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Newborn car bed testing in a community hospital: implementing the American Academy of Pediatrics recommendations
Richard E Wilker1, Brenda J Cotoni2, Carolyn S Mirando2
1Department of Pediatrics, Newton-Wellesley Hospital, Newton, Massachusetts.
Insights
Newborns failing car seat tests can safely use car beds. This study successfully implemented American Academy of Pediatrics car bed challenge testing, ensuring infant safety during travel.
Area of Science:
- Neonatal care
- Pediatric safety
- Transportation safety
Background:
- The American Academy of Pediatrics (AAP) recommends car bed testing for infants who fail car seat challenges.
- Implementing this recommendation requires a structured testing protocol and defined failure criteria.
Purpose of the Study:
- To describe the experience of implementing AAP car bed challenge testing for infants.
- To evaluate the safety and efficacy of car bed use for infants who fail car seat tests.
Main Methods:
- Car seat challenge tests were conducted for 90 minutes or trip duration, whichever was longer.
- Infants failing car seat tests were subsequently tested in car beds, with pulse oximetry monitoring.
- Testing occurred in both normal newborn nurseries (NBN) and special care nurseries (SCN).
Main Results:
- Out of 197 infants tested in car seats, 177 (89.8%) passed.
- Of the 20 infants who failed car seat tests, 16 passed car bed tests and were discharged.
- All infants who failed the car bed challenge were initially NBN patients.
Conclusions:
- Successfully implemented AAP car bed challenge testing using 93% as the lower limit of oxygenation.
- Car bed testing is a viable strategy for ensuring the safety of infants who cannot pass car seat challenges.
Objective:
This study was designed to describe our experience in implementing the American Academy of Pediatrics (AAP) recommendation to test infants in a car bed if they fail a car seat challenge test.
Study Design:
Car seat challenge testing was performed for 90 minutes or the anticipated duration of the trip home, whichever was longer. Based on the pulse oximetry saturation values (90-92% or < 90%) two categories of test failure were used. Infants who failed in the car seat were tested in the car bed. Testing took place in both the normal newborn nursery (NBN) and special care nursery (SCN). NBN babies who failed in the car bed were transferred to our SCN for additional assessment and management.
Results:
A total of 197 infants were tested in car seats out of which 177 (89.8%) passed the test. Of the 20 infants who failed, 16 passed the car bed challenge test on the first attempt and were discharged in those devices. All infants who failed the car bed challenge were NBN patients.
Conclusions:
Using 93% as the acceptable lower limit of oxygenation we successfully implemented the AAP recommendations for car bed challenge testing in our nursery.
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