child/parent bond

[emt/ff71185]

I am new here so this topic may have been discussed before but here it is again. When I took my emt-b class we got into a heated debate during the ped's chapter about child restraints. In my system we have a child seat on the rig but in my class we are told to always let the child sit in the parent's lap during transport to keep the child calm to help there breathing. Now I've heard of methods of strapping the mother and the child to the cot together but do not find any of them effective.

The debate is this. Is it more important to keep the child calm or to insure that that child does not become a missle if there is an accident.

Another thing to think about when analyzing this is what about the liability issue. If you are driving a rig and get in a wreck when you didn't have the child properly secured in a child safety seat what will that mean for your licsense and your pocket book?

 

[Ridryder911]

There is only one acceptable case to allow or excuse the mother/parent to hold the child in lieu of approved car seat/litter in the back of an EMS unit. That is epiglottitis where causing the child to become excited will cause increased swelling to the epiglottis, and increasing respiratory patterns.

Simply put... that's it.. the only acceptable time!

Debate, all you want to.. but, strapping mother and child together is only asking for litigation. One in EMS knows and is quite aware of one is not being able to hold a non-restrained person (mother holding child does not count, child is NOT restrained). As well, now instead of one patient, you will have two..

Use common sense, and some knowledge, read some court cases and litigation's... there is a reason for pedi-transfer devices.

R/r 911

 

[reaper]

I always make the parents bring their car seat in the ambulance. it is secured to the stretcher and mom is aloud to sit in CPR seat. This way child is still next to mom and everyone is safe.

Plus, when they bring their own seat, they have it when they leave the hospital.

 

[Gbro]

I always make the parents bring their car seat in the ambulance. it is secured to the stretcher and mom is aloud to sit in CPR seat. This way child is still next to mom and everyone is safe.

Plus, when they bring their own seat, they have it when they leave the hospital.

That too was my preferred method, but i got ripped by my own crew as there was no protocol, Never heard of any other's doing that.
Oh it was different if the little one was in the car seat already(MVA).
This was a fall, and we didn't have the nice pedi-board we now carry.

 

[crash_cart]

That too was my preferred method, but i got ripped by my own crew as there was no protocol, Never heard of any other's doing that.

That suggestion is mentioned in the Prehospital holy grail, I'm surprised others would be so vociferously against it.....interesting:excl:

 

[triemal04]

Might have been because securing someone in a carseat after a fall, when they aren't in the car seat to begin with is a bad idea. An adult sized longboard can be used for a ped without a problem, you just can't always use the straps for it (unless they're spider straps).

 

[reaper]

I wasn't talking about a peds trauma. I was talking about transporting just sick kids. We do carry peds spine boards for the traumas.

 

[triemal04]

I wasn't talking about a peds trauma. I was talking about transporting just sick kids. We do carry peds spine boards for the traumas.

Sorry, I should have included a quote; I didn't mean you. I love carseats for medicals, and if you can adequately pad around the kid and they're still in them for some traumas too.

I was referencing someone who it sounds like took a kid who had fallen and then placed them into a carseat for immobilization instead of using a board.

Edit: Damn...my ego may be showing...

 

[DisasterMedTech]

There is only one acceptable case to allow or excuse the mother/parent to hold the child in lieu of approved car seat/litter in the back of an EMS unit. That is epiglottitis where causing the child to become excited will cause increased swelling to the epiglottis, and increasing respiratory patterns.

Simply put... that's it.. the only acceptable time!

Debate, all you want to.. but, strapping mother and child together is only asking for litigation. One in EMS knows and is quite aware of one is not being able to hold a non-restrained person (mother holding child does not count, child is NOT restrained). As well, now instead of one patient, you will have two..

Use common sense, and some knowledge, read some court cases and litigation's... there is a reason for pedi-transfer devices.

R/r 911

This is exactly what I was taught. But what do you think about strapping mom in next to child on the crew bench. Some of ours have three seperate seat belts. Would that be acceptable? To me it seems like a viable alternative. At least then mom can comfort the child, child can still see mom and all that good stuff.

 

[Epi-do]

Little kids always go in their car seat. The seat is either secured to the cot or the airway seat. If they don't have a car seat, we have a 5-point harness for peds inside the airway seat. We just pull part of the back of the seat down and the harness is right there. Kids who are bigger than car-seat aged kids go directly on the cot.

If I let mom or dad ride in the back, they are typically in the CPR seat with a seatbelt on. That way they can be next to the kid on the cot/in the carseat. Alot of times, the parents demeanor will determine if they get to ride in the back with me if the child is a little bit older. I have found that an extremely upset parent in the back tends to make the kid even worse. In those situations, the parent sits up front, where the child can hear mom or dad's voice, but can't see them. That way I can talk to the kid and work on calming them down. Alot of times, a stuffed animal and asking about school, sports, favorite tv shows, etc will go a long way to getting the kid to feel comfortable with me and calm down enough to talk to me.

 

[Gbro]

T..04
I was referencing someone who it sounds like took a kid who had fallen and then placed them into a carseat for immobilization instead of using a board.

Is it possable to list the negative points of using a car seat for imobilization?

Prior to getting good pediatric imobilization devices, we all would use the Adult long board. There are some issues with this. the angle of the straps make it nessesary to roll sheets blankets pillows, darn near everything in store to fill the voids created by such a small body on a large board, not to forget the 1-2 inches under the body for a nutral head on the little ones.
The biggest negative i can come up with the car seat is removal. With assessing being a posible, but that is done prior to placment in seat.
Maybe a KED would be of some value??

 

[triemal04]

Is it possable to list the negative points of using a car seat for imobilization?

Prior to getting good pediatric imobilization devices, we all would use the Adult long board. There are some issues with this. the angle of the straps make it nessesary to roll sheets blankets pillows, darn near everything in store to fill the voids created by such a small body on a large board, not to forget the 1-2 inches under the body for a nutral head on the little ones.
The biggest negative i can come up with the car seat is removal. With assessing being a posible, but that is done prior to placment in seat.
Maybe a KED would be of some value??

Sure. That's easy.

Stability-padding will probably be needed around the body/head.
Access-no way to assess the back.
Airway management-if something changes with the pt, the car seat is awkward to have them in.
Venous Access-doesn't make it hugely harder, but a bit if you have to start a line.
Removal-we (some of us anyway) get taught how to remove someone from a car seat. You may get some dumbfounded looks in (some, not all) ER's.

Now, negatives to a ped on an adult longboard...none. You'll just need different straps (maybe, and 2 inch tape works great) and some padding. No biggie.

Now, negatives to putting someone INTO a carseat after you have determined that they need c-spine precautions...well that's a no brainer. How about compromising the spine by putting them in? If you find a ped in a car seat after a wreck and elect to leave them in, that's probably ok. If you decided to place one in a carseat after a fall instead of using the appropriate device...wrong.