Car Seat Safety: Literature Review

After staggering numbers of infants were killed in automotive crashes in the 1970s, the American Academy of Pediatrics (AAP) recommended in 1974 universal use of car seats for all infants. However, positional problems were reported when car seats are used with premature infants less than 37 weeks gestational age as a result of head slouching and its sequelae. In 1990, the AAP responded with another policy statement introducing car seat testing. It recommended that any infant at or under 37 weeks gestational age be observed in a car seat prior to discharge from the hospital. The AAP did not give specific guidelines on type of car seat, length of testing, equipment, or personnel proficiency, however. Few nurseries have standard policies to evaluate car seats, to teach parents about car seats, or to position newborns in them, and not all hospitals actually conduct car seat challenges or have common standards for testing that is performed.

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Monitoring Premature Infants in Car Seats: Implementing the American Academy of Pediatrics Policy in a Community Hospital

PEDIATRICS ◽

10.1542/peds.91.6.1137 ◽

1993 ◽

Vol 91 (6) ◽

pp. 1137-1141

Author(s):

Joel L. Bass ◽

Kishor A. Mehta ◽

Jeanne Camara

Keyword(s):

At Risk ◽

American Academy ◽

Premature Infants ◽

Community Hospital ◽

Medical Center ◽

Monitoring Program ◽

Policy Statement ◽

Car Seat ◽

American Academy Of Pediatrics ◽

Level Ii

Objectives. In 1990, the American Academy of Pediatrics (AAP) Committeee on Injury and Poison Prevention issued a policy statement which recommended that all infants born at less than 37 weeks gestational age be monitored in their car seat before discharge to identify infants at risk for apnea associated with car seat use. The objective of this report is to summarize the experience of a community hospital in implementing this recommendation, including: education of health professionals about the problem and its management, development of an effective hospital policy and procedure for testing at-risk infants, overcoming logistical difficulties for nursing staff who implement the policy, overcoming liability concerns, and summarizing the clinical results which we observed during a 15-month period. Methods. MetroWest Medical Center, Framingham Union Campus is a community hospital with a Level II Neonatal Unit with approximately 2200 deliveries annually. Hospital procedures and policies were developed to implement the AAP policy for safe transportation of premature infants. Consequently, infants less than 37 weeks gestation at birth were monitored for a 90-minute observation period for oxygen saturation, apnea, or bradycardia in the car seat that they would be going home in from the nursery. Results. Policies and procedures for car seat monitoring were instituted successfully during 15-month period. Sixteen of 87 (18.4%) monitored infants 26 to 36 weeks gestation had abnormal results. In addition, one 37-week gestational newborn who was monitored because of duskiness during feeds also became apneic and bradycardic in the car seat. Conclusions. A car seat monitoring program can be incorporated effectively into a Level II community hospital nursery discharge plan provided that appropriate medical staff policies, nursing procedures, and administrative support to deal with the logistics of the program is established. Our monitoring results are consistent with previous reports that premature infants are at risk of desaturation in a car seat. In addition, we have demonstrated that a full-term neonate may also be at risk if other evidence of desaturation (eg, duskiness during feedings) is observed.

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Pediatric Clinical Practice Guidelines & Policies

10.1542/9781610021494 ◽

2018 ◽

Author(s):

Keyword(s):

Clinical Practice ◽

American Academy ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Policy Statement ◽

Clinical Report ◽

American Academy Of Pediatrics ◽

Technical Report

Keep current with the latest clinical practice guidelines and policies from the American Academy of Pediatrics covering more than 40 clinical practice guidelines, plus every AAP policy statement, clinical report, and technical report through December 2017.

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Policy of the Academy on Day Care: Some Doubts I. From Indiana

PEDIATRICS ◽

10.1542/peds.53.1.123 ◽

1974 ◽

Vol 53 (1) ◽

pp. 123-123

Author(s):

Robert M. Sweeney

Keyword(s):

Child Care ◽

American Academy ◽

Executive Committee ◽

Day Care ◽

Policy Statement ◽

Daycare Centers ◽

American Academy Of Pediatrics ◽

General Tone

The policy statement on day care released in Pediatrics has been discussed at length by the Executive Committee of the Indiana Chapter of the American Academy of Pediatrics. It is understood that it is necessary on the part of the American Academy of Pediatrics to make such a policy statement regarding daycare centers. One does, however, become somewhat concerned regarding the general tone and philosophy of the statement. It is felt that it mainly glosses over the fact that, for most children, child care and guidance are best given in the homes by the families.

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