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Finally – A Step Towards Safe Transport for Kids in Ambulances!

Last updated on August 8th, 2019 at 07:02 pm

In 2008 the National Highway Traffic Safety Administration (NHTSA) convened a working group of representatives from the American Academy of Pediatrics, Emergency Medical Services for Children, the American Ambulance Association, and other key organizations and started a project called “Solutions to Safely Transport Children in Emergency Vehicles”. Finally a long-standing problem was being recognized and addressed: “there are no Federal standards or standard protocols among EMS and child safety professionals in the U.S. for how best to transport children safely in ground ambulances from the scene of a traffic crash or a medical emergency to a hospital or other facility. The absence of consistent national standards and protocols … complicates the work of EMS professionals and may result in the improper and unsafe restraint of highly vulnerable child passengers.”(1)

In fact a 1998 study regarding the use of child restraints in ambulances revealed that 35 States did not require patients of ANY AGE to be restrained in a ground ambulance. Of those States that did require some sort of child restraint system, requirements for an “acceptable restraint” varied significantly.(2)

It is illegal in the US to travel with an unrestrained child in an automobile. However, when a child is already sick or injured, we have been willing to transport them in a vehicle where the passenger compartment is exempt from most safety requirements, they cannot be properly restrained and they have a higher probability of an accident than an automobile. We might not if we knew the following:

  • It is estimated that up to 1,000 ambulance crashes involve pediatric patients each year.(3)
  • In a collision at 35mph, an unrestrained 15kg child is exposed to the same forces as in falling from a 4th story window.(4)

Wednesday September 19, 2012, after an intense 2 year research effort, a public meeting in August 2010 to review the findings and gather input (see Pediatric Safety Post by Sandy Schnee “A Public Meeting on Safe Transport for Kids on Ambulances“), and 2 additional years refining the results, NHTSA has released the official:

BEST PRACTICE RECOMMENDATIONS FOR THE SAFE TRANSPORT OF CHILDREN IN EMERGENCY GROUND AMBULANCES Thank you NHTSA!!

The working group outlined 5 potential child transport “Situations” (see chart below) and for each described their “Ideal” solution – the best practice recommendation for safe a safe transport for each situation. They also presented an “If the Ideal is not Practical or Achievable” alternative – basically an “acceptable” backup plan.

They also came up with guidelines to assist EMS providers in selecting a child restraint system – particularly important because due to the lack of regulation and testing requirements specific to ground ambulances, many of the available child restraint devices were not designed for use in ambulances, some were tested to automotive standards and others were not tested at all.

In the end, the ultimate goal of ALL the recommendations: Prevent forward motion/ejection, secure the torso, and protect the head, neck, and spine of all children transported in emergency ground ambulances.

In short – transport these children safely.

We know that since the adoption of “mandatory use laws” in the U.S. for child safety restraints in automobiles, that thousands of children’s lives have been saved. Yet for years we have continued to allow children to be transported unrestrained on ambulances. With this report, we have finally taken a step in the right direction

It is hoped that the recommendations provided in this report will address the lack of consistent standards or protocols among EMS and child passenger safety professionals in the United States regarding how to most safely transport children in ground ambulances from the scene of a traffic crash or medical emergency to a hospital or other facility. It should be noted that the expectation is that States, localities, associations, and EMS providers will implement these recommendations to improve the safe transportation of children in emergency ground ambulances when responding to calls encountered in the course of day-to-day operations of EMS providers. In addition, it is hoped that EMS providers will be better prepared to safely transport children in emergency ground ambulances when faced with disaster and mass casualty situations”.

…. Amen to that !!

 

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Editorial Update: Quite a bit has happened since the original publication of this article. Suffice it to say that while this was a terrific step in the right direction – it was not enough to cause the system-wide level of change hoped for. According to ems.gov… unanswered questions remain, primarily due to the lack of ambulance crash testing research specific to children.To address this, in 2017 the National Association of State EMS Officials (NASEMSO) established the Safe Transport of Children Ad Hoc Committee, with the goal of improving the safety of children transported by ambulance through the creation of evidence-based standards. Pediatric Safety will continue to follow their efforts in future articles as they work to improve the national standard of care and establish consistent guidelines for the safe transport of all our children on ambulances. Every ride, every time.

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References:

1. Notice published by NHTSA of Public Meeting on August 5th, 2010 to discuss draft version Recommendations for Safe Transport of Children on Ground Ambulance Vehicles: Federal Register, July 19, 2010,

2 & 3. Working Group Best-Practice Recommendations for the Safe Transportation of Children in Emergency Ground Ambulances: NHTSA / USDOT, September 2012

4. “EMS to Your Rescue?” Int’l Forum on Traffic Records & Hwy Safety Info. Systems – Levick N, July, 2008

Research Trials Make Treatments Affordable for Special Needs Kids

Last updated on September 2nd, 2019 at 07:45 pm

When you have a special needs child, or a child who is ill or any child with a medical need you want to do anything to get them what might help them. Many times treatments are very costly and insurance doesn’t cover all of it, or any of it. One way to give a treatment a try is by getting involved in a research trial.

Many universities and hospitals run these tests, where a new medication or treatment is used and progress carefully monitored. Sometimes there are groups that get a substitute treatment or medication to compare against the group that got the real stuff. If you are uncomfortable subjecting your child to a new medication (and I don’t blame you there) you may not want to look into these tests, but think about how much progress has been made thanks to people who were willing to take a risk.

Sometimes the trials are for new treatments or techniques, and there are very little risks. I have been hoping to get my child involved in riding therapy, aka hippotherapy, for years, but insurance doesn’t pay for it and neither does our local regional center. They say there is no quantitative proof that it works, even though every involved parent I speak to raves about it. A physical therapist I know who is not easily impressed told me that she saw it work miracles. Plus, the kids have fun doing it, so how could it be bad? A parent whose child does it told me about a research study in the hopes of providing some proof. There were very specific qualifications, which my daughter meets, so with any luck she will get to be a test subject. Fingers crossed!

To find a research trial in your area check your local Craig’s List under ETC or call or write your local university or hospital.

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Editor’s Note: You can now also try searching for trials by checking the following:

  • Center Watch – where you can search clinical trials by medical condition and location
  • Clinicaltrials.gov – sponsored by the US National Library of Medicine – where you can search by condition or disease, other terms like the drug name and the country

Join Pediatric Safety in Supporting Vulnerable Children

Last updated on October 14th, 2018 at 08:25 pm

The weather is getting cooler, the leaves are changing colors, and the giving spirit is starting fill the air. Are you and your family looking for something to do this fall?

How about something you can do together that raises money for something wonderful? We’ve got some ideas.

Let us introduce you to some children’s health charities and fundraising events that we here at Pediatric Safety think are absolutely worth your time. Vulnerable children and their families depend on organizations and events like these to help support them in their time of need.

Please join us and support one of these great causes and help make the lives of these families, who have already been through so much, better.

Rett Syndrome

“Rett syndrome is a rare, non-inherited genetic neurological disorder that occurs almost exclusively in girls and leads to severe impairments, including seizures, scoliosis, and digestive difficulties.”

Children with Rett syndrome are believed to be able to understand a lot more than they can communicate and express a wide variety of emotions.

The trademark symptom of Rett syndrome is almost continuous repetitive hand movements when the child is not sleeping.

Fundraising

Rettysyndrome.org has a signature fundraising program called the Strollathon. This is their 16th year and they have over 25 locations participating around the country.

Their goal is 1 million dollars and they are almost halfway there.

For more information on how to donate, volunteer, or participate check out their website here.

St. Jude Children’s Research Hospital

St. Jude’s was founded in 1962 and is one of the world’s leading treatment and research centers for children with cancer.

Since 1962 treatments invented there have helped move the childhood cancer survival rate from 20% to more than 80% and their patient’s families never pay a dime.

They have treated patients from across all 50 states as well as other countries and have been able to do so primarily through individual’s donations.

Fundraising

Join Pediatric Safety in supporting the Sons of Thunder as they run in the St. Jude Memphis Marathon Weekend because “all a family should worry about is helping their child live.”

You can sign up to donate directly, sponsor a team, or you can participate in the marathon weekend yourself! Check out all the details here.

Autism Speaks Walk

“Autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication.” ~ Autismspeaks.org

Roughly 1/59 children is affected by autism.

Autism speaks has funded nearly $150 million predominantly in scientific grants. The results of which have led to an additional $396 million in autism-related funding. They seek to support innovative research and lifelong supports and services for those affected by autism.

Fundraising

They have walks all over the country at different times throughout the year.

Find a location near you and participate in one of their fundraising walks or donate to them directly on their website.

Other Upcoming Fundraising Events:

Children’s National Health System – They have several events coming up in the Virginia area that you can check out here.

Nationwide Children’s Hospital – Big Lots just announced a national fundraising campaign to benefit the hospital, details here.

Children’s Miracle Network – They have national and local partners who have fundraising events year round. Or you can host your own!

National down syndrome society – They have upcoming events all across the US. Check them out here.

The Instability of the “Dreamers'” Future Hurts All Children

Last updated on May 27th, 2018 at 09:09 pm

If you follow the news at all, I’m sure you’ve heard about the Deferred Action for Childhood Arrivals program. To summarize it, it is a program that has kept around 690,000 young, illegal immigrants from being deported. It was put into place by the Obama administration in 2012 after numerous attempts by Congress to come up with a permanent solution for “Dreamers” failed. The DACA provides children who were brought into the United States illegally, as minors, the ability to work and go to school without fear of deportation.

Many of these children grow up without having any idea of what their legal status is or what being illegal means. Now, they are facing a very uncertain future, especially those who plan to go to college. However, what I really want to address here is why the debate over what to do with Dreamers matters to us as guardians of young people.

When we choose to take responsibility for a child or teenager, even to the smallest degree, we are choosing to also have a direct impact on the future of our society. Culture affects young people differently than it does adults. As adults, we have, in many cases, been given the resources and experiences to learn which aspects of our culture we agree with and which we do not. We then build up a worldview that we protect and that protects our sense of self.

Children do not have this yet. They are still sorting through their understanding of the world and learning their emotions. It is up to us to guide them along that path. This brings me back to the debate over the DACA. Social environments have distinct impacts on child and adolescent development. Children must be able to have faith in the structures of authority that surround them. These structures are supposed to provide them with the safe space they need to develop as human beings. When these structures show themselves as unstable it has far reaching psychological effects not just for the children directly involved, but also for the rest of the population.

Uncertainty and fear can cripple the human mind, especially the tender developing mind of a child or teenager that is particularly vulnerable to stress. Many of these children who are now facing an uncertain future want to pursue higher education. Putting their futures in jeopardy hurts them as individuals and through their struggles their friends and their friends friends will lose faith in a system that is already on shaky ground. The ripple effect of this kind of uncertainty is sure to have lasting repercussions past what we can see.

As these uncertainties become more apparent, it falls on us as caretakers, to work even harder than we do already to provide a stable and healthy environment for our children and the children around us to grow in. We must listen to their needs and support them, as individuals, and as a whole as we strive towards a better future for all.

Children Learn What They Live

by Dorothy Law Nolte

If children live with criticism,

They learn to condemn.

If children live with hostility,

They learn to fight.

If children live with ridicule,

They learn to be shy.

If children live with shame,

They learn to feel guilty.

If children live with encouragement,

They learn confidence.

If children live with tolerance,

They learn to be patient.

If children live with praise,

They learn to appreciate.

If children live with acceptance,

They learn to love.

If children live with approval,

They learn to like themselves.

If children live with honesty,

They learn truthfulness.

If children live with security,

They learn to have faith in themselves and others.

If children live with friendliness,

They learn the world is a nice place in which to live.

(Copyright © 1972/1975 by Dorothy Law Nolte)

Child Health & Safety News: 2/05: Chip Funding Extended

Last updated on March 4th, 2018 at 02:20 pm

twitter thumbIn this week’s Child Health News: USA Gymnastics Chose Medals Over Child Safety

Welcome to Pediatric Safety’s weekly “Child Health & Safety News Roundup”- a recap of the past week’s child health and safety news headlines from around the world. Each day we use social media to communicate relevant and timely health and safety information to the parents, medical professionals and caregivers who follow us. Occasionally we overlook something, but overall we think we’re doing a pretty good job of keeping you informed. Still, quite a bit happens every day – so to make sure you don’t miss anything, we offer you a recap of this week’s top 15 events & stories.

  • Research-Backed Examples of Baby Books that Boost Brain Development – brilliant article by the Thoughtful Parent – must read if you have little ones! 2018-02-04
  • ‘My Baby Almost Died’: Formula Scandal Sends Shudders Through France 2018-02-04
  • 11 Kid-Friendly YouTube Channels Even Parents Will Enjoy: YouTubers for Kids 2018-02-03
  • Your questions about rabies: answered 2018-02-03
  • Free Family Safety Webinar: Teen apps your students should avoid 2018-02-02

PedSafe Child Health & Safety News Headline of the Week:
CHIP Funding Has Been Extended, What’s Next For Children’s Health Coverage?

  • Can Crowdsourcing and Collaboration Improve the Future of Human Health? Can it improve the 80 year old Finnish “Baby Box”? 2018-02-02
  • How to Improve Children’s Math Skills With Play http://zpr.io/nTXuj 2018-02-02
  • For children with respiratory infections, antibiotics with narrower targets are better since this helps avoid antibiotic resistance and adverse side effects 2018-02-01
  • 8 Ways to Help a Shy Child – Thurs Time Capsule:12/11 2018-02-01
  • Dispatcher helps mom who called 911 about hungry kids 2018-01-31
  • Turn Off Messenger Kids, Health Experts Plead to Facebook 2018-01-31
  • Teaching Your Specials Needs Child How to Eat on Their Own http://zpr.io/nTnAi 2018-01-31
  • 7 Ways to Teach Kids Kindness That Will Reduce Bullying 2018-01-30
  • Hasbro is proud to match up to $100,000 in donations to the KidsforPeace Kind Coins program to help fund new playgrounds in areas affected by the recent hurricanes 2018-01-29
  • 5-Year-Olds Work Farm Machinery, and Injuries Follow 2018-01-29
  • Count on play – Kids who play with numbers, from reading them on cards to counting spaces on a board game have better executive functioning skills such as impulse control and memory! 2018-01-29

Transition to Independence Act Opens Doors for the Disabled

Last updated on August 28th, 2015 at 11:05 am

Senator Wyden meetingLike most special needs parents, I don’t have a lot of free time. Sometimes I can’t even keep up on the news or find time to vote (although I fixed that problem by voting by mail). But recently three senators put party lines aside to work together on the Transition to Independence Act and this time I put a few things on hold to read up on it.

This program would work through Medicaid to financially reward states that increase job training and employment opportunities for people with disabilities over the course of five years. It would also allow individuals with disabilities to buy their way into Medicaid. The act may improve the financial situation of disabled individuals as well as improve their working conditions and expand their possibilities. It will finally allow people to work and pursue a career without losing Medicaid benefits. You can read a summary of the bill here.

As with any piece of legislation this bill may have a long road ahead of it, but kudos to Senators Chuck Grassley (R-IA), Ron Wyden (D-OR) and Bob Casey, Jr. (D-PA) for stepping up to bring these issues into focus and for at least trying to take some action. While most of the media attention tends to focus on autism, people with other conditions, such as muscular dystrophy, will also benefit from the bill.

Transition to Independence Act – Primary Purpose:

  • Improve opportunities for people with disabilities to obtain integrated employment and reduce their relegation to subminimum wages and segregated environments;
  • Modernize and coordinate systems to offer cost-effective supports and services to people with disabilities consistent with the rising expectations of and for people with disabilities; and
  • Ensure that people with disabilities and their families regularly receive accurate information about and have access to services and supports that promote self-determination, independence, productivity, and integration and inclusion.

Photo credit: Bureau of Land Management Oregon; CC license

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