|
Chapter 1 Index
A. General Information
about the well child examination B. Nutrition Issues
C. Sleep Issues
D. Dental Issues
E. Anticipatory Guidance
--Discipline: Normal
Toddlers
--Discipline: To Spank
or Not to Spank
--Toilet Training: or Once Upon a Potty
--Reach Out and Read
--Anticipatory Guidance: Other Items to Ask
Birth – 6 years of age
--Smoking: Adverse
Effects on Children |
|
What’s New in Car Seats in 2002
Drs. Palumbo, Crane, Hebert, Davis, McBurney
Introduction: This refers to normal children with no
specific medical needs. Need to know:
- The AAP has recently come out with guidelines for children with
disabilities: Pediatrics 2001;108:516-18: e.g. those with tracheostomies,
wheelchairs
- People are not using them: 90% first year of age; 63% in 2-4 year
olds.Laws not enforced
- Ages at which children need to be in the middle of the back seat
facing back (1 year), forward, move to booster seats (4 years) and using
seat belts (8 years). Children should stay in the back seat until 12
years of age.
- Data: in 1997, more than 1400 children died in car crashes; motor
vehicle crashes is the leading cause of unintentional injury related
deaths among children under 15 years of age. Some studies show that 50%
of children less than age 5 were not in safety seats. Of those in seats,
over 85% are installed incorrectly. Remind parents: airbags kill children
- if no back seat, front seat should be moved back as far as possible, and
child face backwards. Children should always be in the back.
- Prematures or those with possible hypoxia need to be observed before
put in car seat.
Types of Car Seats: Instruct parents that not all seats fit
all cars; also store that sells parent the car seat will often install it
properly. Never buy a used car seat or one that has been in an MVA.
- Infant seats: Used until the baby is 20-22 pounds. Most have a
base that can stay in the car and are rear facing. If child is over 27
inches long (50th %ile for 7-8 mo old), car seat needs to be changed -
though child needs to face backwards until 12 mos of age. Specialty seats
exist for bigger children less than one year old: Safeline Sit N Stroll,
Evenflo Horizon, Century Smart Move, Britax Elite or Roundabout.
- Convertible seats: Can be used as rear facing (up to 1 year
old, 20 lbs. or 27 inches). Can then convert to forward facing until
child is 40 lbs. or 4 years old. Many come with tethers on back. These
come with 5 point harness, and have retaining clips to secure shoulder
strap. Ears need to be below the top of the back of the seat.
- Booster or Toddler seats: forward facing with a harness system
and belt-positioning who have outgrown convertible seats.
Most Frequent Errors in the Use of Car Seats:
- Safety belt not holding seat tight: 63%: should be no side to side
movement
- Harness straps not snug: 33%; harness straps not routed correctly: 20%
- Locking clip not used correctly: 17%. Place clip within one-half
inch.
- Car seat recalled and not repaired: 9%
- Infants facing forward before 1 year of age and 20 lbs.: 11%
Resources:
- KARS/Special KARS program through National Traffic Safety
Administration and National Easter Seal Society (800-221-6827) to provide
car seats for healthy and physically challenged children. Internet:
www.nhtsa.dot.org
- US Dept of Transportation Auto Safety Hotline: 800-424-9393: questions
about car seats
- National Safe Kids: provides loaner and giveaway programs :
www.safekids.org
- Augusta-RCHD: free loaner seats: Cheryl Turner/Malcolm Washington:
667-4234.
Next Page |