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Babes in Arms

Gone are the days when most considered it safe and okay for a mom to hold her young child in the rig; even if the mom is seat belted in, the child is not. Even though many crews allowed mom to hold and calm a crying, scared child, it has been a no-no for quite a while. A 2012 study by the National Highway Traffic Safety Administration (NHTSA) found that “up to 1,000 ambulance crashes involve pediatric patients each year.” No one in the ambulance – parents, caregivers, medics, or other passengers should be unrestrained during transport.

Many ambulance agencies have already invested in child restraint systems/seats — know the manufacturer’s recommendations for size and weight of the child. While child safety seats made for PUBLIC use offer strict age and size limits, most restraints used in ambulances do not offer that guidance. If your ambulance does not carry a child restraint seat, use one that parents have IF it can be installed safely and securely. Some companies offer inflatable, padded restraints that will help make the transport of small infants easier and safer. Other restraints are made for older children from toddlers to smaller teens that feature 4 or 5-point harnesses and attach to the ambulance cot. If your agency carries this equipment, make sure that you and your crew are familiar with its features and know how to use it properly.

If you are completely without a child restraint system on hand, then be sure to place the child in a position to prevent forward thrust or ejection in an accident; use straps (and padding if necessary, especially in the voids) to secure the child’s torso to the cot; and always protect the head, neck, and spine of all children being transported. Ensure that you always have free access to the child’s windpipe and areas of injury. In addition, make sure that ALL equipment is firmly secured in place (a good idea during any transport) to prevent secondary injuries while en route to the hospital. Everyone, including parents and healthcare providers, should also be wearing restraints for their safety as well as the pediatric patient.

Especially in cases of severe injuries, any transport of a child should be triaged to determine both the best facility and the best manner of transport. High speeds, which are not necessarily due to a child’s injuries or illness, will only increase the risk of an accident en route. Always drive cautiously and observe all traffic laws. Transport additional children, who are NOT patients in another vehicle (such as parents) if possible; if you must transport other non-patient children in the rig, be sure that the children are properly restrained in their seats. Make sure that you consistently monitor the pediatric patient’s condition, children are not always able to communicate their complaints or illness. Remember that if you do need mom or dad to help keep the child calm, ensure that they are properly seat belted close enough to the child and in their line of sight.

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