A Public Meeting on Safe Transport for Kids on Ambulances
In the Federal Register, dated July 19, 2010, a notice and invitation was posted by the National Highway Traffic Safety Administration of the Department of Transportation (NHTSA). This Thursday – August 5th – NHTSA will be hosting a Public Meeting to hear comments regarding the newly-submitted draft recommendations for the safe transport of children in emergency ground ambulances.
What wonderful news! It’s about time that positive steps are finally being taken in the effort to establish consistent Federal guidelines for the safe transport of infants and children in emergency vehicles. This is most definitely a banner day for the Emergency Medical Service (EMS).
The issue of inconsistent guidelines for child emergency transport was first highlighted in a 1998 survey of state requirements for child safety restraints in ambulances, and the resulting report was the first to identify the many variations in guidelines existing from one state to another.
In 1999, a national consensus committee was convened to review EMS child transport practices. The resulting document, the “Do’s And Don’ts of Transporting Children in an Ambulance”, provided general guidance for EMS practitioners in the field. This document has remained the guide for the industry from then until now, even though protocols and practices remained inconsistent, often varied across jurisdictions and sometimes provided limited or inadequate guidance.
This problem is finally being publically recognized. The July 19th issue of the Federal Register states: “Currently 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 regarding the transportation of children in ground ambulances complicates the work of EMS professionals and may result in the improper and unsafe restraint of highly vulnerable child passengers. As a result, EMS agencies, advocates and academicians have turned to NHTSA for leadership on this issue.”
In September of 2008, in recognition of the need for improving child-oriented, safe, emergency ambulance transport, NHTSA initiated a project called: “Solutions To Safely Transport Children In Emergency Vehicles”, and formed a Working Group of experts in the field of Emergency Medical Services for the purpose of “drafting consistent national recommendations that will be embraced by local, state and national EMS organizations, enabling them to reduce the frequency of inappropriate and potentially unsafe transportation of ill, injured, or not sick/uninjured children in ground ambulances.”
In June of 2009, this website, Pediatric Safety.net was launched. This site made public awareness of the lack of safety guidelines and the use of inappropriately sized, non harness–equipped stretchers for child transport a primary concern. As a means of promoting awareness of the problem, pediatricsafety.net established a cause, ANSR (Ambulances Need Safety Regulations) for kids, which included a petition to be forwarded to each signer’s congressmen. The hope was that if enough people signed the petition, attention would force the government to play an active role in finding a viable solution to the problem.
In its “Innovation” section, pediatricsafety.net followed the development of the PedREST, a child-size safety transport system for infants and young children. From its humble beginnings as a crayon drawing concept idea, to a video prototype and now a physical prototype, the PedREST seemed to be a credible answer to the problem. Designed by an Emergency Medical Technician, it could, with a small amount of additional design modification by a qualified engineer, become this desperately needed safety transport device.
I am the cause advocate for Pediatric Safety. Two of my daughters were key in developing the PedREST. It took 15 years to get the PedREST through the patent process and the building of a prototype. Once created, it was disheartening to realize that companies were not falling all over themselves for the opportunity to take the idea and help commercialize it, so that it could be put to use as quickly as possible. What could be more important than protecting the life of an infant or small child already in the care of the very people committed to doing just that? What was even more upsetting was the fact that, even though so many articles had been written about the need for government intervention to establish industry guidelines, nothing had been publicly introduced over all these years to show that steps were at least being taken to that end.
Statistics say it all:*
- Approximately 1 in 10 patient ambulance transports involve children. The result: 6 Million Children are transported by emergency medical vehicles each year
- 3 out of every 100 transports involve children under 5 years of age. The result: approx. 1.8 million children are transported by emergency vehicles each year
- 5,000 ambulance crashes per year with minor to fatal results. The result: approx. 4 child fatalities per year
I think the time has finally come for action!
- Participate in the public hearing concerning the draft recommendations on safe transport for children on ambulances. Register for the webinar by sending an email to: sandy.sinclair@dot.gov
- Please sign the ANSR petition and tell your congressman/woman that we require that our kids be transported safely on ambulances – anything else is unacceptable!
Help us help NHTSA pass formal regulations and guidelines to be used on local, state, and national levels to keep our kids safe when they need it the most.
With thanks from all my grandchildren, and from me.
Sandy Schnee
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Reference:
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Dr Nadine Levick, MD/MPH, “Ambulance Transport Safety – Where is the State of the Art?”, Child Passenger Safety Conference NHTSA Region II, Sept 26th, 2008
Tweeners and Innovation
For the purpose of this discussion a tweener is a child who has outgrown a car seat and is too small for a conventional shoulder and lap belt configuration. The proper course of action to secure this group is to use booster seats. However, three states have no laws requiring the use of booster seats and in many others the requirements are vague and not enforced. In most cases of a tweener a shoulder belt does not fit correctly and the lap belt by itself is dangerous. Not knowing better many parents will tuck the shoulder belt behind the child, unaware of the hazard this poses.
Ford recently demonstrated a new shoulder harness with an air bag built into it. This is a tremendous improvement for all- especially for children. Regardless of the law in your state, regardless of whether you are required to use a booster seat- do it for the safety and life of your child. For more information on the new airbag and a compelling story to use booster seats please see the following Today Show video.
Making Changes for Safety
Now that we had 3-Dimensional pictures, it enabled us to make any necessary changes to make transporting children the safest way possible…
The most important one was going from a 3-POINT HARNESS…or this
to this…a 5-POINT HARNESS that allowed for a single strap to be detached rather than the entire harness, so if necessary it would allow a medical technician access to injuries without risking a child’s safety
Another change of critical importance was ADDING A BACKBOARD specifically designed to fit this seat. EMS personnel needed to be able to safely immobilize and transport a child with severe head or neck injuries to an emergency care facility, transfer the injured child into their care and then depart to handle the next emergency. Without a backboard, we soon discovered this was not possible. The child could be secured directly to the device, but then the device would need to remain behind…along with all the pediatric medical supplies stored in its compartments. The safest path for the child and best for the EMS staff was for us to add a backboard to the design…so that’s what we did.
Turning our 2-Dimensional Prototype into a 3-Dimensional One
The 2-D patent drawings were really just the first step in bringing our concept to life
With a little more help from our engineer…
we added some color…and some depth…
and our concept came alive
Child Passenger Safety is a 24/7/365 Job
For one week, Child Passenger Safety was on everyone’s mind! The National Highway Traffic Safety Administration and the Ad Council combined to make an all-out effort to get the message out: parents and other caregivers need to make the right choices regarding child safety car seats…and resources are available…help is available.
But one week is not enough time to get the message out to all who need to hear it. Child passenger safety, when it comes to choosing the right car seat, installing it properly, and making sure it that it is appropriately latched, is an issue that requires addressing 24 hours a day/ 7days a week/ 365 days a year.
To that end, the message has to continue. Everyone you know who transports young children needs to know that free help is available for the purpose of making sure that they are choosing safe car seats and using them properly.
On Twitter: Any child passenger safety questions will be answered by an actual safety expert. Go to the @ChildSeatSafety account on Twitter.
On Facebook: The page at http://facebook.com/childpassengersafety is the place for parents to learn about the LATCH program, location of inspection offices, and any other up-to-date information from NHTSA.
On the Website: Created by the Ad Council, in conjunction with NHTSA, http://childcarsafety.adcouncil.org/ is a website for parents to go to in order to be able to view instructional videos, locate inspection stations, and take a fun quiz to make sure you have the correct information regarding child passenger safety.
The more caregivers who become aware of, and utilize this information, the more childrens’ lives we save.
