Infant/Child Restraint - Techniques and Equipment

[Bieber]

So Dwayne mentioned something in another post that got me thinking. This was his quote:

I like mom the best too. Of course we're about to start a massive flame war about inappropriately restrained mothers and infants.

So, let's talk about it. I know we don't deal with a lot of pediatric patients, but it happens and it seems like, especially for the itty bitty ones, restraining them safely can be a delicate task. I know that our captain chair has a fold down child restraint harness, but what about infants? What are the policies/equipment your service uses to ensure that infants are safely secured during transport, or do you have such policies in place?

I would have to look, but to be honest I'm not sure that we actually do have a policy set in stone regarding this. My last pediatric call was a four month old with a fever, and as we picked him up while the mother was headed to the hospital herself (she stopped because she heard him gasping and was concerned) she had the car seat ready to go. Luckily, the mother was able to help guide me through securing it to the stretcher (it was a reverse facing car seat and I was a bit lost trying to find a spot on the back to loop the belts through, not knowing that the hooks were on the sides of the seat), but I know that there may not always be a car seat available to me.

So, what do you do in such situations? Do you have any special equipment that you carry on the truck (infant restraint systems, car seats, etc)? Or do you sit mom or dad on the cot and have them hold onto baby? What about critical infant calls where you have a lot of work to do? Do you throw them on the stretcher and hope for the best?

I think we are supposed to be getting specialized infant restraint somethingorothers that attach to the cot and have child/infant-sized belts, but they're not out yet.

[Aprz]

We use Ferno Pedi-Mates which can handle 10-40 lbs.

[BushyFromOz]

We use Ferno Pedi-Mates which can handle 10-40 lbs.

ditto

[Arctickat]

We've got infant car seats in our units for non spinal transports and for spinals we're evaluating one of these http://www.ossur.com/lisalib/getfile.aspx?itemid=21724

[croaker260]

We have the pedi mates, but I prefer to use a car seat secured to the cot..though it depends a lot on the condition and cleanliness of the car seat.

For immobilization we have pediatric immobilizers, large vacuum splints, and KED's as needed.

[Bieber]

Thanks for all the replies so far, guys. I think the pedi-mates are what we're getting. How do you guys like them? Are they pretty easy/simple to use? Do you use them on critical pediatric patients as well or does that ever get forgotten in the heat of patient care?

Arctickat, where do you guys keep your car seats? In one of the outside compartments? I had a look at that link you posted, looks like a pretty secure spinal immobilization device. What do you use to immobilize infants currently?

Croaker, you said you preferred to use a car seat strapped to the cot, any particular reason why?

[Arctickat]

It depends which unit we're using and where we can find a spot to stuff it. Our previous spinal procedure was, and actually still is, to leave the infant secured in the car seat with padding to prevent movement. Unless one of the ABCs becomes compromised, the car seat is damaged, or the infant wasn't actually in a car seat, we'll leave it there, otherwise we used the KED, now the papoose.

[croaker260]

Thanks for all the replies so far, guys. I think the pedi-mates are what we're getting. How do you guys like them? Are they pretty easy/simple to use? Do you use them on critical pediatric patients as well or does that ever get forgotten in the heat of patient care?

Arctickat, where do you guys keep your car seats? In one of the outside compartments? I had a look at that link you posted, looks like a pretty secure spinal immobilization device. What do you use to immobilize infants currently?

Croaker, you said you preferred to use a car seat strapped to the cot, any particular reason why?

Simple comfort and familiarity for the kid., takes a touch of the stress of the situation off the kid.

I should clarify that this does not apply to kids in booster seats, or to critical kids.

[rat115]

We have a strap seat that attaches to our cot for kids.

I agree with some of the others that I prefer to have an infant/toddler in a full carseat attached to the cot if I can. If there are reasons to remove them, I will readily. We do leave those in a full carseat with padding around them if we need to spinal immobilize and there are no other reasons to remove them. It keeps the kiddo more comfy and you know that it's already fitted to them.

[Bieber]

It depends which unit we're using and where we can find a spot to stuff it. Our previous spinal procedure was, and actually still is, to leave the infant secured in the car seat with padding to prevent movement. Unless one of the ABCs becomes compromised, the car seat is damaged, or the infant wasn't actually in a car seat, we'll leave it there, otherwise we used the KED, now the papoose.

The papoose? I haven't heard of that before. I'll have to check it out!

Simple comfort and familiarity for the kid., takes a touch of the stress of the situation off the kid.

I should clarify that this does not apply to kids in booster seats, or to critical kids.

That's a great point that I hadn't even considered, and an important one at that. Are there any particular techniques in general (aside from the usual) that you use to help comfort kids or to facilitate IV access?