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Infant Car Seat

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1. Assessment of cardiorespiratory stability using the infant car seat challenge before discharge in preterm infants (<37 weeks? gestational age)

Assessment of cardiorespiratory stability using the infant car seat challenge before discharge in preterm infants (<37 weeks? gestational age) Preterm infants younger than 37 weeks corrected gestational age are at increased risk for abnormal control of respiration. The infant car seat challenge has been used as a screening tool to ensure cardiorespiratory stability before discharging preterm infants from many hospitals in Canada. While it is clear that infants placed in a car seat are more (...) likely to experience oxygen desaturation and/or bradycardia than when they are supine, neither positioning predicts an adverse neurodevelopmental outcome or mortality post-discharge. A review of the literature yielded insufficient evidence to recommend routine use of the infant car seat challenge as part of discharge planning for preterm infants. This finding has prompted a change in recommendation from a previous Canadian Paediatric Society position statement published in 2000. Key Words: Apnea

2016 Canadian Paediatric Society

2. Preventive effects of car safety seat use on clinical outcomes in infants and young children with road traffic injuries: A 7-year observational study. (PubMed)

Preventive effects of car safety seat use on clinical outcomes in infants and young children with road traffic injuries: A 7-year observational study. Road traffic injury (RTI) is one of the major mechanisms of injury leading to high disability and case-fatality in infants and children. Proper car safety seat use can reduce fatal outcomes in pediatric patients with RTI; however, the use rate is still low. This study aimed to measure the preventive effects of car safety seat use on clinical (...) outcomes among infants and young children injured from RTI.A multicenter cross-sectional study was conducted using the Emergency Department-based Injury In-depth Surveillance (EDIIS) registry from 23 EDs between Jan 2010 and Dec 2016. All pediatric patients who were under 6 years of age and who sustained RTI in a vehicle with fewer than 10-seats were eligible. Primary and secondary endpoints were intracranial injury and mortality. We calculated the adjusted odds ratio (AOR) of the car safety seat

2018 Injury

3. Assessment of cardiorespiratory stability using the infant car seat challenge before discharge in preterm infants (<37 weeks’ gestational age) (PubMed)

Assessment of cardiorespiratory stability using the infant car seat challenge before discharge in preterm infants (<37 weeks’ gestational age) Preterm infants younger than 37 weeks corrected gestational age are at increased risk for abnormal control of respiration. The infant car seat challenge has been used as a screening tool to ensure cardiorespiratory stability before discharging preterm infants from many hospitals in Canada. While it is clear that infants placed in a car seat are more (...) likely to experience oxygen desaturation and/or bradycardia than when they are supine, neither positioning predicts an adverse neurodevelopmental outcome or mortality post-discharge. A review of the literature yielded insufficient evidence to recommend routine use of the infant car seat challenge as part of discharge planning for preterm infants. This finding has prompted a change in recommendation from a previous Canadian Paediatric Society position statement published in 2000.

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2016 Paediatrics & child health

4. Teaching infant car seat installation via interactive visual presence: An experimental trial. (PubMed)

Teaching infant car seat installation via interactive visual presence: An experimental trial. A large portion of child restraint systems (car seats) are installed incorrectly, especially when first-time parents install infant car seats. Expert instruction greatly improves the accuracy of car seat installation but is labor intensive and difficult to obtain for many parents. This study was designed to evaluate the efficacy of 3 ways of communicating instructions for proper car seat installation (...) : phone conversation; HelpLightning, a mobile application (app) that offers virtual interactive presence permitting both verbal and interactive (telestration) visual communication; and the manufacturer's user manual.A sample of 39 young adults of child-bearing age who had no previous experience installing car seats were recruited and randomly assigned to install an infant car seat using guidance from one of those 3 communication sources.Both the phone and interactive app were more effective means

2016 Traffic injury prevention

5. Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle. (PubMed)

Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle. The American Academy of Pediatrics recommends that preterm infants complete a predischarge 'car seat challenge' observation for cardiorespiratory compromise while in a car seat. This static challenge does not consider the more upright position in a car or the vibration of the seat when the car is moving. This pilot study was designed to assess the cardiorespiratory effects of vibration, mimicking the effect (...) of being in a moving car, on preterm and term infants.A simulator was designed to reproduce vertical vibration similar to that in a rear-facing car seat at 30 mph. 19 healthy newborn term and 21 preterm infants, ready for hospital discharge, underwent cardiorespiratory measurements while lying flat in a cot (baseline), static in the seat (30°), simulator (40°) and during motion (vibration 40°).Median test age was 13 days (range 1-65 days) and median weight was 2.5 kg (IQR: 2.1-3.1 kg).Compared

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2016 Archives of Disease in Childhood. Fetal and Neonatal Edition

6. Infant Car Seat

Infant Car Seat Infant Car Seat Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Infant Car Seat Infant Car Seat Aka: Infant Car Seat (...) , Car seat for infants From Related Chapters II. Indications Newborns Infants under 20 to 22 pounds (under age 1 year) Infants head must be >1 inch below top of seat III. Positioning Seat always faces rear Semi-reclined position (45 degrees) maintains airway Rear-facing position supports head and neck Front-facing does not offer head and neck support Rear-facing position continued until Child over age 2 years and Child weight over 20 pounds Harness straps should be at or below level Carrier handle

2018 FP Notebook

7. Clinical Outcomes Associated with a Failed Infant Car Seat Challenge. (PubMed)

Clinical Outcomes Associated with a Failed Infant Car Seat Challenge. To assess comorbid conditions and clinical outcomes among late preterm and low birth weight term infants (<2.5 kg) who failed the Infant Car Seat Challenge (ICSC) on the Mother-Baby Unit.This was a retrospective chart review of consecutive infants who failed ICSC on the Mother-Baby Unit and were subsequently admitted to the neonatal intensive care unit at Prentice Women's Hospital between January 1, 2009, and December 31 (...) , 2015. Regression models were used to estimate risk differences (RDs) with 95% CIs for factors related to length of stay.A total of 148 infants were studied (43% male; 37% delivered via cesarean). ICSC failure in the Mother-Baby Unit was due to desaturation, bradycardia, and tachypnea in 59%, 37%, and 4% of infants, respectively. During monitoring on the neonatal intensive care unit, 39% of infants experienced apnea (48% in preterm vs 17% in term infants) in the supine position, 19% received

2016 Journal of Pediatrics

8. Car Seat Tolerance Screening in the Neonatal Intensive Care Unit: Failure Rates, Risk Factors, and Adverse Outcomes. (PubMed)

Car Seat Tolerance Screening in the Neonatal Intensive Care Unit: Failure Rates, Risk Factors, and Adverse Outcomes. To characterize the epidemiology of Car Seat Tolerance Screening (CSTS) failure and the association between test failure and all-cause 30-day postdischarge mortality or hospital readmission in a large, multicenter cohort of preterm infants receiving neonatal intensive care.This retrospective cohort study used the prospectively collected Optum Neonatal Database. Study infants were (...) born at <37 weeks of gestation between 2010 and 2016. We identified independent predictors of CSTS failure and calculated the risk-adjusted odds of all-cause 30-day mortality or hospital readmission associated with test failure.Of 7899 infants cared for in 788 hospitals, 334 (4.2%) failed initial CSTS. Greater postmenstrual age at testing and African American race were independently associated with decreased failure risk. Any treatment with an antacid medication, concurrent use of caffeine

2017 Journal of Pediatrics

9. Child Convertible Car Seat

Convertible Car Seat Aka: Child Convertible Car Seat , Convertible Child Seat From Related Chapters II. Indications Infants (rear facing until age 2 years and 20 pounds) Children (forward facing) Used up to 40 pounds and 4 years old Childs ear level should be below top of seat III. Types: Convertible Car Seats Five Point Harness (preferred for safety) Five straps: 2 , 2 leg, 1 crotch Best protection against for all children Best fit of convertible s for small infants T-Shield Plastic T-shaped yoke buckles (...) Child Convertible Car Seat Child Convertible Car Seat Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Child Convertible Car Seat Child

2018 FP Notebook

10. A 3-month-old infant with recurrent apparent life-threatening events in a car seat. (PubMed)

A 3-month-old infant with recurrent apparent life-threatening events in a car seat. A 3-month-old infant was brought to clinic for evaluation of recurrent apparent life-threatening events (ALTEs). Two ALTE episodes occurred while the infant was sleeping in a safety car seat. The first one occurred when he was 4 weeks old. His mother noticed that he was not breathing; he appeared limp with full body cyanosis. His mother picked him up from the car seat, and he started breathing spontaneously (...) and without any sign of distress. His skin color returned to normal. He was evaluated at the ED where the physical examination was normal. He was hospitalized 1 day for observation. During this time, workup, including ECG and chest radiograph, was normal. The parents were instructed on cardiorespiratory resuscitation and recommended to change car seats. The infant was discharged with an apnea monitor. He wore the apnea monitor while in the car seat. A second similar episode occurred at 10 weeks of age

2015 Chest

11. Infant car safety seats and risk of head injury. (PubMed)

Infant car safety seats and risk of head injury. We observed a high incidence of traumatic brain injuries (TBI) in properly restrained infants involved in higher speed motor vehicle crashes (MVCs). We hypothesized that car safety seats are inadequately protecting infants from TBI.We retrospectively queried scene crash data from our State Department of Transportation (2007-2011) and State Department of Public Health data (2000-2011) regarding infants who presented to a trauma center after (...) %) properly restrained, and 31/73 (42.5%) improperly/unrestrained (p=0.34). Average head abbreviated injury scale was similar for properly restrained (3.2±0.2) and improperly/unrestrained infants (3.5±0.2, p=0.37).Car safety seats prevent injuries. However, TBI is similar among properly restrained and improperly/unrestrained infants involved in higher speed MVCs who present to a trauma center.© 2014.

2014 Journal of Pediatric Surgery

12. Randomized controlled trial of a car safety seat insert to reduce hypoxia in term infants. (PubMed)

Randomized controlled trial of a car safety seat insert to reduce hypoxia in term infants. To test the hypothesis that a foam plastic insert that allows the infant head to rest in a neutral position in sleep may prevent obstruction of the upper airway and thus reduce episodes of reduced oxygenation in term infants in car seats.Healthy full-term babies were randomized to be studied during sleep while restrained in an infant car safety seat either with or without the insert, with continuous (...) in the rate of obstructive apnea (0.3 ± 0.1 vs 0.9 ± 1.5/hour, P < .03), the severity of desaturation events (minimum SpO2 82% ± 1% vs 74% ± 2%, P < .001), and time with SpO2 <85% (0.6% ± 0.3% vs 1.8% ± 1.4%, P = .03).In full-term newborn infants, a car seat insert that helps the head to lie in a neutral position was associated with reduced severity of desaturation events but not the overall rate of moderate desaturations.

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2013 Pediatrics

13. Randomized Controlled Trial of a Car Safety Seat Insert to Reduce Hypoxia in Term Infants. (PubMed)

Randomized Controlled Trial of a Car Safety Seat Insert to Reduce Hypoxia in Term Infants. To test the hypothesis that a foam plastic insert that allows the infant head to rest in a neutral position in sleep may prevent obstruction of the upper airway and thus reduce episodes of reduced oxygenation in term infants in car seats.Healthy full-term babies were randomized to be studied during sleep while restrained in an infant car safety seat either with or without the insert, with continuous (...) in the rate of obstructive apnea (0.3 ± 0.1 vs 0.9 ± 1.5/hour, P < .03), the severity of desaturation events (minimum SpO2 82% ± 1% vs 74% ± 2%, P < .001), and time with SpO2 <85% (0.6% ± 0.3% vs 1.8% ± 1.4%, P = .03).In full-term newborn infants, a car seat insert that helps the head to lie in a neutral position was associated with reduced severity of desaturation events but not the overall rate of moderate desaturations.

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2013 Pediatrics

14. Epidemiology and Predictors of Failure of the Infant Car Seat Challenge. (PubMed)

Epidemiology and Predictors of Failure of the Infant Car Seat Challenge. The American Academy of Pediatrics recommends all neonates born at <37 weeks' gestation receive a predischarge Infant Car Seat Challenge (ICSC), a resource-intensive test with little information on failure rates and risk factors. We sought to determine incidence and predictors of failure to allow more selective testing.We conducted a retrospective medical record review of 1173 premature neonates qualifying for the ICSC (...) between 2009 and 2010. We looked at ICSC result and potential risk factors and then performed bivariate and multivariable logistic analyses to evaluate for predictors of failure.Overall incidence of failure was 4.3%. Infants who failed were less premature and had higher birth weights. Late-preterm infants made up 60% of our study population but accounted for 78% of failures (P = .019). Infants who passed had older chronologic ages at time of testing, were more likely to have been exposed to caffeine

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2013 Pediatrics

15. A comparison of the infant car seat challenge and the polysomnogram at the time of hospital discharge. (PubMed)

A comparison of the infant car seat challenge and the polysomnogram at the time of hospital discharge. The American Academy of Pediatrics recommends all infants born at <37 weeks gestation spend a period of observation in a car seat prior to hospital discharge to assess for apnoea, bradycardia or oxygen desaturation. The most recent Cochrane review suggested further studies to determine if the infant car seat challenge (ICSC) accurately predicts the risk of clinically adverse events. We (...) reviewed our experience with the ICSC and the polysomnogram (PSG) to determine if the ICSC accurately predicts the risk of adverse events when compared with the PSG.Retrospective chart review of all infants in our institution who had an ICSC and a PSG between January 2005 and December 2008.785 infants had ICSCs. In addition, 313 infants (56.6%) had an abnormal PSG, even though the vast majority, 158 (88.3%), passed their ICSC. There were no significant differences in gestational age at birth, birth

2013 Archives of Disease in Childhood. Fetal and Neonatal Edition

16. What we know about kids and car seats

, infants and young children are required to use car seats in all 50 states. And 48 states require booster seats for older children. ( lists specific laws for each state.) Even though fewer children are dying in car accidents than ever before, So safety experts continue to learn more about how children respond in car crashes, and update the guidelines about how to keep kids safe. The latest recommendation — — recommends that children sit in rear-facing seats for as long as possible, at least until age 2 (...) What we know about kids and car seats What we know about kids and car seats Bridging the gap between research and real life You are here: / / What we know about kids and car seats What we know about kids and car seats September 22, 2015 By Car seat technology has certainly come a long way in the past three decades. I have clear memories sitting in the front seat of my mom’s car (and playing with the radio buttons!) at age five — a practice that is now against the law in most states. Today

2015 Evidence Based Living blog

17. Car Seat Screening for Low Birth Weight Term Neonates. (PubMed)

Car Seat Screening for Low Birth Weight Term Neonates. Car seat tolerance screening (CSTS) is a common predischarge assessment of neonates. Almost half of nurseries and NICUs have low birth weight (LBW, <2.5 kg) as an inclusion criterion, regardless of birth gestational age (GA). Little is known about the epidemiology of CSTS in this cohort. The objective of this study was to identify incidence and risk factors for CSTS failure in term LBW infants.This was a retrospective medical record review (...) of 220 full-term LBW infants qualifying for CSTS over a 4-year period between January 2010 to December 2013. We described CSTS results and performed bivariate analyses to evaluate for predictors of failure.Overall failure incidence was 4.8%. There were no differences between those who passed and those who failed based on birth weight, birth GA, race, gender, Apgar scores, respiratory support requirements, magnesium exposure, corrected GA, or weight at the time of CSTS. Maternal urine toxicology

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2015 Pediatrics

18. Infant Car Seat

Infant Car Seat Infant Car Seat Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Infant Car Seat Infant Car Seat Aka: Infant Car Seat (...) , Car seat for infants From Related Chapters II. Indications Newborns Infants under 20 to 22 pounds (under age 1 year) Infants head must be >1 inch below top of seat III. Positioning Seat always faces rear Semi-reclined position (45 degrees) maintains airway Rear-facing position supports head and neck Front-facing does not offer head and neck support Rear-facing position continued until Child over age 2 years and Child weight over 20 pounds Harness straps should be at or below level Carrier handle

2015 FP Notebook

19. Use of child safety seats during transportation of newborns (PubMed)

to home.We interviewed parents of newborn infants, using a structured questionnaire, at the time of their discharge from Cheil General Hospital & Women's Health Care Center, between May 2014 and July 2014.A total of 403 participants were interviewed. The rate of CSS use was only 14.9%. Overall, 76.4% of the families interviewed were not aware about the recommendations on CSS use for newborns when travelling in a car. The provision of education on using CSS significantly influenced their rate of use (...) . Parents who were educated about mounting the CSS in a car used it more as compared with others (25.7% vs. 12.2%) (P=0.002). Furthermore, if parents had heard about the importance or necessity of CSS, they used it more than others did (19.5% vs. 10.6%, P=0.032).Despite the legal regulation, most parents transport their newborn infants without a CSS while traveling from hospital to their home. The rate of CSS use was influenced by parental education and their knowledge about its necessity. Education

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2018 Korean journal of pediatrics

20. Best Practices on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents

negative functional, esthetic, and psychological effects on children. 111 Practitioners should provide age-appropriate injury prevention counseling for orofacial trauma. 15,96 Initially, discussions would include advice regarding play objects, pacifiers, car seats, and electrical cords. As motor coordination develops and the child grows older, the parent/patient should be counseled on additional safety and preventive measures, including use of athletic mouthguards for sporting activities. Dental (...) Best Practices on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents Overview Upcoming Events News Room Get Involved Member News Parent Resource Member Benefit AAPD 2019 AAPD CE Course Highlight Pedo Teeth Talk Oral Health Policies & Recommendations Practice Management Open Access Policy Center Update New Best Practice Recommendation Evidence-Based Dentistry Latest Advocacy News Grassroots Advocacy

2018 American Academy of Pediatric Dentistry

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