Pediatric Restraint

[waylon1226]

Just wondering how medics are keeping kids safe in transport. So far most medics confirm using car seats or no harness at all. Some even let parents hold their kids (usually toddlers), which should NOT be tolerated. So what do you do?

[tcripp]

Just wondering how medics are keeping kids safe in transport. So far most medics confirm using car seats or no harness at all. Some even let parents hold their kids (usually toddlers), which should NOT be tolerated. So what do you do?

100% of the time, my pedi's are restrained. We will attempt to get the car seat from the family that the child/infant is used to. On the off chance that that isn't possible, we carry a harness that adapts to our stretcher. Only 1 time have I taken an infant out of the car seat during transport and, while most likely not the brightest move, it was necessary at the time during an IFT of > 1.5 hours.

Also, 100% of the time, family members are restrained as well. (Seat belted in the Captain's chair or on the bench in sight of the patient.)

[Chief1C]

LSP Pediatric Immobilizer. Or as I call it, the flat straight jacket. Whether they need immobilized or not, if you don't want them to move around, IV, etc.. Strap them down. If they're small, and sitting up is better, eg, respiratory issues, etc.. The Ferno Pedi-Mate is pretty helpful, just need to buy Ferno Straps, if you have different (like Stryker) stretchers.

Edited June 1, 2011 by 2c4

[WolfmanHarris]

Ferno pedimate, childseat built into captain's chair in pt. module, or for those falling outside the minimum weight restriction for those devices we secure the Pt.'s child seat to the stretcher. If spinal motion restriction is required I'll either use a KED, pad and tape void space in a child seat, or pad and strap as appropriate on the LSB (my service does not carry pediatric specific boards).

Call me cynical, but for a first post this comes across as having an axe to grind.

"Most medics confirm..."

Based on what? What sample size? What area?

"...which should NOT be tolerated."

Is there a story here?

Edited June 1, 2011 by docharris

[NYCEMS9115]

http://www.nydmv.state.ny.us/broch/c-1.htm

In NYS, having to wear seatbelts on Ambulances are exempt from the Law. No fines or points.

Another way to go above and beyond the Government and Governing Body's Policy and Procedure; in this case "Law". I tell my employees; everyone must be fastened in, when the vehicle is in motion. No exceptions. Safety is paramount. If other Ambulance Companies choose not to require this, that's on them, the law does require it.

[NYCEMS9115]

http://www.nydmv.state.ny.us/broch/c-1.htm

In NYS, having to wear seatbelts on Ambulances are exempt from the Law. No fines or points.

Another way to go above and beyond the Government and Governing Body's Policy and Procedure; in this case "Law". I tell my employees; everyone must be fastened in, when the vehicle is in motion. No exceptions. Safety is paramount. If other Ambulance Companies choose not to require this, that's on them, the law does require it.

Meant, the law doesn't require it....

[uglyEMT]

Every pedi we have ever transported has been in their own child seat or our supplied seat if we were called to an area where the child's seat wasn't available. Yes we actually carry child seats in our rigs and all trained in proper installation. We occasionally use the Captain's chair pedi seat although we don't like it much due to it being upfront and not very provider friendly.

If the pedi is old and weighs enough not to require a child seat they are on our cot and fully strapped in (as is every patient for that matter) shoulder harness is adjusted as not to be too uncomfortable about the only strap not used would be the 3rd leg strap down by the D tank due to the child's legs no being long enough to use said strap.

I agree with doc sounds like a fishing expedition with this as your first post? Whats the background for the question?

[waylon1226]

Ferno pedimate, childseat built into captain's chair in pt. module, or for those falling outside the minimum weight restriction for those devices we secure the Pt.'s child seat to the stretcher. If spinal motion restriction is required I'll either use a KED, pad and tape void space in a child seat, or pad and strap as appropriate on the LSB (my service does not carry pediatric specific boards).

Call me cynical, but for a first post this comes across as having an axe to grind.

"Most medics confirm..."

Based on what? What sample size? What area?

"...which should NOT be tolerated."

Is there a story here?

Sorry, I should have said that of the medics I've talked to (not many) and from the posts on the forums, I got the impression that most medics either uses customers' own car seats or no restraints when transporting pediatric patients. I agree that the tone I used was a little over-the-top, so sorry about that.

I started the topic to foucs discussion on pediatric restraints on the forums becuase so far I've only come across bits of discussion here and there. I'm an undergraduate mechanical engineering and industrial design student currently working on a research project looking at pediatric restraint designs as a summer project. I'm in the research and benchmarking stage right now and hopefully from the input on this thread, I will be able to gather good information to generate some design concepts. So thanks to everyone who has contributed so far! Keep it rolling!

Every pedi we have ever transported has been in their own child seat or our supplied seat if we were called to an area where the child's seat wasn't available. Yes we actually carry child seats in our rigs and all trained in proper installation. We occasionally use the Captain's chair pedi seat although we don't like it much due to it being upfront and not very provider friendly.

If the pedi is old and weighs enough not to require a child seat they are on our cot and fully strapped in (as is every patient for that matter) shoulder harness is adjusted as not to be too uncomfortable about the only strap not used would be the 3rd leg strap down by the D tank due to the child's legs no being long enough to use said strap.

I agree with doc sounds like a fishing expedition with this as your first post? Whats the background for the question?

Thanks UGLy! So where do you store the child seats in your rigs? Don't they take up a lot of space? Also, how heavy or how big does a child have to be in order to not require a child seat per your opinion?

As I responded to doc's post, this is for a summer research project aimed at possibly generating some design concepts. Thanks a lot for posting!

[WolfmanHarris]

Thanks for the explanation. Sounds like an interesting project.

A few ideas to consider for you:

- How to properly and safely restrain Pt.'s that are below the weight requirements for current devices (pedimate, etc).

- Perhaps an add on strap or device for safely securing a childseat to the stretcher.

- Maybe a small pedimate designed more for newborns.

[waylon1226]

Thanks for the explanation. Sounds like an interesting project.

A few ideas to consider for you:

- How to properly and safely restrain Pt.'s that are below the weight requirements for current devices (pedimate, etc).

- Perhaps an add on strap or device for safely securing a childseat to the stretcher.

- Maybe a small pedimate designed more for newborns.

Good points. One of the main challenge of the design is to accommodate the wide range of patient sizes and weights. Here's a British product (not available in the US) similar to the pedimate. It's called the ACR (ambulance child restraint) and it has three sizes of restraints. I might look into something of the sort. What do you think about it?

http://www.paraid.co.uk/p-1-ACR-(Ambulance-Child-Restraint).aspx

LSP Pediatric Immobilizer. Or as I call it, the flat straight jacket. Whether they need immobilized or not, if you don't want them to move around, IV, etc.. Strap them down. If they're small, and sitting up is better, eg, respiratory issues, etc.. The Ferno Pedi-Mate is pretty helpful, just need to buy Ferno Straps, if you have different (like Stryker) stretchers.

2c4, I came across the LSP Pediatric Immobilizer at an AMR site. Medics there seem to think that the Velcro straps aren't suitable for EMS purposes. Have you had any trouble with them? Thanks a lot for posting!