Agran Phyllis F, Hoffman Benjamin
Department of Pediatrics Faculty Associate, Center for Trauma and Injury Prevention Research, University of California, Irvine School of Medicine, USA.
Pediatr Ann. 2008 Sep;37(9):614-21. doi: 10.3928/00904481-20080901-01.
The most significant risk factor for death and serious injury in a car crash is the failure to use a size-appropriate restraint system. Providing accurate car safety seat anticipatory guidance to families is the standard of care. Guiding families on the best car seat for best protection can be done with the four messages, direction, selection, location, and refer, if needed, to community resources for correct installation. Addressing special issues that impact use of a car seat on each and every ride, including challenging behaviors and obesity, will transfer to many other situations. Data support a new recommendation that children stay rear-facing in size-appropriate car seats until they reach the highest weight and height allowed for rear-facing by the manufacturer of the convertible seat. Premature graduation to the next seat type/size/position increases risk of injury. A driver who is distracted by a cell phone, food, or something else, becomes a risk factor for a car crash. State laws may lag behind best practices. Advocacy for stronger laws, better enforcement, and best practices at the local, state, and national levels is a critical role for the pediatric professional community.
在车祸中，导致死亡和重伤的最主要风险因素是未使用尺寸合适的约束系统。为家庭提供准确的汽车安全座椅预期指导是护理标准。通过“方向、选择、位置”这四条信息，并在需要时向社区资源咨询正确安装方法，可为家庭提供关于能提供最佳保护的最佳汽车座椅的指导。解决每次乘车时影响汽车座椅使用的特殊问题，包括具有挑战性的行为和肥胖问题，这将适用于许多其他情况。数据支持一项新建议，即儿童应使用尺寸合适的后向式汽车座椅，直到达到可转换座椅制造商允许的后向乘坐的最高体重和身高。过早更换为下一种座椅类型/尺寸/位置会增加受伤风险。因使用手机、吃东西或其他事情分心的驾驶员会成为车祸的风险因素。州法律可能落后于最佳实践。在地方、州和国家层面倡导更严格的法律、更好的执法和最佳实践，是儿科专业团体的关键作用。
