In 2008 the National Highway Traffic Safety Administration (NHTSA) convened a working group of representatives from the American Academy of Pediatrics, Emergency Medical Services for Children, the American Ambulance Association, and other key organizations and started a project called “Solutions to Safely Transport Children in Emergency Vehicles”. Finally a long-standing problem was being recognized and addressed: “there are no Federal standards or standard protocols among EMS and child safety professionals in the U.S. for how best to transport children safely in ground ambulances from the scene of a traffic crash or a medical emergency to a hospital or other facility. The absence of consistent national standards and protocols … complicates the work of EMS professionals and may result in the improper and unsafe restraint of highly vulnerable child passengers.”(1)
In fact a 1998 study regarding the use of child restraints in ambulances revealed that 35 States did not require patients of ANY AGE to be restrained in a ground ambulance. Of those States that did require some sort of child restraint system, requirements for an “acceptable restraint” varied significantly.(2)
It is illegal in the US to travel with an unrestrained child in an automobile. However, when a child is already sick or injured, we have been willing to transport them in a vehicle where the passenger compartment is exempt from most safety requirements, they cannot be properly restrained and they have a higher probability of an accident than an automobile. We might not if we knew the following:
It is estimated that up to 1,000 ambulance crashes involve pediatric patients each year. It is also estimated that there are approximately 4 child fatalities per year.(3)
In a collision at 35mph, an unrestrained 15kg child is exposed to the same forces as in falling from a 4th story window.(4)
This past Wednesday, after an intense 2 year research effort, a public meeting in August 2010 to review the findings and gather input (see Pediatric Safety Post by Sandy Schnee “A Public Meeting on Safe Transport for Kids on Ambulances“), and 2 additional years refining the results, NHTSA has released the official:
The working group outlined 5 potential child transport “Situations” (see chart below) and for each described their “Ideal” solution – the best practice recommendation for safe a safe transport for each situation. They also presented an “If the Ideal is not Practical or Achievable” alternative – basically an “acceptable” backup plan.
They also came up with guidelines to assist EMS providers in selecting a child restraint system – particularly important because due to the lack of regulation and testing requirements specific to ground ambulances, many of the available child restraint devices were not designed for use in ambulances, some were tested to automotive standards and others were not tested at all.
In the end, the ultimate goal of ALL the recommendations: Prevent forward motion/ejection, secure the torso, and protect the head, neck, and spine of all children transported in emergency ground ambulances.
In short – transport these children safely.
We know that since the adoption of “mandatory use laws” in the U.S. for child safety restraints in automobiles, that thousands of children’s lives have been saved. Yet for years we have continued to allow children to be transported unrestrained on ambulances. With this report, we have finally taken a step in the right direction…
“It is hoped that the recommendations provided in this report will address the lack of consistent standards or protocols among EMS and child passenger safety professionals in the United States regarding how to most safely transport children in ground ambulances from the scene of a traffic crash or medical emergency to a hospital or other facility. It should be noted that the expectation is that States, localities, associations, and EMS providers will implement these recommendations to improve the safe transportation of children in emergency ground ambulances when responding to calls encountered in the course of day-to-day operations of EMS providers. In addition, it is hoped that EMS providers will be better prepared to safely transport children in emergency ground ambulances when faced with disaster and mass casualty situations”.
…. Amen to that !!
1. Notice published by NHTSA of Public Meeting on August 5th, 2010 to discuss draft version Recommendations for Safe Transport of Children on Ground Ambulance Vehicles: Federal Register, July 19, 2010,
2 & 3. Working Group Best-Practice Recommendations for the Safe Transportation of Children in Emergency Ground Ambulances: NHTSA / USDOT, September 2012
4. “EMS to Your Rescue?” Int’l Forum on Traffic Records & Hwy Safety Info. Systems – Levick N, July, 2008Pin It
A new rule that goes into effect in 2014 will require car-seat makers to warn parents NOT to use the Latch anchor system to install a car seat if the combined weight of the child and the seat is 65 pounds or higher.
The LATCH anchors (Lower Anchors and Tethers for Children) were designed to make child seats easier to install and have been required in vehicles since 2001, but child-safety seat advocates say the strength of the anchors can’t be guaranteed because they don’t take into account the weight of the child seat, which typically weighs 15 to 33 lbs.
In the June 6th USA Today, according to Joseph Colella, one of five child-safety advocates who petitioned the National Highway Traffic Safety Administration (NHTSA) for a change to the rule, “the anchor requirements are based on old child seats and outdated recommendations on how long kids should be in child seats”.
And children are getting heavier and staying in child seats longer. Just this past year the American Academy of Pediatrics and NHTSA issued enhanced new guidelines on booster seat use for older children, recommending that children ride in a booster seat until they are big enough to fit in a seat belt properly, typically when the child is somewhere between 8-12 years old and about 4 feet 9 inches tall. Colella says “car makers aren’t able to guarantee the safety of heavier kids given the strength of LATCH anchors”. And that to me, sounds a bit risky
So what does this mean for you?
Transportation Department spokeswoman Lynda Tran told USA Today: “While Latch makes it easier to properly install car seats in vehicles, it’s important for parents and caregivers to know that securing a child seat with a seat belt is equally as safe — and that they have the flexibility to use either system.” Very good to know.
So…if you have a child that weighs around 30 lbs, double check the weight of your car seat with the manufacturer. Make sure the weight of your child + the weight of that seat does not exceed 65 lbs. And while you’re having that conversation with them, double check the weight their LATCH anchors are rated to support. And if you have any doubt – use a seat belt to secure the car seat.
In my opinion, waiting until 2014 to require car seat manufacturers to warn parents about a potentially dangerous situation is being overly “nice” to car-seat manufacturers…but when the safety of a child is even a question, “nice” should not be an option.
I’d prefer we start notifying parents today. What do you think???
To clean most child car seats covers requires complete removal of the car seat from the vehicle. As a result, there are two groups of parents, those who are constantly taking their child’s car seat out of the car for cleaning and those who never remove it from its secure position in the vehicle.
My husband (an award winning pediatrician) and I used to fall in the first camp. Then we came up with a solution. The S.A.F.E.R. Child Car Seat Cover provides a washable cover that doesn’t require removal of the child seat from the car.
Here’s our story:
We spend a lot of time in our car. Whether it’s taking the kids to school, afternoon or weekend activities or the long drives to grandma and grandpa’s house. All that driving often equals hungry and restless kids. The Cheerios® that used to pacify our kids at a younger age, soon turned into sticky apple slices, crumby granola bars, and drippy drinks. These snacks didn’t always make it into our kids’ mouths. More times than not, we’d find the leftovers in the child car seat. And after playground dates, our worn out kids mixed their dirty bottoms with this flavorful mess.
The only way to try and return their car seat to “like new condition” was to unfasten it from the vehicle, unhook the harness straps from the back of the seat, and then peel away the manufacturer’s car seat cover. Into the wash it went and if we were lucky, some of the stains disappeared. Then we’d reverse the process to put the seat back together. This process is not easy and takes plenty of time. When we’d go to put the child car seat back into our car, we could never quite get it right and would have to venture to our local Division of Motor Vehicles (DMV) for a trained technician to properly resecure it.
Sitting and talking with other parents, we knew we weren’t alone. Our frustrations were echoed amongst our friends. Some told us stories of leaky diapers and potty training accidents. Others, had kids who easily became carsick and frequently vomited. We’ve all experienced runny noses and drool that finds their way onto sleeves and nearby surfaces.
Searching the shelves at our local baby and toddler store, we found all sorts of mess-preventing items, like sippy cups, bibs, and high chair mats, but we couldn’t find something that would protect our child’s car seat cover from the inevitable every day dirt and grime accumulation. How could we create a better way to clean our children’s car seat covers while keeping them safe?
We turned our frustrations into action. Once we put our children to bed, we turned “together time” into “brainstorm time”. We carefully looked at both outgrown and current seats and we tried to figure out how to remove a car seat cover without having to disassemble the seat. We put our ideas on paper. We drew car seats and cut out the paper models. We did the same thing with scrap fabric. We even cut apart the manufacturers car seat cover to fully explore some options. Our late nights led to creation of specially designed release elements for a child car seat cover…5 years and many prototypes later, the S.A.F.E.R. Child Car Seat Cover was born!
The S.A.F.E.R. Child Car Seat Cover – (Secure And Fast, Easily Removable) – allowed us to remove and wash an otherwise disgusting car seat cover without having to jeopardize the car seat’s secure position in our car. It took less than 1 minute to remove and put back the cover. Our kids could now sit in a clean seat and we could eliminate removing the entire seat from the car, and avoid additional trips to the DMV. And, since proper hygiene is the first line of defense in keeping your child well and safe from illness, we now had an easy way to ensure our car was as safe an environment as our home!
But there were other ways we wanted it to be “SAFER” too. During the manufacturing process, we made sure the S.A.F.E.R. Child Car Seat Cover underwent lab testing that included checking for absence of specific toxins and against flammability. The testing also included proper washability, ensuring that it will hold up to multiple washes in the washing machine. In the end, we came up with a cover that was <1/8 inch thick and slipped easily on top of an existing car seat cover.
Once we were comfortable with our solution we knew we wanted to market it so kids like yours could be S.A.F.E.R., too. We were granted two patents for our designs and received a “Gold Medal” at INPEX 2008- America’s largest invention trade show.. Most important of all we received numerous comments from parents like you that their child’s car seats were a mess and they hated cleaning them…the S.A.F.E.R. Child Car Seat Cover made all the difference.
Car Seat Safety
- Always check that your child car seat is tightly secured in your vehicle by pushing and pulling it side to side. It should not move more than one inch in either direction. We encourage a child car seat to be installed at least initially by a certified child passenger safety technician. Locate one in your state here
- Shoulder harness straps for children in a forward facing car seat should always sit at or above the child’s shoulders. The S.A.F.E.R. Child Car Seat Cover has 3 levels of slots, designed to line up with a manufacturer’s original design.
- Harness straps should be pulled tightly against your child and the chest clip should be at armpit level. Do not wear winter coats in a child car seat.
Keeping your child seat cover clean:
- When washing a child seat cover, wash it in a mesh bag on a gentle cycle to minimize damage (the S.A.F.E.R. Child Car Seat Cover can be washed in the mesh “wash me” bag in which it was originally packaged).
- Since the cover needs to maintain its shape to function properly, hang it to dry overnight – do not put it in a dryer. This will reduce the possibility of shrinkage.
Hi! I’m Bruce Mather, the inventor of the SeatSnug which enhances the safety and comfort of children in car booster seats. How did I end up inventing a new child safety device? Because I like to drive fast. Very fast. Let me explain.
Some people take golf lessons. Some people take tennis lessons. I take driving lessons. Like millions of others, I enjoy driving my car very fast and I take my every day car out on a racetrack to do so, where a professional driver coaches me on how to drive even faster.
As I’m sure you know, race car drivers use multi-point harnesses in their cars for better driving control and for safety. But, because I was using the car I drove to work in every day as my race car, it was not convenient to put harnesses in it. Unfortunately, this meant I was sliding around all the time at the track, and not able to control the car as well as I would like because the car’s seat belt allows looseness to develop in the lap belt while riding.
So I invented the CG-Lock to hold me in the seat, yet keep the car unmodified. The CG-Lock is a small, palm sized device that easily clips onto the buckle part of your seat belt. What it does is allow you to lock the lap belt portion of your seat belt from gentle to very tight. Think of an aircraft seatbelt. You buckle it up, and pull on the loose end to make the lap belt as tight as you want. That’s what the CG-Lock does, except it does it with a seat belt that also has a shoulder belt portion. You buckle your seatbelt and pull up on the shoulder belt to make the lap belt as tight as you want. The shoulder belt is unaffected, so you can stretch and reach as usual. After all, this is your daily driver. The lap belt stays as tight as you have set it until you unbuckle or push a lever that releases the tension.
So how did this turn into a child safety device? Because of a rule: when sports car drivers take driving instruction, both the driver’s and the passenger’s seats must be equipped identically. This means that a sports car driver using a CG lock for better control, must also put one on the instructor’s seat. Since most of these cars are driven daily, moms use the cars too. And some of the moms began writing us how much of an improvement in stability and comfort the CG-Lock provided. They suggested that the CG-Lock could be used to more safely secure children in booster seats and older children who are not safely secured by the seat belt itself.
When I looked into this unexpected use for the CG-Lock, I found there was a big need to improve booster seat safety. Booster seats rock and tip, allowing looseness or slack to develop in the lap belt portion of the seatbelt. This not only makes the seat rock more and sometimes even fall over, but it allows the child to slouch. This is dangerous. In the event of an accident, a loose lap belt can ride up over the abdomen of the child causing severe injury. Abdominal injuries are the most common injuries for children in booster seats after an accident. Further, a loose lap belt can allow a child to submarine under the belt or to be thrown against the side of the vehicle or to be ejected. A slouching child also allows the seat belt to be out of position when an accident occurs and to not be properly positioned to take optimum advantage of the safety equipment in the vehicle.
So it looked like the CG-Lock was a great product for child safety. But when I tested it with a larger number of moms, I found that most did not like the look, weight, or attachment method. To meet moms’ needs, I needed to completely redesign the CG-Lock…I did, and called it SeatSnug. Now it gets really interesting!
Using a modified version of the government’s child car seat crash test protocol, and an instrumented six year old sized “crash test dummy” at 30 miles an hour, I found that the G forces on a child would be about 7 Gs less at the chest and 11 Gs less at the hips when SeatSnug is added to the seatbelt! Wow! These were amazing improvements in the safety potential measurements. In addition, with only a gentle tightening, the lap belt always stays low across the upper thighs and hips of the child (exactly where the government and child car seat manufacturers recommend). This gentle tightening restricts the booster seat from rocking or tipping to make the child more comfortable too. I’ve even received testimonials that the reduced bouncing reduces car sickness. Finally, a snugged lap belt means the child is sitting up straight at all times, which is the optimum position for absorbing the energy in the event of a crash.
Most parents, like me during track days, probably thought the manufacturer-supplied seatbelts found in cars today are sufficient for providing the safest possible situation for their children. Not true! As I soon found out, standard, comfortable, one-size-fits-all seatbelts alone can’t offer maximum protection to occupants, including small children. SeatSnug solves that problem and enhances both safety and comfort for children.
Parents’ and Grandparents’ awareness of the problem, and the SeatSnug solution, is JUST starting to grow and I am very proud of the acceptance our devices are receiving. Now, our CG-Lock is widely used by the motion picture industry during the performance of dangerous driving scenes to enhance driving control and safety. I like to think if the CG-Lock is good enough for James Bond, it should be something every parent would want in every vehicle to protect their loved ones.
To help raise awareness that you CAN do more to protect your children, Lap Belt Cinch, Inc. announced the SeatSnug “Snug Up America” campaign – a major nationwide children’s safety campaign aimed at promoting greater child passenger safety and awareness. To join SeatSnug in helping to raise awareness by educating others on child passenger safety issues visit www.seatsnug.com and click on the “Snug Up America” button to see how you can make a difference.
About Booster Seats:
Children of booster seat age and/or weight should ride in a booster seat in the rear seat. To locate the age and weight requirements for your state, visit
Check out booster seats to make certain they properly fit your child.
Always buckle up children in booster seats with the seatbelt. Make certain that the shoulder strap properly fits across a child’s chest, over the shoulder and not across the neck. Visit safekids.org for the “safety belt fit test”.
For an instructional video on how to best secure your child in a booster seat, click here.
Did You Know???
- An estimated 8,959 lives were saved by child restraints from 1975 to 2008.
- Still…each year, thousands of children are tragically injured and killed in automobile accidents.
- Motor vehicle crashes are the leading cause of death for children ages 3 and older. Why???
- The National Highway Traffic Safety Administration (NHTSA) estimates that nearly 3 out of 4 car seats are not used correctly. And most of these parents have no idea…
NHTSA is aiming to change that with National Seat Check Saturday on September 25. As part of Child Passenger Safety Week (September 19-25), communities nationwide will have certified technicians available to provide hands-on child safety seat inspections and advice – for free! Click here to find nearby car seat inspection stations on National Seat Check Saturday and throughout the year. Other resources available to you:
- A poster for you to place on your blog to help spread the word about Child Passenger Safety Week and National Seat Check Saturday to other parents and caregivers
- A site where you can easily find instructional videos, handy informational flyers, and links to product ratings and recall lists …and FINALLY
- The Child Passenger Safety Twitter account (@childseatsafety) will be hosting a Twitter party on Wednesday, September 22 at 2 p.m. EST. NHTSA experts will be available to offer information and insight on car seats and how to travel safely with children. Just use the hashtag #CPSweek to follow along and ask your questions.
Thanks for helping us save lives!!