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Crash protection for children in ambulances
1Department of Pediatrics, Developmental Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
Insights
Securing children in ambulances is crucial. Crash tests show a two-belt system with an elevated cot backrest is most reliable for child restraints and car beds, ensuring child safety during transport.
Area of Science:
- Emergency Medical Services
- Pediatric Safety
- Crashworthiness Engineering
Background:
- Effective restraint of children during ambulance transport is a critical safety concern.
- Existing methods for securing pediatric patients on ambulance cots have shown variability in performance.
- Standardized procedures are needed for emergency medical service (EMS) providers.
Purpose of the Study:
- To identify the most effective and reliable methods for restraining children on ambulance cots.
- To develop recommended field procedures for EMS personnel.
- To enhance pediatric patient safety during emergency medical transport.
Main Methods:
- Conducted crash tests at 48 km/h using various child restraint systems (convertible restraints, car beds, harness systems).
- Utilized infant, 3-year, and 6-year size dummies for testing.
- Varied belt configurations and backrest positions to evaluate restraint performance.
Main Results:
- A new cot and fastener system demonstrated significantly improved restraint performance compared to older systems.
- A two-belt attachment with an elevated cot backrest exhibited the least performance variability for both convertible child restraints and car beds.
- None of the tested harness configurations were satisfactory, though potential for improvement exists.
Conclusions:
- Children weighing up to 18 kg, fitting in a convertible child restraint, and tolerating a semi-upright position can be safely restrained using a two-belt system on an elevated ambulance cot.
- Infants requiring a flat lying position can be secured in a modified car bed with two seatbelt paths, attached to an elevated cot.
- All systems require crashworthy cots and anchor systems; harness systems need further development based on established restraint principles.
Abstract:
The objectives of the study were to determine the most effective and reliable means of restraining children on an ambulance cot and to develop recommended field procedures for emergency medical service providers. A series of crash tests at 48 km/h were conducted using convertible child restraints, car beds, and harness systems tested with 3-year, infant, and 6-year size dummies. Belt configuration and backrest position were varied. A new cot and fastener system significantly improved restraint performance over older systems previously tested. A two-belt attachment with elevated cot backrest was found to be the method with the least performance variability for securing either a convertible child restraint or a car bed. It was concluded that children who weight up to 18 kg, fit in a convertible child restraint, and can tolerate a semi-upright seated position can be restrained in a convertible child restraint secured with two belts to an ambulance cot. Infants who must lie flat can be restrained in a car bed modified for two seatbelt paths and secured to a cot. In each case, the cot backrest must be elevated, and the cot and anchor system must be crashworthy. None of the harness configurations tested proved to be satisfactory, but an effective system could be developed by following accepted restraint design principles.