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Emergency departments not doing enough to educate parents about car seat safety

More than one-third of ER physicians say they are uncertain whether their department has safety restraint info for patients, according to new U-M study

Each year, more than 130,000 children younger than 13 are treated in U.S. emergency departments after motor-vehicle crash-related injuries.

Each of these visits offer a chance to pass along tips for proper use of child passenger restraints, but a new study from the University of Michigan indicates emergency departments may not be taking advantage of those opportunities.

In the study published today in Pediatric Emergency Care, more than one-third of ER physicians say they are uncertain whether their departments provide information about child passenger safety resources to their parents, says lead author Michelle L. Macy, M.D., M.S., of the University of Michigan's C.S. Mott Children's Hospital.

Less than half of the physicians responding in this study said that a parent of a 2-year-old being discharged following a motor-vehicle crash would be provided with discharge instructions including advice about car seats.

"Unfortunately, our research showed that many emergency physicians are not aware of community resources for child passenger safety," says Macy, who is a clinical lecturer in the Department of Emergency Medicine.

"We know the visit to the emergency department is a crucial opportunity to prevent future injuries. Families are frequently discharged following a car crash without referrals to local resources where parents can obtain additional information about child safety seats. This is concerning because child safety seats are complicated, and serious misuses are common," says Macy.

Motor-vehicle collisions remain a leading cause of death among children younger than 4 years and the leading cause of death among older children in the United States, in part because child passengers continue to be unrestrained, and 20 percent of 1- to 3-year-olds and nearly half of 4- to 7-year-olds do not use the recommended restraint for their age.

Macy and her co-authors also found that children who are seen in general emergency departments (without pediatric specialization) are the least likely to receive car seat information. But these general emergency departments treat more than 85% of children who need emergency care.

"Fewer than 15 percent of children seeking emergency care in the U.S. are seen in an emergency department with specialized pediatric services, such as our ER at C.S. Mott Children's Hospital. So there's a huge number of physicians out there who may not have specialized pediatric resources available for their patients," Macy says.

According to the National Highway Transportation Safety Administration, child safety seats should be replaced following a car crash unless these conditions are met: (1) the airbags did not deploy, (2) there was no vehicle intrusion nearest the safety seat, (3) the vehicle could be driven away from the collision, and (4) no passengers were injured.

Macy says she hopes this research will spur more emergency departments to begin providing resources to patients and connecting parents to existing community resources.

"It will be the kids that benefit, if their parents get the right information about how to use restraints and prevent injuries," says Macy.

C.S. Mott Children's Hospital is a proud champion of child passenger safety through our Mott Buckle Up Program. In 2012 our team checked over 2,500 car seats across our region and distributed nearly 600 car seats to low-income families.

For more information on scheduling a car seat check or to find a location nearest you, please call 734-763-2251 or visit:

Journal citation: Pediatr Emer Care 2013;29: 00Y00

Additional authors: All of the University of Michigan: Sarah J. Clark, M.P.H,; Rebecca M. Cunningham, M.D.'; and Gary L. Freed, M.D., M.P.H.

Funding: Grant from the Michigan Center for Advancing Safe Transportation throughout the Lifespan.

About C.S. Mott Children's Hospital in the University of Michigan Health System:

Since 1903, the University of Michigan has led the way in providing comprehensive, specialized health care for children. From leading-edge heart surgery that's performed in the womb to complete emergency care that's there when you need it, families from all over come to the University of Michigan C.S. Mott Children's Hospital for our pediatric expertise. In 2013, C.S. Mott Children's Hospital was ranked eighth in the nation in Parents Magazine's 10 Best Children's Hospitals ranking.

Mary F. Masson | EurekAlert!
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