rear-facing child restraint systems do not distribute

Rear-facing Child

Restraint Systems

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Objectives: LEARN• Why children should travel rear-facing• Why rear-facing CRS should not be used with frontal

airbags• How to teach parents to correctly secure and install a

child in a rear-facing CRS

Selecting & Securing - 2

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Objective: PRACTICE• Identifying parts of a RF CRS• Selection, direction, location and installation of a child

in a rear-facing CRS• Using check list form• Identifying misuse


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Objective: EXPLAIN• Proper use with caregivers• Misuse errors with caregivers• Best practice and tough choices with caregivers


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4 steps

• Rear facing

• Forward facing with harness

• Booster

• Seat belt

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Why Children Should Travel Rear-facing• Physical development

- Babies have big heads

- Bones, tendons and muscles not fully developed

• Increased crash protection- CR absorbs forces of the crash

- Spreads crash forces along the entire head, neck and back

- Protects head and spinal cord

Correct Installation - 3

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Child’s Body Proportions

Update to infant

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Types of Rear-facing CRS

• Infant-only CRS with or without base

• Convertible CRS used rear-facing


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Rear-facing Infant Only CRS• Rear-facing ONLY • Use rear-facing to the highest weight and

height allowed by the manufacturer’s instructions

• Head must be 1” below the top of the shell

• Use in semi-reclined position• Use harness straps at or below shoulder

level


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Low Birth Weight and Premature Infants• AAP recommends testing

in CSS before discharge to monitor baby’s heart rate, levels of oxygen and breathing

• Testing completed in a car safety seat positioned at appropriate angle

• Results may show child should use a car bed

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Breathing Problems

Add pict in veh – diff car bed – on back

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Low Birth Weight and Premature Infants• Avoid trays or shields• Rear facing child safety seat with

small internal harness dimensions• CSS that meets child’s low weight• Center in seat with rolled receiving

blankets and crotch roll if necessary

• Angle for testing should be same as angle in car

• Use CSS only for transportation

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Low Birth Weight and Premature Infants

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Breathing Problems

• Apnea (breathing stops for more than 20 seconds)

• Tracheostomies (breathing tube in trachea): Avoid seats with shields or trays

• Upright position in CSS may make breathing problems worse.

• Children may travel with apnea monitors, ventilators, oxygen

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Rear-facing Convertible CRS• Use when babies outgrow infant-only seat• Use rear-facing to the highest weight/height allowed by the

manufacturer’s instructions • Use in semi-reclined position• Use harness slots at or below shoulder level


5 Point Harness

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These seats not appropriate for young infants


Tray Shield

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CRS Parts & Functions


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Other CRS – (Infant Seats)

Baby Safe Companion

Foot Prop

Anti-Rebound Bar

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Hands-on Activity: Using Rear-facing CRS

• Locate instruction manual and CRS seat labels- Wt and ht limits- Use with or without base

• Check if on recall list• Practice harness adjustments (pull tab, O-ring, metal rod and A-lock)• Change harness slots• Adjust harness clip• Adjust recline mechanism• Adjust handle (when present)• Locate safety belt or LATCH belt paths• Locate locking clip or built-in lock-off

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FOUR STEPS To Remember • SELECTION• DIRECTION• LOCATION• INSTALLATION

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SELECTION


• Fits your child- Appropriate for weight and height

of child according to CRS instructions

- Harness straps must be at or below the shoulders

- Harness snug (pinch test)- Crotch strap that fits best

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SELECTION


• Fits your vehicle– Consult vehicle owner’s manual– Vehicle seat type and size (contoured, bench, captain)– Works with safety belt or LATCH system

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SELECTION


• Ease of use- Physical problems for caregivers

(arthritis, limb deficiency, bad back, etc.)

- With CRS (front vs. back harness adjustment)

- Works with safety belt or LATCH system

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SELECTION – Securing into Rear-facing CRS

• Back & bottom are flat into CRS

• Rolled cloth at crotch strap if necessary

• Blankets at sides for positioning

• Harness at or below shoulders• Harness snug• Harness retainer clip at armpit

level


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Selection - Low Birth Weight and Premature Infants• Avoid trays or shields• Rear facing child safety seat with

small internal harness dimensions• CR that meets child’s low weight• Center in seat with rolled receiving

blankets and crotch roll if necessary

• Use CR only for transportation

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Types of Special Needs Restraints: Car Beds

Source: Automotive Safety Program

Dream Ride SE

5-20 pounds and 26 inches; 3-point harness

Angel Ride

Birth-9 pounds and 20 inches; 3-point harness

Snug Seat

Birth to 21 pounds and 29 ½ inches; sleeping bag instead of harness

Car beds:•Infants who must lie down

•Head placed toward center of vehicle in all beds

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Selection: Conventional Restraints

• First option if meets child’s needs

• Less expensive• Usually easier to find, use

and install• Often meets needs of

children with special health care needs

Insert age/weight

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DIRECTION


• For optimal protection, use rear-facing to highest weight and/or height according to the CRS instructions

• Rear-facing until at least 1 year old AND at least 20 pounds

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LOCATION• A back seat is the safest location• If available, use center back seat of vehicle (away from

front, side, rear-end crashes)• Consider position of other passengers• Consider safety belt versus LATCH system• Airbag implications

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LOCATION - Airbags and Rear-facing CRS

• NEVER place a rear-facing CRS in front of an active passenger air bag

• If no back seat airbag = off!

• Very high forces hit child’s head during inflation

• Follow vehicle and CR instructions for side-airbag interactions

Misuse and Compatibility - 23

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INSTALLATION

• Appropriate recline angle• Correct belt path• Tight and locked in place

- Using safety beltOR- Using LATCH System

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INSTALLATION - Angle

• Spread crash forces along the entire head, neck and back

• Helps keep airway open• Angle according to

manufacturer’s instructions• More upright as child grows• Car bed option for special needs

Courtesy of Kathleen WeberChild Passenger Protection Research Program

University of Michigan Medical School


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Special considerations for rear-facing seats:

- Space requirements- Seat slope


NO

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• Follow CRS manufacturer’s instructions

• Use recline adjuster as needed


YES

NO!

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• Pool noodles or a rolled towel may help to recline CRS

• Avoid too much recline• Do not allow pool noodles or

towel to get in the way of safety belt or LATCH system


YES

NO!

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INSTALLATION - Safety Belt or LATCH System

Tightly Securing the CRS:- Install tightly using safety

belt or LATCH system- Grip CRS at belt path to

check - CRS should not move

forward or side to side more than one inch

- Parent or caregiver must be able to repeat installation


Tech pulling on belt to tighten (not knee)

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INSTALLATION - Special Situations

CRS with a switchable

retractor:• Tension in shoulder portion may

lift up CRS- Keep in ELR mode and- Use locking clip or - Try another seating position


NO

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INSTALLATION – Rear-facing CRS and Tethers

• Unless allowed by CRS and vehicle manufacturer, do not tether a CRS rear-facing

• Read CRS/vehicle instructions

Correct Installation – 49

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Rear-facing Tethering Provides...


Swedish Method = Toward Front of Vehicle

Australian Method = Toward Rear of Vehicle

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INSTALLATION – Safety Belt or LATCH System DEMO

• Tightly securing the CRS− Install tightly using (1) safety belt or (2) LATCH

system− Grip CRS at belt path to check− CRS should not move forward or side to side

more than one inch− Parent/caregiver must be able to repeat

installation


Insert RF CRS installation with Safety Belt and LATCH/Tether

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PRACTICE - Hands-On Exercise

Using the information known about “your child”:

- Configure CRS correctly for child, including different harness systems

- Install in vehicle: Rear-facing convertible, infant only

» Lap only» Lap/shoulder» Flexible/Rigid LATCH/Tether

- Teach a parent to do these things


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EXPLAIN - Best Practice and Tough Choices

Role Play• I have 2 kids. Which one should go in the middle?• It is easier if I leave the handle up. Is that okay?• Should I use LATCH or the safety belt? Which is

safer?• Should I use a tether on my RF convertible seat?• I want to see my baby. Can I turn him around?


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EXPLAIN - Common Selection Errors

1. Using outgrown CRS2. Child too small/young for CRS3. Using non-213 certified device4. Using a CRS that is more than 6 years old5. Using a CRS with unknown history6. Using a CRS that has been involved in a crash7. Using a CRS under current recall


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EXPLAIN - Harnessing Errors

1. Too loose2. Not used3. Retainer clip not at armpit level4. Routed through wrong slots5. Not doubled back, if needed6. Knotted, pinned or otherwise incorrectly secured 7. Not placed on child correctly8. Frayed or damaged9. Metal adjuster not flush with slot or out of position10. Crotch strap too long or wrong position11. Using "add-ons" not approved by the CRS manufacturer


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EXPLAIN - Installation Errors

1. Safety belt or LATCH too loose or not locked2. CRS facing wrong way3. Using wrong belt path4. Incorrect recline angle5. CRS installed using both safety belt and LATCH system6. Incorrect LATCH use7. Incorrect tether use8. Carrying handle not used as specified in the instructions


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PRACTICE - Classroom Activity

• Determine what is correct or incorrect with the CRS installation

• How would you explain to a parent or caregiver?


“What’s Wrong With This Picture?”

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Misuse -What’s Wrong With This Picture?

Misuse and Compatibility - 28 Standardized CPS Training Program - Winter 2004

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SHARE with Parent or Caregiver-

• Child too upright• Needs some type of support

under front of CRS• Possibly too big for CRS

Misuse-What’s Wrong With This Picture?


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Misuse-

“What’sWrong

With This Picture?”


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• Harness adjuster bar missing

• Using rope or cords to hold straps in place



Standardized CPS Training Program - Winter 2004

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Misuse- What’s Wrong With This Picture?


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• Rear-facing seat is forward facing

• CRS too small for child• Bulky clothing means

harness is too loose



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Misuse- What’s Wrong With This Picture?


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• This is a household carrier• No CRS labels (but a very small

sticker stating it is not to be used in a vehicle)

• No belt paths for vehicle use • No harness straps• No harness retainer clip



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SHARE with Parent or Caregiver-• CRS reclined too far in rear seat• Wedged into vehicle seat



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SHARE with PARENT or Caregiver-

• Cargo tie down used in addition to safety belt

• Tie down secured to vehicle seat frame

• Too upright



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Misuse-

“What’sWrong



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SHARE with Parent or Caregiver-• Wood added under rear-facing CRS to obtain correct angle for infant



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Misuse-

“What’sWrong



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• Front- facing only CRS used rear- facing

• Too upright for rear-facing• Harness too loose• Safety belt used for installation is

threaded though the wrong belt path and is too loose



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• Infant is facing the front• Rear-facing only CRS installed is

installed facing forward• Handle left up• Harness too loose and off the

shoulders• No retainer clip used



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• Handle left up• Harness may be too loose if infant

can turn around• Note: Shoulder belt around back of

CRS is allowed on this model



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• CRS is not semi-reclined• Harness on edge of shoulders



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• Infant bundled before harnessing• Harness retained clip is not at

armpit level



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• Too upright for infant• Harness too loose• Harness retainer clip twisted and

out of position• Safety belt not through belt path

slots• Safety Belt too loose



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Objectives – A REVIEW

• Describe an infant’s physical characteristics that require added protection during travel.

• Describe ways that rear-facing CRS provide additional protection during travel.

• Identify all CRS parts on a:- rear-facing infant CRS (with and without a base) - rear-facing convertible CRS.

• Identify correct CRS installation techniques - tight fit, appropriate angle, harness use, and seat selection

• Describe correct placement of harness straps, harness retainer clip, carrying handle, etc.


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Core elements

• Why RF (phys char)?

• Selection IO and RFC

• Harness adjustment

• Install – angle, belt path, tightness

• location

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Hands-on Activity:Identifying Labeling

• Participants will locate labels re: weight and height requirements on infant-only CRS and convertible CRS

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Adjustment Foot

Detachable Base


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ADD – RF Convertible


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LOCATION

• Airbags- Passenger

» NEVER place a rear-facing CRS in front of an active passenger air bag

» If no back seat airbag = off!

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INSTALLATION – ID Safety Belt Path HANDS ON

- Read CRS manufacturer’s instructions

- Identify belt path on » Infant seat (with and without

base)» Rear-facing Convertible

Seat


Update to RF seat – safety belt RF only

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I INSTALLATION – Identify LATCH System

- Read CRS manufacturer’s instructions

- Identify LATCH belt path » Infant seat (with and without

base)» Rear-facing Convertible Seat


Update to RF seat – LATCH system

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INSTALLATION - Safety Belt or LATCH System

Tightly Securing the CRS:- Install tightly using safety

belt or LATCH system- Grip CRS at belt path to

check - CRS should not move

forward or side to side more than one inch

- Parent or caregiver must be able to repeat installation


Tech pulling on belt to tighten (not knee)

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INSTALLATION – Rear-facing CRS and Tethers


• Currently, ONLY the Britax CRS is designed to be tethered rear-facing

• Rear-facing tethering with Britax provides…..

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Best Practices

• Suggested option for the safest way to travel • May conflict with the real world


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LATCH - Best Practices

Situation for rear-facing infant CRS or rear-facingconvertible CRS:• If CRS has LATCH attachments but vehicle has no LATCH anchors.• Vehicle has LATCH anchors but CRS does not have LATCH

attachments.• Both CRS and Vehicle have user-ready LATCH hardware but the system

is not used.• Both CRS and vehicle have LATCH hardware but no tether is used.• LATCH components used incorrectly.


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EXPLAIN - Most Common Misuses

• Selection• Harness• Installation

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Child’s Body Proportions

Update to infant

rear-facing child restraint systems do not distribute

Documents

crs rear

infant slide

seat use rear

oxygen slide

transportation slide

shields rear

types of rear

steps rear