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By Tim Nowak for SA国际传媒 BrandFocus
You鈥檝e likely read how 鈥�mom holding onto baby鈥� is not an acceptable transport option. That鈥檚 because it鈥檚 not safe. Just like it鈥檚 illegal to hold children and infants in your lap in your personal vehicle while it鈥檚 traveling, the same is true in an ambulance.
So let鈥檚 break down what is acceptable for transporting patients of a younger age (and smaller size).
1. Start with their own car seat
Ideally, the child鈥檚 parents have kept up with their child鈥檚 growth and have them secured in a properly-sized seat. If this is the case 鈥� and if you have the time (i.e., your patient is in a stable condition) 鈥� lobby for taking the child鈥檚 own car seat along for the ride in your ambulance.
If the child鈥檚 seat was inside of a vehicle that was involved in a collision, that doesn鈥檛 automatically discard its use from further transport use, according to a . Along with some additional criteria, if the car seat has no visible damage, it may be safe for further use.
Your airway/captain鈥檚 seat will likely be your best place to buckle it into place. An alternative option could be appropriately securing it in a forward-facing bucket seat (in place of your traditional bench seat) 鈥� but remember that having the car seat facing the side of any ambulance is unacceptable, no matter how you try to justify it.
On top of that, securing a rearward-facing car seat to an already rearward-facing seat (like the captain鈥檚 seat) does not equate to the patient facing forward. In this instance, two 鈥渘egatives鈥� don鈥檛 equal a 鈥減ositive.鈥� If the patient is supposed to be rearward-facing in a personal vehicle, they should also be rearward-facing in an ambulance, no matter what you need to do to accomplish that.
Why is the patient鈥檚 own seat the first option? Because they鈥檙e already familiar with the look, smell and contour of it. Providing this familiarity 鈥� again, if it鈥檚 the proper size 鈥� can go a long way toward promoting the patient鈥檚 safety and comfort.
2. Commercial devices offer plenty of options
It鈥檚 not expected that every ambulance carries a variety of full-size car seats to accommodate a one-day-old, a 1-year-old or even an 8-year-old. If this were the case, we would either have to add a hitch to the back of our ambulances or convert all of our fleets into super-sized, mega-ambulances with enough cargo space to make a heavy-duty rescue unit look like a Geo Metro (for those that remember those classics).
Innovative minds and companies have paved the way for multiple commercial options in this market space, including:
- Inflatable car seats.
- In-seat/convertible restraint system.
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It鈥檚 hard to find a one-size-fits-all option because of the wide variance in pediatric patient sizes 鈥� after all, both a 2-year-old and a 9-year-old are considered pediatric, but their sizes are not comparable. Sometimes, relying on your standard EMS cot is your best (and only) option.
3. Four-point shoulder/chest restraints
Sometimes, simply securing your pediatric patient to your standard EMS cot/stretcher may be your best 鈥� or even only 鈥� option. In this case, reverting back to your training with backboards comes in handy, particularly when it comes to 鈥減adding the voids.鈥� As outlined by NHTSA, .
A is also a good option and may provide greater access to the torso without the need to loosen or remove the restraint during transport.
Many states require that ambulances carry some form of child protective restraint system, like (Chapter 4 of the state鈥檚 code of regulations for EMS, which I took part in updating). In the stable condition environment, time should be taken to properly secure patients using some form of approved commercial device.
In instances where true emergent transport is necessary, or where a seated position is not conducive toward the needs of your pediatric patient鈥檚 care, then semi-Fowler or supine transport of the patient on your cot may be the best bet 鈥� with adequate padding and shoulder/chest restraints, of course.
No one in the ambulance 鈥� including parents, caregivers, medics or other passengers 鈥� should be unrestrained during transport. Consider your options and plan ahead so that you鈥檙e prepared when faced with a pediatric patient.
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