’re about 4’9″…though it varies) kids still need booster seats. That not only improves safety, but also improves comfort. A 9-year-old with a shoulder belt across her neck is likely to put it behind her back instead, or might skip the seatbelt all together. See this post for more information on determining when kids are ready to ride without a booster seat.

So how can parents encourage seat belt usage in their tweens? Here are some tips from NHTSA and us:

  • Demonstrate seatbelt use: If parents don’t buckle up, their kids are less likely to.
  • Refuse to move: Sometimes when toddlers unbuckle their harness, we recommend parents tell them the car can’t move unless everyone is buckled. Do the same thing with tweens. They might know the car is physically capable of going, but that doesn’t mean you have to let it.
  • Offer an incentive: As soon as they’re buckled, they can have their 2015KiaSedona7Passengertabletvideo game, music, book, whatever. This also helps keep distraction to a minimum. A kid in the middle of a Minecraft game on his iPad might be too enthralled to stop for a few seconds and put the seatbelt on, so don’t let him have the game until he’s in securely.
  • Give them cold, hard facts: Kids this age are at a point where they can understand statistics better than smaller kids, so throw some (statistics, not smaller kids) at them. Tell them that most fatal crashes occur less than 25 miles from home, and at less than 40 mph.
  • Check on them: Take a glance back in the rear-view mirror, or turn around and make sure they really are buckled, and that the seatbelt is positioned properly.
  • Make them responsible: Remember (and remind them) that these kids will be driving themselves in just a couple years. Tell them that part of earning their license is proving that they can be safe and responsible in the car, and that includes buckling up on every drive, every time.