Keeping Kids Safe: What You Don't Know Could Hurt Them

Mark Zonfrillo, MD, MSCE


September 29, 2014

Editorial Collaboration

Medscape &

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Hello. My name is Dr Mark Zonfrillo. I'm a pediatric emergency medicine physician at the Children's Hospital of Philadelphia (CHOP) and an injury epidemiologist at CHOP Center for Injury Research and Prevention.

Today I'd like to talk about the role of pediatricians in promoting optimal child passenger safety practices among families.

As part of the 2011 policy statement on child passenger safety, the American Academy of Pediatrics encouraged pediatricians to know and promote the latest best practices, recommendations, for all supervision visits. In recent child research published by myself and my colleagues in the Journal of Pediatrics, we sought to identify the awareness, attitudes, and dissemination practices of pediatricians surrounding child passenger safety 2 years following the release of the revised policy statement.[1]

After receiving survey responses from over 500 physicians, we found that although child passenger safety knowledge was generally high, important gaps in knowledge still existed. These included a portion of respondents not knowing the recommended age at or conditions on which a child should be transitioned from a rear-facing child restraint to a forward-facing child restraint, and the age at which children are permitted to ride in the front seat.

Pediatricians reported insufficient time and resources as barriers to regularly providing child passenger safety information to their patients. However, the more knowledge pediatricians had about best-practice recommendations on child passenger safety, the more confidence they had and the more likely they were to discuss this topic with patients and families.

There are several ways that pediatricians can make child-passenger safety a priority topic during all well-child visits. The first is through prompts in the electronic health record. Pediatricians can ensure that their practice has age-, weight-, and height-based prompts for child passenger safety. This streamlines communication of the most current best-practice recommendations to patients and families and allows physicians to tailor the information for each child and family.

The second way is through training that is tailored for physicians. The American Academy of Pediatrics offers a 1-hour child passenger safety training module, which is designed to help healthcare professionals collaborate with child passenger safety technicians within their community.

Finally, the third way is to increase awareness of educational resources and awareness of car-seat inspection stations. Evidence-based child passenger safety resources are available for families at various websites, including The Children's Hospital of Philadelphia, Safe Kids Worldwide, and the National Highway Traffic Safety Administration.

In addition to these Web-based resources, free car-seat fitting stations, also known as "car-seat inspection stations" or "car-seat checks," are available nationwide. At these car-seat checks, a trained technician educates families on the best way to install and correctly use their child safety seat.

The National Highway Traffic Safety Administration and Safe Kids offer information on finding local car seat checks.

In conclusion, pediatricians are among the primary sources cited by parents for information on child passenger safety. It is imperative to be aware of the most current recommendations and offer guidance to families at all well-child visits. Information is available at the Children's Hospital of Philadelphia car seat safety for kids website, including educational resources for parents and professionals.