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Prevención primaria. Sillas para autos: ¿qué saben los padres y qué podemos hacer los pediatras?

01 Jan 2002-

AboutThe article was published on 2002-01-01 and is currently open access. It has received None citation(s) till now.

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Journal ArticleDOI
TL;DR: Greater involvement in car crashes and less use of car restraints explains the 64% higher rate of injury for 3 year olds than for infants, and it is time to target the toddlers.
Abstract: Objective. To determine the effect of car restraints on motor vehicle injury rates for children aged 0 to 14 years. Methods. A probability sample of all police-reported car crashes in the United States in 1990 and 1991 was analyzed for injury rates of passengers aged less than 15 years in relation to restraint usage, age, and seating position. Results. Optimal restraint usage (defined as car seats for children 0 to 4 years old and lap shoulder belts for children 5 to 14 years old) was 40%. The use of the car seat was 76% for infants (0 to 12 months old) and 41% for toddlers (1 to 4 year olds). The non use of a restraint was highest for 10 to 14 year olds (43%). The rate of involvement in car crashes for all children was 21.4 (per 1000/yr). The highest rate was the 14 year olds with 29.6 followed by 2 year olds with 26.5. Injury rates were 4.76 (per 1000/yr) for all children. The lowest rate was 2.91 for infants but increased to 4.78 for 3 year olds. The single strongest risk factor for injury was the non use of a restraint. (Adjusted odds ratio 2.7; 95% CI 2.4 to 3.0.) The risk factor for injury for the front seat was 1.5 (95% CI 1.4 to 1.7). Use of the car seat reduced injuries by 60% for 0 to 4 year olds, whereas the lap shoulder harness was only 38% effective for 5 to 14 year olds (P ≤ .001) Injury rates of unrestrained 0 to 4 and 5 to 14 year olds were similar. Conclusions. Greater involvement in car crashes and less use of car restraints explains the 64% higher rate of injury for 3 year olds than for infants. It is time to target the toddlers. Restraints designed for adults are not as effective for the school age child as car seats are for the preschool child. A better restraint for the school age child should be designed and evaluated. Meanwhile, increased usage of current restraints must be encouraged, as they substantially reduce injuries.

156 citations



Journal ArticleDOI
TL;DR: The data support the current American Academy of Pediatrics recommendations that all infants who are born at <37 weeks' gestation, including those who are admitted to level I community hospitals, be observed for respiratory instability and secure fit in their car seats before hospital discharge.
Abstract: Objective. Premature infants who are discharged from intensive care nurseries are known to be at increased risk for apnea, bradycardia, and oxygen desaturation while in the upright position. These small infants also do not fit securely in standard infant car seats. Because of these problems, the American Academy of Pediatrics recommends a period of observation in a car seat for all infants who are born at Methods. Fifty healthy, nonmonitored, preterm infants (mean gestational age: 35.8 ± 0.6 weeks) and 50 term infants (mean gestational age: 39.5 ± 1.4 weeks) were recruited from a level I newborn nursery in a community hospital. Appropriateness of car seat fit was documented for each infant. Heart rate, respiratory rate, and pulse oximetry were evaluated while infants were supine and in their car seats. Apneic and bradycardic events were recorded in addition to a continuous recording of oxygen saturation values. Results. Twenty-four percent of preterm and 4% of term newborn infants did not fit securely into suitable car seats despite the use of blanket rolls. Mean oxygen saturation values declined significantly in both preterm and term infants from 97% in the supine position (range: 92%–100%) to 94% after 60 minutes in their car seats (range: 87%–100%). Seven infants (3 preterm and 4 term) had oxygen saturation values of Conclusions. Our data support the current American Academy of Pediatrics recommendations that all infants who are born at

95 citations


Proceedings ArticleDOI
12 Nov 1997
Abstract: This paper is based on 25.000 crashes which occurred in Sweden between 1976 and 1996. The analysis is carried out on a subset of 4242 child occupants between 0 and 15 years of age, restrained and unrestrained. A positive trend to more frequent use of child restraint systems (CRS) in Sweden, during the last 20 years, is shown in the paper. During the same period, the overall injury risk, for different age groups of child occupants, has decreased substantially. This indicates the high effectiveness of CRS. Children need car occupant safety systems specifically designed for their size. The paper clearly states the need for child safety systems, and discusses benefits and drawbacks with regard to different restraints, ages, and injuries. The analysis points out, that when a crash occurs, the maximum effect of a CRS is not reached, if the child is not using the correct system for his/her size. There is even a tendency that the injury risk increases when children switch from one restraint system to another, that is to say when they are at the youngest ages for which the specific restraint is recommended. (A) For the covering abstract of the conference see IRRD 899572.

50 citations


Journal ArticleDOI
TL;DR: Hands-on instruction in child safety seat (CSS) installation decreases the number of errors in installation and increases in correct CSS use could result from hands-on education by trained professionals.
Abstract: Objective. To determine if hands-on instruction in child safety seat (CSS) installation decreases the number of errors in installation. Design. Cross-sectional study. Setting. Primary care offices, emergency department, CSS checkpoint. Participants. Parents of children Main Outcome Measure. Errors in CSS use. Results. Only 6.4% of parents had a correctly installed CSS. Hands-on instruction was associated with fewer errors in seat installation. Increased parent age, completion of college, and having private insurance were also associated with fewer errors in CSS placement. The majority of parents learned to install seats from reading the manual, from friends and relatives, and from figuring it out on their own. Conclusions. Errors in CSS installation are a significant problem. Hands-on instruction decreases the numbers of errors in CSS installation. However, few parents receive hands-on instruction from experts in CSS installation. Increases in correct CSS use could result from hands-on education by trained professionals.

46 citations