6/18/2013 10:57:00 AM Guest Column: Growing children and car seats - what is safe?
Shawn Bowker Injury Prevention coordinator for Flagstaff Medical Center's Level I Trauma Center
Dillon was 6 years old at the time of the crash. His mother made sure everyone in her vehicle was buckled up. Since Dillon was in the back seat, she assumed he would be well-protected, even without a car seat. A witness to the car collision on I-17 stopped to retrieve a duffle bag thrown from the vehicle during the rollover. That "duffle bag" turned out to be Dillon. The child had slipped out of his seat belt and ejected during the violent rollover.
Dillon's mom did what she thought was safe for her family. Still, certified child passenger safety instructors do not recommend putting a 6-year-old an adult vehicle seat and seatbelt. Why? Let's address two key points:
Legal requirements of parents for children in vehicles
Safe transportation of children.
Arizona's child seat law changed in 2012, and now requires child-specific restraints for children age 8 and younger. Navajo law requires children younger than age 12 and less than 4 feet, 9 inches to be properly secured in a child passenger restraint system.
According to the Centers for Disease and Prevention (CDC), injuries from transportation are the leading cause of death for children; the highest death rates were among occupants of motor vehicles in traffic.
What is safe?
Starting with infants, parents should use a restraint system on every single trip - even that quick trip to the corner store. Infants (younger than age 2) must ride in a rear-facing, infant or convertible seat, guarding their fragile neck structure and spinal cord. Experts now urge parents to keep children rear-facing as long as the manufacturer's seat instructions allow. Since survival rates drop for forward-facing passengers, parents should not hurry this change. For the best protection, parents should never put a rear-facing car seat in the front seat of a vehicle with an airbag. And remember, the rear seat is safest for any occupant.
Once a child is facing forward, parents should use a child seat until reaching the maximum weight limit for that car seat. The best child seats have 5-point harnesses, like those found in race cars and high-performance aircraft. This harness distributes the crash energy over the strongest parts of a child's body, and in collisions, offers superior protection.
When a child outgrows their car seat, parents should move them to a booster seat and use a lap-shoulder belt. When properly adjusted, booster seats position the lap belt across the pelvis with the shoulder belt crossing the center of the child's chest and over the collar bone. Parents should use the booster seat until the child can properly fit in an adult vehicle seat and seatbelt system.
Because seatbelts are designed for an adult, they often do not fit a child correctly. The recommended minimum height for a child to forgo a booster seat is 4 feet, 9 inches. Until the child can sit with their buttocks completely back, knees bent over the seat front, with the seatbelt braced across the collar bone (not the neck), they should remain in a booster seat. Many car seats and child restraints are incorrectly installed. To learn how to properly install a car seat or booster seat, parents may call the Coconino County Public Health Services District (Health Department) at (928) 679-7262.
Dillon survived the collision, but his injuries will remain with him. His older brother, who fit properly into an adult seatbelt, escaped with minor injuries. emergency departments care for many children who were not properly secured and end up with critical injuries, or tragically, do not survive. Those who are properly restrained most often are discharged from the Emergency department with minor injuries, if any at all. Let's learn from Dillon and others. Their lives depend on it.