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It Takes Two: Child Passenger Safety Technicians (CPSTs) And Pediatric Rehabilitation Clinicians Unite To Address Challenges Associated With Proper Car Seat Restraint In Children With Special Needs
*Michelle Price, *Angela Campos, Stephanie Lyons, Melissa Tally, Patrick Edmunds, *Meera Kotagal, *Richard A Falcone, *Rebeccah L Brown
Cincinnati Children's Hospital Medical Center, Cincinnati, OH

Background: Transportation of children with special needs (SN) is challenging due to the complex interaction of diagnosis, need, vehicle specifications, and multiple passenger configurations. Proper restraint use is also difficult for families to achieve without skilled intervention from a child passenger safety technician (CPST). The purpose of this collaboration was to leverage the combined expertise of pediatric rehabilitation clinicians, who are not CPSTs, and SN-trained CPSTs. A “triage” process was developed for selecting, ordering, and providing hands-on education for CPS restraints for children and families with complex needs.
Methods: Once a patient requiring a SN car seat is identified by the rehabilitation team, a referral is forwarded to a SN-CPST who contacts the family to discuss specific needs and options for proper restraint. Recommendations are sent back to the rehabilitation clinician who completes the letter of medical necessity and orders appropriate equipment based on the information provided by the SN-CPST. Upon equipment delivery, hands-on education for fit and installation is provided by the SN-CPST to the family.
Results: Prior to this collaboration, without oversight by SN-CPSTs, proper installation of complex SN car seats upon delivery was essentially nil. Since initiating this “triage” process in March 2020, we have markedly improved and streamlined the selection/ordering process for SN car seats, provided hands-on fit and installation education to >100 families, and increased proper use to >90% at day of delivery.
Conclusion: Collaboration between pediatric rehabilitation clinicians and SN-CPSTs may significantly improve the proper use of CPS restraints among children with special needs.


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