Riley Riders Bike Safety Smart Program.
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Biomedical subjects
Publications and source records attributed to K B Stroup.
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OBJECTIVE: To determine what child restraints would accommodate infants with Pierre Robin sequence who often require special attention in motor vehicle travel since microagnathia usually requires a prone position to keep the infant's airway open. RESEARCH DESIGN: Dynamic testing and clinical trial. SETTING: An Indiana children's hospital providing primary and tertiary care. PATIENTS: Four patients with Pierre Robin sequence are described to illustrate use of the modified infant car seat and the appropriateness of the car bed restraints for meeting requirements for prone positioning during travel. SELECTION PROCEDURES: Convenience sample. INTERVENTION: Selected restraints were loaned to families through a clinical setting until the patient was able to use a conventional child restraint. MEASUREMENTS AND RESULTS: Three child restraint systems were determined to accommodate the prone position necessary to keep the airway open for children with Pierre Robin sequence. Dynamic crash testing demonstrated the crashworthiness of an infant car seat modified to allow for prone positioning. Through a clinical trial, two car bed restraints were also found to provide safe prone positioning of infants. CONCLUSIONS: To enable safe transportation for infants with Pierre Robin sequence, health care providers can direct parents to appropriate resources for travel and can monitor the airway and oxygenation of the infant with Pierre Robin sequence before hospital discharge.
Although many students with disabilities are transported daily in school vehicles, few state guidelines address special transportation needs. This study collected information from two states on the types of vehicles and safety restraints used, and the problems encountered by public schools, community agencies, and rehabilitation centers that transport people with disabilities from birth to 21 years of age. The information collected, together with a review of research on special needs transportation, contributed toward development of state regulations for school buses used to transport special education students. Vehicular transportation safety is an important part of individualized education planning for the 18.6% of occupational therapists working in schools. Using this study's questionnaires, occupational therapists who are primary resources for selection of seating and transportation equipment may become informed advocates for implementing safer transportation on an individual and state level for clients with disabilities.
Attention must be devoted to proper positioning and selection of an appropriate child restraint system for infants with severe hydrocephalus to reduce the risk of potential injury during motor vehicle travel. Due to the infant's head size, parents may fear the head and neck will fall forward, or they may encounter difficulty positioning the head forward-facing in a child safety seat. Two case studies illustrate how a commercially available infant-only care seat can be modified to accommodate the infant with severe hydrocephalus and how use of a car bed restraint can meet positioning needs of these infants.
Car seat loan and rental programs have provided many families with low-cost access to child restraints. When an infant or child is unable to be accommodated in a standard car seat or seat belt owing to physical or medical problems, parents of these children have few, if any available resources. The establishment and operation of a loan program at the Indiana University School of Medicine for children who are medically fragile is reviewed in this article. This program was developed by the Automotive Safety for Children Program at the James Whitcomb Riley Hospital for Children, Indiana University Medical Center, to meet the special transportation needs of children with respiratory, orthopaedic, and other medical and physical difficulties. A summary table is included to highlight restraints that have performed satisfactorily during dynamic crash tests and are used to meet patient transportation needs at Riley Hospital. Guidelines for establishing and maintaining a child restraint loan program for children with special needs are outlined to encourage replication of this effort.
Few guidelines are available on providing safe transportation for children who cannot use conventional auto restraints. This article discusses the misuse of restraints and reviews several modified car seats and other restraints that have been tested and that meet safety standards.
Automotive restraint systems suitable for use with low birth weight infants were crash tested using a small infant dummy developed for the study. Conventional semiupright rear-facing child restraints were tested, as well as a new car bed restraint that may be advantageous for infants who are medically fragile and who must remain in a prone or supine position. This car bed can be adapted to accommodate a very small infant effectively.
Correct use of car seats for small children is essential to prevent serious injuries and death from automotive accidents. Failure to use a car seat properly can contribute to serious injury or death of a child. A case study in which misuse of a car seat occurred is reported. The infant died of hemorrhage and shock secondary to liver laceration which resulted from excessive pressure over the abdomen sustained on impact. Surveys of car seat use for small children prior to and following a child restraint law are also reported. Observers noted types of car seats and specific forms of misuse. Survey results suggest that parents are more likely to misuse car seats for infants than toddlers. Medical professionals can reinforce the importance of proper car seat use by incorporating specific car seat use questions into the patient interview and by providing educational materials.
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Treatment of children with congenitally dislocated hips requires that an infant be placed into a plaster spica cast for a duration of 3 to 12 months. Because the use of a safety seat is difficult, if not impossible, for children fitted with a brace or spica cast, a solution for safe transportation was developed. A Century child restraint model 100 or the Century model 300 was selected as appropriate for modification. Seat padding was removed from the lower sides of the plastic shell, and the shell was cut. The seat padding was replaced and taped tightly to the outer side of the shell. An impact test of the modified safety seat at the University of Michigan Transportation Research Institute indicated that the modification of the shell did not compromise the performance of the restraint system. Seats with this modification have been loaned to children treated at the James Whitcomb Riley Hospital for Children with satisfactory results.
Advancements in health care have made it possible for many premature infants weighing less than 2.2 kg (5 lb) to be discharged from the hospital. Medical professionals, however, have no information available from which to make recommendations on which child safety seats are most appropriate for safely transporting the low-birth-weight infant. Current federal safety standards do not specify the minimum weight of an infant for which a seat is appropriate. The suitability of various types of infant car safety seats for premature infants was documented by placing 2.0-kg (4 lb 8 oz) babies in a representative sample of seat models. Ease and ability of the seat to fit the size of the infant and allow for proper positioning of the baby was noted. Each seat was measured from the seat back to crotch strap and shoulder strap to seat bottom to provide a basis for comparison of various seat models. Convertible seats with seat back to crotch strap height of 14 cm (5 1/2 in) or less provided relatively good support for the infant. Seats with longer seat back to crotch strap distances allowed the infant to slouch. Seats with lap pads or shields were uniformly unacceptable.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Pediatric orthopaedic surgery clients may be unable to safely, comfortably, and affordably use child safety seats (car seats) for a variety of reasons. This article describes commercially available child safety seats suitable for transporting pediatric orthopaedic surgery clients. Discussed are those children with cerebral palsy, spina bifida, hip dislocations, arthrogryposis, scoliosis, and osteogenesis imperfecta.
While motor vehicle crashes remain one of the leading causes of death and injury to children, proper and consistent use of child safety seats and safety belts can greatly improve children's chances of survival in motor vehicle crashes. Children with orthopaedic conditions and children after orthopaedic surgery, however, may be restricted to specialized child restraint options that are capable of providing proper fit and safe travel for a period of time after the procedure. To assure proper selection and avoid secondary injury, parents and health care professionals need to be aware of best practices for transporting children postoperatively and of restraint options that exist for children with orthopaedic conditions.