ND Conference on Injury Prevention

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Common Solutions to Special Needs Transport

• ND Conference on Injury Prevention Control
• Preventing Responding to Injuries
• October 28-30, 2008
• Speaker
• Connie Rongen

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What is Special Needs Transport?

• Finding the safest way to transport any child
  with a short or long term disability

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Why would I need it?

• Special needs transport may be needed for a short
  or long term disability to maintain the families
  day to day life.
• A plan for safe transport should be made with the
  childs medical team.

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Statistically

• Nationwide, an estimated 9.36 million children
  have long term special healthcare needs
• This comprises 13-18 of all children in the US
• Children with special healthcare needs Minding
  the gaps. National Health Policy Forum(2005)
  http//www.nhpf.org

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Statistically

• Motor Vehicle crashes remain the 1 cause of
  death for children adolescents ages 1-21 in the
  United States
• American Academy of Pediatrics

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Long Term Disabilities

• muscle tone poor trunk control, breathing
  issues (cerebral palsy, spina bifida, paralysis
  or severe scoliosis)
• cardiac respiratory conditions
• heart rhythm problems, breathing difficulties
• behavioral issues autism, ADHD,
• cognitive impairments

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Short Term disabilities

• Premature , low birth weight less than 37 weeks
  gestation or under 5 pounds
• post operative/medical devices tracheotomy
• braces/casts developmentally(dislocated hip),
• post op (tendon release), trauma (fracture)

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Travel Tips for Children with Special Needs

• Children with certain medical conditions can ride
  in conventional car seats that are found in
  stores
• Others may need a special medical car seat or
  restraint.
• A variety of options are available of both
  conventional and special needs car seats.

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Travel Tips for Children with Special
Needs

• Consult your surgeon or pediatrician about
  childs positioning transportation needs
• Never alter a car seat, stay up-to-date on what
  is available, keep child in seat to upper weight
  or height limits

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Things to Consider for Conventional or Special
Needs car seat

• Childs age, weight height
• Medical, physical, /or behavioral condition
• Positioning requirements
• allergies/physical sensitivities
• Family members/caregivers responsible for
  transport

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Things to Consider for Conventional or Special
Needs car seat

• Financial situation
• Help with transportation resources/networks
  (adapt vehicles, etc)
• Medical equipment needed
• Type of vehicle to be used

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Things to Consider for Conventional or Special
Needs car seat

• Always use car seat according to manufacturers
  instructions
• Consult vehicles owners manual pertaining to car
  seat use
• Never place anything under or behind child in car
  seat

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Conventional Car SeatsInfant Seats

• Premature/Low Birth Weight Babies
• Use rear-facing infant CR with small
• internal harness dimensions
• Use CR designed for childs low birth
• weight
• Center infant in CR with rolled
• receiving blankets and crotch roll,
• if necessary

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Conventional Car Seats Infant Seats

• Premature/Low Birth Weight Babies
• Infant should be tested while
• in car seat
• AAP policy Angle Tolerance
• Testing
• Use CR for transportation
• ONLY

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Conventional Car Seats Rear facing Convertible

• First Option use a Conventional Car Seat if it
  meets child's needs
• Check rear facing
• Weight limits
• Less Expensive
• Easier to find use

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Conventional Car Seats Forward Facing Seat

• Car seat in Upright position
• Some manufacturers allow
• semi-reclined position when
• Forward Facing
• Some car seats have harnesses that
• have weight limits up to 65

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Special Needs Car Seats

• The following slides feature examples of some of
  the more common special needs car seats.

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Infant Car Beds

• For infants who must lie down or
• fail angle tolerance test
• Infants head placed toward center
• of vehicle in all beds

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The Roosevelt Car Seat byMerritt Manufacturing

• 35 to 115
• 33.5-62
• 995.00 approx.
• www.eztether.com

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Columbia Car Seat

• Good option for kids needing
• Harnesses to higher weight limits
• Example Cerebral Palsy
• Made with Latex silicon free
• materials
• 2 sizes 20-102 65-130 approx.
  780.00

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Recaro Start Plus Car Seat

• Latex-free car seat for children with special
  needs
• children 30 to 80 lbs.
• max. user height is 60
• Backrest tilts from 90 to 105
• Approx. 1,300.00

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Snug Seat Hippo

• Commonly used for hip casts
• RF 5-33
• FF 1 yr. 20-65
• FF recline to 40
• approx. 450.00

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Casts Other Conditions

• Follow weight limits using casted weight
• Specialized Child Restraints
• aap.org or
• preventinjury.org
• for specific product
• Recommendations Q/A

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E-Z-ON Vest

• 2 yrs over 20-168
• For Children who can sit upright
• Works with lap belt only vehicles
• Must be used with tether anchor
• Approx. 100.00
• Check website for more details
• www.ezonpro.com

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Modified E-Z-ON Vest

• Use for body casts, hip spica casts, braces
• Supine, prone, side-lying
• 2-5 yr 20-65 19-25 extremity belt
• 5-12 yr 20-100 25-32 extremity belt

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Modified E-Z-ON Vest

• For children 212 years old who must lie down
• Child must fit lengthwise on bench seat
• Follow weight limits using casted weight
• If not casted, this child would ride facing
  forward

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Common Solutions to Complicated Issues

• Behavioral management counseling
• Reward system
• Your solution may be as simple as a seat with a
  buckle type retainer clip, or a vest that zips up
  the back, or one that has lower sides to
  accommodate a cast. Many options are available.
  

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Travel Tips for Children with Special Needsfrom
the American Academy of Pediatrics

• Never place rear facing seat in front of a
  passenger side air bag
• If you must transport a medically fragile child
  in the front with an air bag, have air bag
  switched off by contacting NHTSA
• 888/DASH-2-DOT or 888-327-4236
• Back seat safest place to ride
• SourceSafe Transportation of Children with
  special needs a guide for families AAP

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Travel Tips for Children with Special Needsfrom
the American Academy of Pediatrics

• Limit car travel depending on condition
• Stop often if trip is long
• Cell phone
• Adult ride in back with child if possible
• SourceSafe Transportation of Children with
  special needs a guide for families AAP

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Travel Tips for Children with Special Needsfrom
the American Academy of Pediatrics

• Develop medical care plan in case of medical
  emergency during travel, attach a copy of the
  plan to child's car seat
• Carry an emergency kit with medications/supplies
  that child may need, use checklist to ensure
  correct medications/supplies are in kit
• (do not leave kit in vehicle due to temperature
  changes)
• SourceSafe Transportation of Children with
  special needs a guide for families AAP

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Travel Tips for Children with Special Needsfrom
the American Academy of Pediatrics

• Never use a reclined vehicle seat to transport a
  child
• Professional transport may be needed
• (ex ambulance)
• Apply for handicap parking permit if necessary
• SourceSafe Transportation of Children with
  special needs a guide for families AAP

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Travel Tips for Children with Special Needsfrom
the American Academy of Pediatrics

• NEVER leave your child alone in the vehicle, even
  for a few minutes. Your childs safety is worth
  the effort to remove him/her from vehicle and
  take with you.
• Federal law gives special needs school age
  children the right for equal services including
  transportation
• SourceSafe Transportation of Children with
  special needs a guide for families AAP

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Travel Tips for Children with Special Needsfrom
the American Academy of Pediatrics

• Medical equipment must be secured in the vehicle
  to prevent them from becoming projectiles. Wedge
  equipment on vehicle floor with pillows or secure
  with available seat belts.
• There are no products to secure medical devices
  at this time.
• Always make sure devices using batteries have
  enough power for twice the length of your trip.
• SourceSafe Transportation of Children with
  special needs a guide for families AAP

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Special Needs Resources

• How to find them consult the child's medical
  team local school special needs
• How to access them set up a meeting with the
  team of those with access to all areas of the
  child's life including transportation.

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Special Needs Resources

• If long term issues consult medical team, if in
  school, all teachers including special needs
  teachers, principal, bus drivers, parents, etc.
• This Child Study Team is a group that will
  work out the best plan for all areas of the
  child's needs to create the
• IEP-Individual Education Plan.

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Special Needs Resources

• Consult the American Academy of Pediatrics Car
  Seat Shopping Guide for Children with Special
  Needs
• Contact ND State Health Dept.
• Internet is a great Special Needs resource try
• adaptivemall.com

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Questions??
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Thank you

• Please help protect those who cant protect
  themselves!
• Buckle up our kids!