II. Technique: Correct fitting of adult auto safety belts
- Use Child Safety Seat if adult belt does not fit
- Indications
- Weighs more than 80 pounds (36 kg)
- Child standing height over 57 inches (145 cm)
- Child Sitting Height over 29 inches (74 cm)
- Proper fit
III. Technique: Pregnancy
- Do not disable air bags for pregnant patients
- Move seat back as far as possible (at least 10 inches between Abdomen and air bag)
- Deployed air bags save maternal lives and are safe in pregnancy given enough distance between air bag and Abdomen
- Schiff (2010) Obstet Gynecol 115(1): 85-92 [PubMed]
- Seat Belt use is critical
- Many pregnant women fail to use Seat Belts despite their protective effects
- Fetal death is most commonly due to maternal death in blunt Abdominal Trauma
- Protecting the mother is the best way to protect the fetus
- MVAs affect 2% of pregnant women (accounts for 50% of all Traumatic injuries in pregnancy)
- Maternal (U.S.): 368 maternal deaths per year
- Fetal: MVAs account for 82% of fetal deaths
- Properly positioned Seat Belts decrease the risk of fetal injury while keeping their mothers safer
- Uterine injury and fetal risk does increase if belts are incorrectly placed across the dome of the Uterus
- Relative Risk of fetal loss if unbelted: 2.8
- Fetal outcomes
- Properly restrained women: 29% adverse fetal outcomes
- Improperly restrained women: 50% adverse fetal outcomes
- Klinich (2008) Am J Obstet Gynecol 198(4): 450 [PubMed]
- Many pregnant women fail to use Seat Belts despite their protective effects
- Proper 3 point Seat Belt application in pregnancy
- References
IV. Prevention: Miscellaneous
- Seat Belt use protects other occupants in car
- In accident Unrestrained Passengers become missiles
- Unrestrained Passengers strike belted passengers
- Unrestrained Passenger raises risk of death for others
- Cummings (2004) JAMA 291:343-9 [PubMed]
