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Childhood Crash Injury Patterns Associated with Restraint Misuse: Implications for Field Triage

Published online by Cambridge University Press:  28 June 2012

Eileen M. Bulger ,
Robert Kaufman  and
Charles Mock
Eileen M. Bulger*
Affiliation:
Department of Surgery, University of Washington, Seattle, Washington, USA The Harborview Injury Prevention and Research Center, Seattle, Washington, USA
Robert Kaufman
Affiliation:
The Harborview Injury Prevention and Research Center, Seattle, Washington, USA
Charles Mock
Affiliation:
Department of Surgery, University of Washington, Seattle, Washington, USA The Harborview Injury Prevention and Research Center, Seattle, Washington, USA
*
Associate Professor of Surgery Box 359796 Harborview Medical Center 325 9th Ave Seattle, WA 98104 USA E-mail: ebulger@u.washington.edu
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Abstract

Introduction:

Restraint misuse is a common problem leading to increased morbidity and mortality for children involved in motor vehicle crashes. The purpose of this project was to describe the injury patterns associated with restraint misuse in the pediatric population, with particular focus on clues to significant injury that can be identified by the prehospital provider that may impact subsequent triage decisions.

Methods:

This is a case series presentation that illustrates the injury patterns associated with various types of restraint misuse in infants (ages 0–1 years), toddlers (age 1–4 years), young children (ages 4–8 years), and pre-teens (ages 8–14 years). Cases were identified from the Crash Injury Research and Engineering Network (CIREN) database.

Results:

Six cases are presented that illustrate the injury patterns associated with misuse of rear-facing infant car seats (0–1 years), forward-facing child seats (1–4 years), booster seats (4–8 years), and shoulder belts (8–14 years). Prehospital assessment of appropriate restraint use is described.

Conclusions:

Restraint misuse in children is a common problem. Emergency medical services providers need to be aware of these issues when assessing children and determining appropriate triage to a trauma center. Ongoing educational efforts also are vital to inform parents regarding the risks of inappropriate restraint use and can encourage legislators to better define appropriate restraint use for older children.

Keywords

childhood crash injuriesfield triagemotor vehicle crashesrestraint misuse
Type
Review Article
Information
Prehospital and Disaster Medicine , Volume 23 , Issue 1 , February 2008 , pp. 9 - 15
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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