Author Archive

What Is A Tether?

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Updated September 2017

There are so many confusing things about carseats for parents and tethers rank right up there with “do I use LATCH and the seatbelt together?” (the answer to that one is a wishy-washy no). We have a tether use rate of much less than 50% in the U.S., about the same as it was back in the mid-70s. Yes, you read that correctly! It’s gone up and down, but it’s still right around the same—pathetic. Even after teaching a child passenger safety technician class and going over tethers with them—when to use them, how important they are for safety—I still got the deer-in-headlights look from some of the new techs when I quizzed them about tether usage. So if my trained technicians are hesitant about when to use a top tether (how about all the time forward-facing!), I can only imagine the confusion parents are feeling. Without further ado, let’s get to it and learn about tethers.

KIM Conference 2017: Update on Rear-Facing to Age 2

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We’ve recently returned from the Kidz in Motion (KIM) Conference, which is the National Child Passenger Safety Conference, where we had a chance to talk with the very experts who help to shape policy on rear-facing. An open forum was added to the conference schedule at the last minute to address the current status of research on which the American Academy of Pediatrics’ rear-facing to age 2 policy is based. The original study from 2007 claims that rear-facing to age 2 is five times safer; however, Dorel commissioned a review of the study that shows those statistics to be in error. We now have a better idea of what’s going on with the recent Dorel policy statement, where they removed language from their labels and instruction manuals requiring children to remain rear-facing in their convertible seats until age 2.

Dr. Ben Hoffman MD FAAP CPST-I, Chair of the AAP’s Committee on Injury, Violence, and Poison Prevention, led the session and stated that the AAP is not making any changes to their rear-facing policy right now. Jeya Padmanaban, the author of the new research, who found the errors in the original study, has submitted her research to an unknown journal and we are all waiting for it to be peer-reviewed and published. Dr. Hoffman said the AAP is closely monitoring the situation but has no inside information on when, or even if, publication may happen. And he’s the guy who would know.

There was a discussion of research currently being done in the area of child passenger safety and it’s pretty slim. As we all know, money has dried up. Years ago, State Farm had an excellent partnership with the Children’s Hospital of Philadelphia (CHOP) where they pulled data from State Farm’s customers. That program, Partners for Child Passenger Safety, ended a decade ago. CIREN is another network where data from level one trauma centers was analyzed in conjunction with biomechanical engineering teams. The last data set from that program is dated 2015. That’s not to say there aren’t currently any studies being made and progress being made in CPS. It’s just that data to focus on injuries to RF children exclusively isn’t being collected.

The panel did discuss Sweden, since it’s a popular comparison country because of its low crash injury rates for children. All agreed that because of the way their carseats are engineered and installed, we can’t compare the U.S. to Sweden. Their vehicle fleet is newer and different, their roads are different as are the miles driven. They also don’t use forward-facing carseats with a harness so there is no way to compare the effectiveness of RF seats to FF seats in that country. From a pediatrician’s perspective, Dr. Hoffman contributed that their entire healthcare system sets them up for different crash outcomes because they may start out healthier.

The big take-home message of the session was that when used and installed properly, carseats are doing an amazing job of keeping children safe, no matter which direction they face.

What to Do

  • Keep your child rear-facing until age 2
    • Stay the course until/unless it’s proven to change
    • There’s no evidence currently that RF until 2 is harmful
    • Some carseats and some state laws require it
  • Don’t say “It’s 5 times safer to RF to age 2”
    • That’s the statistic that’s being called into question
  • After 24 months, it’s a parental choice when to turn
    • We simply don’t know if it’s safer to RF after age 2. Yes, it seems logical that it should be safer, but there are other variables in the vehicle crash environment.
    • If you choose to RF after age 2, make sure to snug up the harness so you can’t pinch any webbing above the chest clip and put the seat in its most upright angle as the manufacturer allows

At this point in the research, there are more unknowns than knowns and we’re definitely in a holding pattern waiting for that revised journal article to come out. There’s no doubt that Dorel’s statement came at a damaging time when states are passing laws requiring rear-facing to age 2 based on what turned out to be a flawed study. We’re in shock as much as the original authors are, as they didn’t set out to mislead anyone. They are all highly qualified researchers in their fields with professional reputations to uphold.

Just as I say to all my child passenger safety technician candidates in tech class: “Never say never in CPS. It’s an ever-changing field with no absolutes.”

 

 

Kids Are Still Dying in Hot Cars

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I remember the good ol’ days when my neighbor friends and I would climb into their old truck in their driveway and pretend to drive to faraway lands. We would each take turns “driving” the old stick shift and using our imagination, pointing out landmarks and making tire squealing noises as we yanked on the steering wheel. I think back and wonder how I’m alive today; that truck could have easily slipped into neutral and we would have rolled into the street or over one of us as we played or did one of our other insane things (I did not partake in jumping from my roof into the pool, but my friends, on the other hand . . .). But even in the good ol’ days, kids were dying in hot vehicles, just as they are now. They’re dying on a weekly basis now, sometimes daily, and we need to change this.

People who live in hot climates know this isn’t a modern phenomena, though with the advent of social media where news travels at lightning speed, hot vehicle deaths become known about within moments. Rear-facing carseats also have contributed to an increase in these deaths, though kids have fallen asleep in cars since there have been cars, so it’s hard to place the sole blame there. The old “out of sight, out of mind” adage is often mentioned with rear-facing seats, but it’s much more than that.

We know the human brain is fallible; it forgets things, especially when there’s a change in its routine. The brain likes to fly on autopilot. Think about what you grab before getting in your car: your keys, cellphone, and wallet. One day you also want to take a bottle of water, but your wallet is on the kitchen counter instead of next to the door with your keys and water. You’re still taking 3 things with you, right? You take the keys, water, and cellphone because your brain expects you to take 3 items. You get to your destination and realize you don’t have your wallet. Or maybe the time you left a drink on top of your car because your hands were full and you needed to unload items into your back seat? Recognizing this is the first step in taking away the “It can never happen to me” mentality because guess what? That’s what the parents who forgot about their kids thought too. And before you cast stones on parents who do accidentally leave their kids in cars and proclaim, “I’d *never* forget *my* child in a car,” read this article. It’s so important, I’ve linked it twice in the same paragraph.

We also need to dispel this idea that the vehicle is a babysitter. This is NOT proper parenting practice and needs to STOP. Do NOT leave your child in the car without supervision while you run into the store/bank/cleaners/hair salon. Just don’t. This is 2017 not 1977 and we know better now. I’m going to judge you on this one. And call the cops. We’ve had too many instances of kids who can’t open their carseat buckles bake to death in their carseats, who can’t open car doors because they’re locked, who are stuck in stolen vehicles—I can go on.

Vehicles are tools to get us from one place to another. We wouldn’t let our kids play with a power tool, right? When our vehicles are parked, they should be locked and the keys put in a place where kids can’t access them so they don’t accidentally get stuck in them (otherwise known as vehicle entrapment). Think like your child for a moment: perhaps they left a crayon or marker in the car and want to go get it. So they go to the car, climb in and locate the item. But the child locks are on and they can’t open the door—they’re stuck in the back seat now! Panic sets in and it’s hot because the car’s been in the sun or hot garage. Maybe there’s stuff on the center front console and your child sees it as too big a wall to climb over. Since a child’s body heats up 5 times more quickly than an adult’s, their thinking can be foggy very quickly and they can become overheated in minutes. If you can’t find your child, check bodies of water first (including neighbors’ pools and ponds), then check your vehicle thoroughly.

Don’t forget to ask your childcare provider to follow up with you immediately if you don’t drop your child off at your prearranged time. With our technology now, it takes only a minute to send out a text blast at even the largest daycares. Even an hour can make a difference, so it’s important to confirm drop off times quickly.

What about alarms? Evenflo has the SensorSafe Technology™ on certain carseats (we previewed the Embrace DLX with SensorSafe here) that chimes when the 2008 or later vehicle is turned off (or when the chest clip is opened while the vehicle is in motion). GM offers a Rear Seat Reminder on all new 2017 Acadia models and will be expanding it to more Buick, Cadillac, Chevrolet, and other GMC models for 2018 models. A smart pre-teen from Texas created an alarm that blows a fan after a neighbor’s 6 month old died in a hot car. Can we rely on alarms? Do they give us a false sense of security or will we eventually succumb to warning fatigue? The thing about humans is that we’re lazy and unless we’re highly motivated, we’re going to start to ignore the sounds and reminders, especially if they’re . . . routine.

I’d like to see mainstream media take these vehicle heatstroke deaths and make half as big a deal out of them as they do most news stories. Having been in a grassroots organization for years trying to get media coverage for child passenger safety, it’s frustrating not to have this topic taken seriously. Word of mouth only goes so far in getting the message out. But of course, there are still a lot of people out there who don’t think keeping children safe in and around vehicles should be a priority so it’s not surprising this topic doesn’t rank higher in the news cycle. I wonder how many kids have to die until it does?

 

Infographic provided by noheatstroke.org, run by meteorologist Jan Null. He keeps this website up-to-date with the sad statistics and other scientific data regarding hot vehicles.

Does Where You Live Predict How Likely Your Child Will Die In A Crash?

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The Journal of Pediatrics recently released an interesting study examining whether geography made a difference in children deaths from vehicle crashes. It stated things we already know: unintentional injury is the leading cause of child death in the US and vehicle crashes cause the most injury. Some of the most common causes of injury included not using restraints, misusing restraints, putting children in the front seat before age 13, alcohol and drug use by drivers, high speeds, and rural roads.

After examining the Fatality Analysis Reporting System (FARS) database, researchers concluded that 13% of children who died in crashes were inappropriately sitting in the front seat when they should have been in the back seat. Across all states, 20% of children who were either unrestrained or inappropriately restrained died. And nearly 9% of drivers who were under the influence of alcohol were driving with children. The type of road made a difference too: rural roads counted for 62% of child fatalities.

The vast majority of children who died in crashes (52%) lived in the South, followed by 21% in the West, 19% in the Midwest, and 7.5% in the Northeast. Factors include what was discussed above: unused or misused restraints and driving on rural roads. Also found to be a factor in reducing deaths were red light cameras. In states where there were red light cameras in operation, death rates were lower. Also interesting was that there appears to be a minivan “safety bubble” effect. Children riding in minivans had a slightly lower death rate, though it’s not the minivan itself that may be necessarily safer; rather people who drive minivans may drive slower, use child restraints and use them properly, and so on.

What does the study tell us? A carseat isn’t going to work if it’s not used and it has to be used properly to do its job. The front seat isn’t safe for kids under 13; it’s just not. Red light cameras work. Rural roads are more dangerous because they’re smaller, twistier, and don’t have barriers between oncoming traffic.