Optimal performance of restraint systems depends on an adequate fit between the restraint system and the occupant at the time of the crash. Restraint systems are designed to reduce the risk of ejection during a crash, better distribute the energy load of the crash through structurally stronger bones rather than soft tissues, limit the crash forces experienced by the vehicle occupant by prolonging the time of deceleration, and limit the contact of the occupant with interior vehicle structures. Although there were significant declines in total motor vehicle mortality across all racial groups, improvement in occupant injury was greater for white children, and disparities actually widened for both African American and American Indian and Alaskan native children, compared with white children. Occupant mortality among children 1 to 4 years of age revealed a tendency toward increased mortality in African American, Hispanic, American Indian, and Alaskan native children. However, among infants (age 0–12 months), improvements in mortality rates among African American children have slowed more recently. 3 Examining trends over a 20-year period through 2003 reveals significantly declining rates for child occupant deaths among all race and ethnic groups examined. In the United States, motor vehicle traffic-related mortality rates are highest in African American, American Indian, and Alaskan native children, lowest among Asian American and Pacific Islander children, and intermediate for Hispanic and white children. Finally, this technical report provides pediatricians with a number of resources for additional information to use when providing anticipatory guidance to families. In addition, a summary of evidence on a number of additional issues affecting the safety of children in motor vehicles, including the proper use and installation of child restraints, exposure to air bags, travel in pickup trucks, children left in or around vehicles, and the importance of restraint laws, is provided. The algorithm is designed to cover the majority of situations that pediatricians will encounter in practice.
These recommendations are presented in the revised policy statement on child passenger safety in the form of an algorithm that is intended to facilitate their implementation by pediatricians with their patients and families. This technical report provides a summary of the evidence in support of 5 recommendations for best practices to optimize safety in passenger vehicles for children from birth through adolescence that all pediatricians should know and promote in their routine practice. Therefore, the American Academy of Pediatrics continues to recommend the inclusion of child passenger safety anticipatory guidance at every health supervision visit. Despite significant reductions in the number of children killed in motor vehicle crashes over the past decade, crashes continue to be the leading cause of death to children 4 years and older.
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