Related Experiment Video
Updated: Dec 7, 2025
A Test Bed to Examine Helmet Fit and Retention and Biomechanical Measures of Head and Neck Injury in Simulated Impact
Published on: September 21, 2017
Pediatric Safety Restraint Use in Motor Vehicle Crashes at a Level I Safety-Net Trauma Center
Scott Sylvester1, Jamie M Schwartz2, Albert Hsu3
1Department of Surgery, University of Florida, College of Medicine-Jacksonville, Jacksonville, Florida.
Insights
Many children are improperly restrained in vehicles, increasing injury risk. Improving child passenger safety requires understanding and addressing barriers to proper restraint use.
Area of Science:
- Pediatric Trauma
- Public Health
- Injury Prevention
Background:
- Child passenger safety is critical for preventing motor vehicle crash injuries and fatalities.
- Non-adherence to safety recommendations can significantly increase a child's risk of injury.
Purpose of the Study:
- To investigate the use of safety restraint devices among children under 15 admitted to a trauma center.
- To assess compliance with state recommendations for child passenger safety.
Main Methods:
- A retrospective review of a level I trauma center's database over a two-year period.
- Inclusion criteria: children (<15 years) admitted after motor vehicle crashes, with identifiable restraint information.
- Exclusion criteria: patients with unknown restraint details or discharged directly from the trauma center.
Main Results:
- Of 80 included children, 40% were unrestrained and 27.1% were improperly restrained.
- Improper restraint often involved front-seat placement before the recommended age.
- Unrestrained children had lower Glasgow Coma Scale scores and higher Injury Severity Scores, indicating more severe injuries.
Conclusions:
- A significant proportion of children admitted to a safety-net trauma center are suboptimally restrained.
- Further research is needed to identify barriers to compliance with child passenger safety recommendations.
- Targeted educational campaigns are necessary for populations with low compliance rates.
Background:
Adherence to child passenger safety recommendations is essential to prevent death and injury in children involved in motor vehicle crashes. Parents may not undertake the proper safety measures, which can lead to increase injury.
Methods:
A safety net, level I trauma center's database was used to identify admitted children (age<15 y/o) involved in motor vehicle crashes over a 2-y period to investigate safety restraint device use and compliance with state recommendations. Variables evaluated were crash characteristics, presence and method of passenger restraint, demographics, Glasgow Coma Scale, and Injury Severity Score. Excluded were patients where restraint characteristics could not be identified and those discharged from the trauma center.
Results:
Eighty patients met inclusion criteria. Thirty-two (40%) children were unrestrained. Safety restraint device was noted in 48 (60%) children with 13 (27.1%) patients improperly restrained. The most common method of improper restraint (6, 46.2%) was traveling in the front seat before the age state law recommends. With respect to proper, improper, and no restraint, age (7.31 ± 14.26, 5.76 ± 3.24, P = 0.36), female sex (17, 8, 13, P = 0.32), low-income status (14, 5, 24, P = 0.28), and race (P = 0.08) did not differ between the groups. The unrestrained children had statistically lower initial Glasgow Coma Scale and higher Injury Severity Score and were more often involved in high-risk mechanism of Injury motor vehicle crashes.
Conclusions:
Despite recommendations and regulations regarding child passenger safety measures, there are a significant number of children that remain suboptimally restrained who are admitted to a safety-net trauma center. Further research is needed to understand the barriers to increase the compliance with recommendations along with targeted educational campaigns in low-compliance populations.
Related Concept Videos
01:29Drug Dosing: Infants and Children
01:21Cardiopulmonary Resuscitation I: Adult