Discordance between age- and size-based criteria of child passenger restraint appropriateness

Smiley, Mary L.; Bingham, C. Raymond; Jacobson, Peter; Macy, Michelle L.

doi:10.1080/15389588.2017.1403016

Cited by 5 publications

(3 citation statements)

References 24 publications

(32 reference statements)

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“…Patients between 12 and 15 years were considered appropriately restrained if they were in a CSS, BPB, or seat belt only. 26,27 There were 113 properly restrained (30.7%), 116 improperly restrained (31.3%), and 137 unrestrained patients, and there were no significant differences in mean age, sex, insurance, or disposition across the 3 groups (Table 1). Properly restrained children were more likely to be White ( p = 0.0033), demonstrating a possible racial disparity of restraint status that has also been previously demonstrated in the literature.…”

Section: Resultsmentioning

confidence: 97%

“…Patients between 4 and 12 years old were considered appropriately restrained if they were in a CSS or belt-positioning booster car seat (BPB). Patients between 12 and 15 years were considered appropriately restrained if they were in a CSS, BPB, or seat belt only 26,27 . There were 113 properly restrained (30.7%), 116 improperly restrained (31.3%), and 137 unrestrained patients, and there were no significant differences in mean age, sex, insurance, or disposition across the 3 groups (Table 1).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Lower incidence of blunt cerebrovascular injury among young, properly restrained children: An ATOMAC multicenter study

Nickoles

Lewit

Notrica

et al. 2023

J Trauma Acute Care Surg

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BACKGROUND:Motor vehicle collision (MVC) remains a leading cause of injury and death among children, but the proper use of child safety seats and restraints has lowered the risks associated with motor vehicle travel. Blunt cerebrovascular injury (BCVI) is rare but significant among children involved in MVC. This study reviewed the incidence of BCVI after MVC causing blunt injury to the head, face, or neck, comparing those that were properly restrained with those that were not. METHODS:A prospective, multi-institutional observational study of children younger than 15 years who sustained blunt trauma to the head, face, or neck (Abbreviated Injury Scale score >0) and presented at one of six level I pediatric trauma centers from 2017 to 2020 was conducted. Diagnosis of BCVI was made either by imaging or neurological symptoms at 2-week follow-up. Restraint status among those involved in MVC was compared for each age group. RESULTS:A total of 2,284 patients were enrolled at the 6 trauma centers. Of these, 521 (22.8%) were involved in an MVC. In this cohort, after excluding patients with missing data, 10 of 371 (2.7%) were diagnosed with a BCVI. For children younger than 12 years, none who were properly restrained suffered a BCVI (0 of 75 children), while 7 of 221 (3.2%) improperly restrained children suffered a BCVI. For children between 12 and 15 years of age, the incidence of BCVI was 2 of 36 (5.5%) for children in seat belts compared with 1 of 36 (2.8%) for unrestrained children. CONCLUSION:In this large multicenter prospectively screened pediatric cohort, the incidence of BCVI among properly restrained children under 12 years after MVC was infrequent, while the incidence was 3.2% among those without proper restraint. This effect was not seen among children older than 12 years. Restraint status in young children may be an important factor in BCVI screening.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Lower incidence of blunt cerebrovascular injury among young, properly restrained children: An ATOMAC multicenter study

Nickoles

Lewit

Notrica

et al. 2023

J Trauma Acute Care Surg

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“…Since then, little progress has been made in the use of recommended CRSs and motor vehicle collisions remain a leading cause of unintentional injury‐related deaths for children in the United States . Many U.S. children travel completely unrestrained and differences in CRS use between minority and white children contribute to disparities in crash‐related fatalities . Additionally, nonfatal injuries place a substantial burden on children, their families, and society …”

mentioning

confidence: 99%

Pilot Trial of an Emergency Department–based Intervention to Promote Child Passenger Safety Best Practices

Macy

Kandasamy²,

Resnicow

et al. 2019

Academic Emergency Medicine

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Background: Despite demonstrated effectiveness of child restraint systems (CRSs), use remains suboptimal. In this randomized pilot trial, we sought to determine the feasibility, acceptability, and potential efficacy of "Tiny Cargo, Big Deal" an ED-based intervention to promote guideline-concordant size-appropriate CRS use.Methods: Parents of children < 11 years old were recruited in two EDs and randomized in a 2 9 2 factorial design to four conditions: 1) generic information sheet, 2) tailored brochure mailed after the ED visit, 3) a single motivational interviewing-based counseling session in the ED, and 4) full intervention (counseling session plus tailored brochure). We assessed feasibility (recruitment, completion, follow-up rates) and acceptability (parent attitudes, uptake of information) in the ED, at 1 month and at 6 months. We obtained preliminary estimates of effect sizes of the intervention components on appropriate CRS use at 6-month follow-up.Results: Of the 514 parents assessed for eligibility, 456 met inclusion criteria and 347 consented to participate.Enrolled parents were mostly mothers (88.1%); 48.7% were 18 to 29 years old; 52.5% were non-Hispanic, white; and 65.2% reported size-appropriate CRS use. Completion rates were 97.7% for baseline survey, 81.6% for counseling, 51.9% for 1-month follow-up, and 59.3% for 6-month follow-up. In the ED, 70.5% rated thinking about child passenger safety in the ED as very helpful. At 1 month, 70.0% expressed positive attitudes toward the study. Of 132 parents who reported receiving study mailings, 78.9% reviewed the information. Parents randomized to the full intervention demonstrated an increase (+6.12 percentage points) and other groups a decrease (-1.69 to -9.3 percentage points) in the proportion of children reported to use a size-appropriate CRS at 6-month follow-up.Conclusions: Suboptimal CRS use can be identified and intervened upon during a child's ED visit. A combined approach with ED-based counseling and mailed tailored brochures shows promise to improve size-appropriate CRS use.

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Ride-Share Use and Child Passenger Safety Behaviors: An Online Survey of Parents

Savage

Kendi

Macy

2021

Academic Pediatrics

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Discordance between age- and size-based criteria of child passenger restraint appropriateness

Cited by 5 publications

References 24 publications

Lower incidence of blunt cerebrovascular injury among young, properly restrained children: An ATOMAC multicenter study

Lower incidence of blunt cerebrovascular injury among young, properly restrained children: An ATOMAC multicenter study

Pilot Trial of an Emergency Department–based Intervention to Promote Child Passenger Safety Best Practices

Ride-Share Use and Child Passenger Safety Behaviors: An Online Survey of Parents

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