Bouncing Babies

This past Thursday, on my monthly morning spot on KLFY TV, I wanted to demonstrate the forces that apply to babies and children in car accidents.  To simulate the effect of a 10 mph car crash on an unsecured infant, I dropped a life-sized baby doll from a 6-foot ladder, face down.  The doll went smack, to a collective gasp from the morning team.  For my own curiosity, the day before, I simulated this in my own car.  I revved up to 10 mph with the unbuckled doll in the back seat and stomped the brake. That baby flew! 

Some people neglect to buckle their infants into car seats, or fail to secure the seat to the car.  Older kids and teens sometimes don’t wear seatbelts. They just don’t understand the danger of sudden decelerations to their bodies. Looking for ways to demonstrate this for TV, I went to the internet.  I found myriad physics lessons that would be confusing to anyone not willing to brush up on higher math. The best I could find: A 30 mph crash into a solid object, like a tree or another car, would be like driving your car off of a 30 foot high building, landing nose first.  Sure, your seatbelt, airbag, and car crumple zones would protect you, but wanna try it?  How about without your belt on?

Humans (and animals) have a much better understanding of falling from heights.  Our ancient ancestors needed to have a fear of heights to survive: don’t jump off that cliff or you’ll die, or at least it’ll really hurt.  We’ve lived with heights for eons and fear of falls is baked into our DNA.  Cars have only been with us for a few generations, so understanding the dangers is an intellectual matter, not a visceral one.  And some people don’t use their intellect.

Thus food for thought: we’ve seen lots of unbelted kids and teens in the past few weeks in car wrecks.  Some had broken bones, including broken hips and femurs, which takes lots of energy.  Like driving your car off of a 3 storey building.  So when your kids get in the car, have them visualize you plunging off that building, the ground rushing up in the windshield.  Buckle up!

In the 1930s, the Boeing Corporation was developing a new, “heavy” bomber for the military.  It was far more complex than any airplane to date: it had four engines, with lots of controls and dials for each. The flaps and rudder were so large that they had to be locked when the plane was just sitting there, lest gusts of wind make them flop around and get damaged.  One day the test pilots took this “B-17″ for a flight, forgot to unlock the controls, and crashed.  Thus Boeing invented the first “checklist,” so pilots wouldn’t have to remember all the important steps it took to fly such a complicated machine.

We discussed above the human perceptions and misunderstandings about the danger of riding in a car without a seatbelt.  It’s not easy to foresee the forces that would slam your body around in a car crash, as opposed to knowing how it will hurt if you fall off a roof.  Though cars are more simple to operate than airplanes, there’s safety considerations that are often forgotten by parents, kids, and especially teens.  Here’s the checklist:

First of course, make sure your kids are buckled properly, in seatbelts or car seats.  Some parents “short-circuit” this step in certain situations. I’ve been told, when talking to parents after a crash, that “we were only going down the street,” to the store or grandmas.  However, the majority of car crashes happen close to home.  Sometimes they let their kids continue trying to buckle up, while starting driving in a parking lot.  Then the crash.  Sure it’s a low speed “fender bender,” but remember our story from above, where a 10 mph crash is like falling from a 10 foot ladder, baby making a horrifying smack.

Some parents just expect their kids to listen.  They say, “buckle up,” and then don’t double check that the belts are on, the doors are closed, or the car seat is properly strapped to the car.  Thus I propose a checklist, taped to the steering wheel (I’ve done this myself!), to remind them that the car should not move an inch until they visually inspect that all is secure in the back.  Boeing Corporation would be proud.

Bumper Cars For Kids

This week’s guest columnist is Dr. Ben Fontenot, a Family Practice resident at the University Hospital and Clinics here in Lafayette.

Juice in one hand, 2 year-old in the other, 15 minutes late for work.  I buckle my girl into her car seat, off to daycare.  After the second curve, screaming came from the back.  In the rear view mirror I saw only feet, sticking up in the air!

I pulled over and found my daughter and her seat upside down, a confused look on her face.  What happened?  Someone had borrowed the car seat and forgot to re-buckle it when putting it back in my car.

Summer travel season is approaching, so everyone needs a reminder on car seat safety: road injuries are the leading cause of preventable deaths in children in the United States.  “Preventable” is an important word in that statistic, because 71% of those deaths would be avoided with proper child seat use.

And “proper” seat use is another important caveat, since 4 out of 5 car seats are used incorrectly, with an average of three mistakes for every seat!  Car seats are complicated things to buckle and position; ask anyone who has tried.  But it’s your kid’s best safety device, since car crashes are her most likely way to die.  Some important tips:

-Know your car seat!  Read the manual!

-Rear-facing seats: for newborns until age 2, or until the child reaches maximum height and weight for that seat (read that manual!).  Most bad crashes are head-on, and rear-facing supports baby’s heavy head.

-Forward-facing seats: when your child has outgrown the rear-facing seat.  Some seats are convertible, from rear to forward-facing.  Your child should stay in this seat until he maxes the seat’s height and weight (manual!)

-Booster seat: used with the car’s standard lap and shoulder harness, to position the child so that the adult seatbelts give maximum protection.  A child sitting in a regular seat would have the shoulder harness resting on his neck (very bad!), and the lap belt over his belly instead of his hip bones.  Boosters avoid this, and are for kids age 4 to 7 years.

Once we saw a case where a car had been hit by a truck.  The driver cried to the firefighters that her baby was in back, but they couldn’t see baby because the car was so crumpled.  They heard no noise from inside and feared the worst.  It took 45 minutes to cut away the roof and find baby in her car seat, sleeping quietly, clutching her stuffed rabbit.  When we examined baby in the ER, she was completely unscathed.  Hooray for car seats!

The backseat is actually the safest place in car crashes, and kids of all ages should be back there, not in front.  It’s not convenient, but it’s safer, and it’s the law.  Follow the rules every time, even for short drives.  Inconsistency with restraint use confuses children, again is illegal, and we see many injuries with unbelted kids when ”I was just going down the block!”  All kids under 13 should be in the back seat; airbags in front can kill younger children.

Shoulder and seat belt use: when kids are 80 lbs. and 4 feet 9 inchest tall, they can go in booster seats, at about 8-12 years old.  When using regular seat belts, the lap belt should fit snugly across the thighs, not on the groin or belly.  The shoulder belt should lie on the mid-shoulder, at least two inches from the neck.

Correct installation: to tell if you have strapped the car seat in properly, use the “tug test,” tugging the seat from side to side.  It shouldn’t move more than an inch.  The “pinch test” ensures that the seat’s shoulder straps are snug on the child; you shouldn’t be able to pinch a fold in those straps when she’s buckled.  Young infants should have their seats in a semi-reclining position; if baby is too upright, his heavy head could fall forward and pinch off his airway.  Most seats have a built-in level on the side to show the proper recline.

If you get a used car seat, be absolutely sure it hasn’t been in a crash.  Replace ones that have been in a crash, are broken, or expired.  Throw them away, don’t give them away!

Finally, always wear YOUR seat belt.  Be a good example, and stay alive for your children!

Car Seats: Whining Down the Road


Today’s Guest Columnist is Dr. John Giuffreda, a family practice resident at the University Health Center here in Lafayette.

It happens too often: mom takes baby out of the car seat because she is fussy, dad takes his eyes off the road to look at what is going on with baby, and SMACK!  At the time of a car crash impact, physics dictates that baby suddenly weighs a ton and flies out of mom’s arms, no matter how tight she holds.  Where baby hits inside the car, we hate to think.

Being in a car crash is a traumatic event for anyone, including children.  Using a child car seat is the best protection you can give your kid.  Every state requires that an infant or small child be in a seat.  And with good reason- accidental injury is the leading cause of death in children, and most such injuries are automobile crashes.

Child safety seats are fantastic inventions.  They substantially reduce the risk of a fatal injury.  Yet many safety seats are used incorrectly.  When choosing any car seat, following some guidelines will help ensure a child’s safety.  The best car seat is not always the most expensive one- it’s the one that best fits a child’s weight, size, and age, as well as your car.

Once you select a seat be sure to try it out, keeping in mind that store displays and illustrations might not show the correct usage.  It’s up to you to learn how to install a car seat properly and harness your child for the ride.  Here are some guidelines:

-Choose a seat with a label saying it meets Federal Motor Vehicle Safety Standard 213.

-Read the instructions!

-Accept a used seat with caution.  Never use a seat more than 6 years old or that was in a crash.  Avoid seats that are missing parts, are cracked, or don’t have an instruction manual.  If you have any doubt about a seat’s history, don’t use it!

-If you get a used seat, call the manufacturer for recommendations on how much useful life the seat has left, and information on recalls.  Recalls are common and the manufacturer may be able to send you replacement parts or a new model.

-For new or used seats, fill out the product registration card so you will be notified about recalls.

When my daughter was half way through grade school, she decided that her booster seat was for babies.  She had long legs and the booster only went half way down her thighs, making the seat uncomfortable for long rides too.  She was also pretty skinny and for a long time did not meet the weight requirement to sit in an adult seat belt.  It was whine whine whine all the way.

These days car seats and booster seats are much more comfortable, but there are different seats and seat positions for different ages.

Birth to 12 months: Kids under 12 months should always ride in a seat that faces the rear of the car.  There are different types of rear-facing seats.  There are infant-only seats, or convertible 3-in-1 seats.  The convertible seats have higher height and weight limits, allowing you to keep your child rear-facing as he grows.

1 to 3 years: Keep your child rear-facing for as long as possible.  Its the best position for high-impact crashes.  Kids should remain rear-facing until they reach the top height or weight limit allowed by the manufacturer.  Once the child outgrows the rear-facing seat, he is ready to travel in a forward-facing seat with a harness.

4-7 years: Again, keep your child in the car seat with harness until reaching the top weight and height limits for that seat.  Then it is time to travel in a booster seat.

8-12 years: Keep your child in a booster until he or she is big enough to fit in a regular seat belt.  For boosters and seat belts, the lap belt must lie snugly across the upper thighs, not across the belly.  Shoulder belts should lie on the shoulder and chest, not across the neck.  Remember: your child should ALWAYS ride in the back seat because it’s safer there.

So use those car seats properly, in the back seat.  Sometimes you’ll just have to take it as they whine on down the road.



Slow Down, Kids Around

We were already busy that night-  every bed had a sick or injured child in it.   The waiting room was also full, full of families clamoring to be seen too.  Then, when it always seems the time is wrong, the ambulance phone rang.  They were bringing in a six year-old child who was hit by a car.  His head and belly were bruised up and his left leg was broken.

When they arrived, our patient was semi-conscious and his left shin was crooked just below the knee, the bone broken.  His  brain and lungs were bruised on the CT scan.   His leg needed surgery, so off to the operating room he went.

The part that had us really loving the boy was when he woke up just before surgery he told us, ”I’m okay, just gimme some crutches and I can walk home.”  Why is it that often the most sick and hurt are the least trouble, and the family with the kid with the runny nose are the biggest complainers about waiting times and not getting antibiotics?   After surgery, our favorite patient went to the Pediatric Intensive Care Unit (PICU).   

Our PICU doctors at Lafayette General are teaming up with the Lafayette Parish Health Department to start a new campaign to prevent the kind of injury like our wonderful boy.  It is called Slow Down, Kids Around. 

Slow Down, Kids Around is our own take on a very successful program from Indianapolis called Drive Smart, Kids Dart.  Both programs were actually started by our PICU specialist, Dr. Rey DelaRosa.  It involves giving away signs to post in your yard reminding motorists to, you guessed it, SLOW DOWN.

The first event will be this June 5, Saturday, from 10 am to 1 pm at the Academy sports store on Ambassador Caffery.  Show up to get your own yard sign for your neighborhood!  And again, Slow Down, Kids Around.