On the occasion of Child Safety Day on June 10th, orthopedists and trauma surgeons recommend allowing children up to the age of three to ride in a rear-facing child seat in the car, thereby going beyond the previously valid framework. In addition to the sitting position, it is important to use a child seat that is correct for your age and height. Parents are also required to drive responsibly.

“Many accidents can be prevented by driving appropriately, and this also applies to parents. When an accident occurs, high speed and distraction usually play a role, especially when using a cell phone. Unfortunately, even when there are children on board,” says Prof. Dr. Benedikt Friemert, President of the German Society for Orthopedics and Trauma Surgery (DGOU). The statements are supported by a current study1 with data from the TraumaRegister DGU®.

It is a recurring question in many young families: Which child seats and seat types are right for the first car journeys in order to increase the safety of children in the car? Forward or backward? From a medical and technical point of view, it would make sense to increase the age for backward transport to three years. Securing children backwards offers advantages in the event of an impact, as the load is distributed over a wide area across the child's torso and increased forces that affect the cervical spine, head and stomach at specific points can be reduced. What is even more important than simply transporting children rear-facing is the use of a child seat that is correct for their age and body size, taking into account the i-Size standard , which divides child seat classes according to body size.

Tips from trauma surgeons for transporting children up to the age of 3

1) Transport babies and small children up to and including the age of three backwards
2) Always secure children properly in suitable child car seats
3) Pay attention to the new i-Size standard, i.e. adjusted to the child's height
4) Older children with a three- Secure point belt system
5) Pay attention to the current safety standard for child seats, such as side impact protection or ISOFIX fastening system

According to the latest i-Size standard, children up to 15 months must be transported facing the direction of travel.2 The later you switch to a forward-facing child seat, the better. “This significantly reduces the risk of injury in a head-on accident,” says Dr. Christopher Spering, head of the DGOU Prevention Section, who was involved in the preparation of the study. Even though the number of road deaths is declining, according to the Federal Statistical Office, 7,300 children under the age of 15 were injured as car passengers in 2020.3 “These numbers must be further reduced; abroad we are already being led to believe that this is possible,” Spering continues. Head and spinal injuries are particularly common.

Serious injuries often occur in the 2-3 year old age group as a result of incorrect use of car seats and incorrect use of restraint systems. The critical so-called “submarine effect” occurs when the child's body slips under the lap belt. The belt then acts like a hinge and as a result, serious abdominal and/or spinal injuries and leg fractures often occur. Therefore, lap belts should be avoided as the sole safety device for older children and attention should always be paid to a so-called three-point system.

The DOGU recommends that the topic of child transport also be included in driver training. Broader public education would also help to raise awareness of the issue and avoidable errors. Precisely because many child seats are not only purchased new, but also used, parents are often not sufficiently informed about the current safety standards and useful features.

background

There are currently three child seat standards in force in the EU: ECE R 44/03, ECE R 44/04 and ECE R 129. The so-called i-Size standard is part of the ECE R 129 test standard. It regulates that child seat classes are divided according to body size and no longer based on body weight as before.

Sources

1) Study: Data was collected via the TraumaRegister DGU® (TR-DGU) in the period from 2010 to 2019. Children aged 0 to 5 years who were seriously injured as car passengers in a traffic accident and taken to a trauma center were recorded ® DGU were transported.
European Journal of Trauma and Emergency Surgery I https://doi.org/10.1007/s00068-022-01917-y
Prevention of severe injuries of child passengers in motor vehicle accidents: is reboarding sufficient?
Christopher Spering · Gerd Müller · László Füzesi · Bertil Bouillon · Hauke ​​Rüther · Wolfgang Lehmann · Rolf Lefering · and Section of Injury Prevention DGOU · and TraumaRegister DGU® 2) ADAC
3) Federal Statistical Office

Further information: http://www.dgou.de

Also read: No drowned children in the back seat of a car


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