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Emergency Care for Children: Growing Pains (2007)
Board on Health Care Services (HCS)

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. "7 Building the Evidence Base for Pediatric Emergency Care." Emergency Care for Children: Growing Pains. Washington, DC: The National Academies Press, 2007.

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Emergency Care for Children: Growing Pains

1993). Patient encounters with EMS and ED providers offer a unique opportunity for preventive education. NHTSA’s 1996 Emergency Medical Services Agenda for the Future emphasized the importance of engaging EMS systems in injury and illness prevention programs designed to address regional needs (NHTSA, 1996). ED providers have similarly been encouraged to play a key role in injury control and prevention (DHHS et al., 2000; Mace et al., 2001; ACEP, 2002).

While emergency providers’ historical role in prevention has focused on surveillance and research, they also play a small but growing part in delivering preventive care and education. In fact, in 49 states and territories, emergency care personnel are utilized for injury prevention activities (MCHB, 2004b). The benefits of such activities (decreased health care consumption, reduced costs, lower morbidity and mortality) have been well established for certain prevention strategies; however, the extent to which prevention activities carried out by emergency care providers reduce the

hour. Children placed in the front passenger seat are at much higher risk for being harmed by airbag deployment than adults for several reasons: they are more likely to be moving around or leaning forward in their seat, even if restrained; children placed in the front seat in a forward-facing child restraint are several inches closer to the airbag than adults; children may shift closer to the airbag during precrash braking because their feet do not touch the floor, so they cannot brace themselves; a child’s head and neck are more likely to be struck by the deploying airbag; and most important, infants placed in the front seat in a rear-facing child safety seat are inadvertently within striking distance of the airbag.

After reviewing the early pediatric injury and fatality data for airbags, the National Transportation Safety Board released a number of recommendations regarding the safe transport of children in automobiles with airbags. For example, infants should ride in rear-facing child safety seats in the back seat. Children under age 12 should be properly secured in the back seat as well. For older children, shoulder belts should not be worn behind the back or under the arm. Additionally, the vehicle seat should be set as far back as possible (CDC, 1996). Additionally, the National Highway Traffic Safety Administration enacted regulatory measures to address the problem, including labeling requirements for vehicles and child safety seats and specifications for airbag cutoff switches (CDC, 1995). In 2002, the American Academy of Pediatrics issued guidelines for counseling parents about the most appropriate child safety seats and positioning of child passengers (AAP, 2002).

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