Car Accidents – Injuries to Children:

In Car accidents, children are at high risk of severe head injuries, damage to the liver and spleen, shock from blood loss. Driving carefully and using car seats correctly can help protect your family.
In the event of an accident and possible injury to the child, here is a simple guide on what to do in such an emergency.

• Turn off the ignition : This reduces the risk of a fire if there is any petrol leaking from the car
• Turn on your hazard lights and if you are able to come out of the vehicle , step out carefully, and place the Hazard Triangles link ( How to Use your Hazard Triangle ‘Lifesaver’)
• Check to see whether anyone is injured. If your child is hurt, follow the following instructions.( However for all injuries seek medical attention to ascertain the degree and severity and also ensure that proper mediation is provided)

Treating Injuries at the scene (Kindly note that this should not be a substitute for immediate medical attention)

Injury: Your Child is unconscious

First Aid: If he is unconscious but breathing, wait for the Ambulance to arrive. If he is not breathing lift his chin to open his airway. If he is still not breathing, remove him from the car seat, gently position him on his back, and lift his chin again.

Place your mouth over his (mouth and nose for children under 6), and give two short breaths. Check for a pulse. If there is no pulse, administer CPR.

 If there is a pulse continues giving one breath every three seconds until help arrives or your child is breathing on his own.

Injury: Your Child is bleeding:
First Aid: Apply firm, direct pressure to the wound with gauze, bandage, a wad of tissue or a T-shirt. Do not remove at all for five to ten minutes, depending on the severity of the cut. You can have the child do this herself if she/he is able Refer to First Aid Kit Essentials

Injury: Your Child’s arm hurts and is bent at a peculiar angle.
First Aid: The arm could be fractured, so don’t try to straighten it. Look for a board or a piece of cardboard so use as a splint. Have your child rest her arm on it, then wrap it carefully with tape or a shirt and wait for help to arrive. Refer to First Aid Kit Essentials

Injury: Your child has neck pain or is short of breath.
First Aid: Wait for help and do not move your child unless it’s imperative. If he has a broken vertebra or rib, for example and you move him, the vertebra could cause a spinal cord injury, or the rib could puncture a lung.

Car Seating For Children

Back seat: The back seat is the safest place for children of any age. Where possible install the child restraint in the centre rear position.
Child seats: Remember to use the child seat for all journeys, however short. A baby is not safe in your arms. Even in a minor crash, collision forces may tear the child from your grip. Where allowable, you may install a forward facing child seat in the front seat (without a side impact airbag), but always move the passenger seat as far back as possible.
Child restraints: Fit child restraints properly. Follow instructions and make sure the capsule or child seat is firmly fitted, with minimal sideways or forward movement on the car seat. Don't use a child restraint that's been in a crash. The protective structure could be invisibly damaged. Every trip, make sure that the child restraint harness is properly adjusted, checking that only the thickness of two fingers can be inserted between the harness and the child's chest.
It's never safe to leave children in cars, particularly in hot weather when temperatures inside a closed car can quickly rise to more than 60C. Leaving windows open a little does not reduce the temperature enough.
Concentrate: Make sure you keep your child occupied on long journeys (with soft toys, music and stories). A bored child can distract the driver, fiddle with buckles and wriggle out of position.

Airbag Alert

Air bags prevent thousands of injuries and deaths every year, but because they engage so forcefully, they can cause serious harm to a small child. That’s one of the reasons you should never put a child’s car seat in the front passenger seat, In fact, all children under 12 should sit in the back. If your car is equipped with rear side air bags, ask the manufacturer/dealer whether the pose a risk to children. The middle seat is always the safest place for a child, but safety experts say that in most cases, rear air bags pose no danger to children riding properly restrained anywhere in the backseat.

Car Seat Basics

Putting your Child in a car seat or booster seat – correctly, is the most important thing you can do to protect him in case of an accident. Here’s what you need to know

• Kids should be in a car seat or booster until they can be seated properly in a seatbelt. For most kids, this is around 8 years old or 4' 9" tall, but proper seatbelt fit is the most important factor.
• Never place a rear-facing car seat in the front seat when there is an active frontal airbag. Keep your baby rear-facing for a minimum of 1 year and (9 Kilos).
• Most convertible car seats allow a child to remain rear-facing to 13 Kilograms or 15 Kilograms pounds, unless they outgrow it by height first, so you may keep them rear-facing longer if your seat allows. Make sure that the harness fits snug on your child, the car seat fits snug in your vehicle, and that your vehicle seatbelts are locked properly.
• Kids 12 and under should ALWAYS ride in the back seat. Infants and children below the age of 8 should ride either in a car seat or booster seat.
• Putting your Child in a car seat or booster seat – correctly, is the most important thing you can do to protect him in case of an accident.

Unfortunately in East Africa there is no legislation on the carriage of children in motor vehicles, and no proper guidelines on car seats. However it is very important for anyone who travels with their children in motor vehicles to carry them safely.

IGNORANCE IN THIS MATTER IS NO DEFFENCE.

Here’s what you need to know:-

Types of Car Seats Available in the Market

Infant Only

These car seats are smaller and usually offer the best fit for newborns. Infants require a rear-facing seat that fits your baby's weight and height. That’s because babies have weak neck and back muscles that need extra support when traveling in a vehicle. A rear-facing infant seat will support your baby's head and neck in a sudden stop or a crash. Carefully refer to the instructions that come with the car seat and attach the seat as recommended to the car. Be cautious about buying or borrowing a used car seat that could be missing parts or instructions and never use a car seat that is more than 10 years old.

They are rear facing and usually hold up to 9kilograms though some will go a bit beyond this. Many are now sold with added features such as bases, ability to attach to shopping carts, strollers, etc. The harness tends to be either a three or five point restraint.

Convertible

These are designed for both newborns and forward facing infants, sometimes through the toddler years. This seat has the ability to be rear facing for smaller and younger infants, and to convert to a forward facing seat once the child is older and weighs more. There are very few features added on to these. Harnesses can be a three/five point restraint, a shield, or an over-the-head shield which acts as a sun visor and also can be protective when carrying the child in the rain or strong wind.

Forward Facing

These seats are strictly forward facing and for infants who are greater than 9 Kilograms. (Or more depending on the car seat, and over one year of age. These cannot be used for newborns or infants under 9kilogrammes. Harnesses can be a three/five point restraint, a shield, or an over-the-head shield.

Boosters

These are generally for children over 13.5 Kilograms – 18 Kilograms, depending on the manufacturer. Harness can be anything from the regular seat belt to a lap shield or a harness system.

Shopping for a car seat

There is no one best car seat, however ensure that you:-
Buy a car seat from a recognized manufacturer with clear labels confirming testing has been down in the country of manufacture and that it has passed government safety standards in the country of origin. All car seats purchased new from a retail store should have a sticker confirming this. This is clearly displayed on the side of the car seat.

When you buy a car seat, make sure you have a good return policy in case it doesn't fit or in case you find you don't like it. Some retailers may allow you to fit the child seat in your vehicle before you purchase it. Select the one that best fits your child and your vehicle. Some models do have different features; select one that has the features that will allow you to use it correctly EVERY trip.

Always read the owners manuals for your vehicle and car seat thoroughly before installing your child’s safety seat.  They often contain specific information about car seat installation that may not be obvious. Some models may vary from what you would expect.

• Extra expensive does not mean added safety.
• Talk to other parents about what they've liked and disliked about car seats.
• Read International Baby Magazines (South African ones are a good place to start) and read their consumer reviews and guides to car seats for more on consumer alerts and comparison shopping. This is important as most brands are imported from various countries by retailers (there are no local East African Manufactures of Car seats).
• Please AVOID used car seats, especially those over 6 years old, those with an unknown history that may have been in a crash, those that show any form of cracks or damage and those with  missing labels, model number, manufacturing date, instructions or parts. Please give driving your complete, unimpaired attention and wear your own seatbelt all the time.
• If a friend or loved one donates a car seat to you (hand me down) carefully assess its overall condition, looking out for cracks, stress points, condition of seatbelts (should not be worn or torn). Also ask if the car seat has been involved in any accident. This will enable you ascertain that it is the best shape for your child. 
• Do your research prior to purchasing aftermarket products. Aftermarket products are products that do not come with your child’s safety seat. (e.g. mirrors that fit on your headrest so you can look back and see your child) These products do not have any highway safety standards from their country or origin   that they have to comply with, and may place prove to be injury causing or place your child in grave danger

Installing The Car Seat

You have made your choice, now you need to install the car seat in your car prior to use. If it is for infants, ensure that it is fitted in the car before your due date, and should remain in the car for as long as the child will use it. Kids should be in a car seat or booster until they can be seated properly in a seatbelt. For most kids, this is around 8 years old or 4' 9" tall, but proper seatbelt fit is the most important factor.

• Always read the owners manuals for your vehicle and car seat thoroughly before installing your child’s safety seat. They often contain specific information about car seat installation that may not be obvious. Some models may vary from what you would expect.

When installing the car seat read the instructions, even though it may look fairly simple, it can be quite confusing. Car seats, or children for that matter, do not belong in the front seat, particularly if there are air bags. They can kill your children, even if buckled in the car seat correctly. Most cars have warnings that say this. Check with your owner's handbook if you're unsure if your car has air bags.

• If you have misplaced your manual you can request a new from the manufacturer or download it from their website.
•  Remember that the photos on the box your car seat came in may not always show the proper way to install the car seat.
• Don't forget to ask for help from an experienced parent when in doubt. In East Africa it is not mandatory to put a newborn baby into a car seat but in most of Europe and America you are not allowed to leave the hospital without a car seat. Many hospitals check for a properly installed car seat prior to discharge, but in East Africa they don't, you don't want a false sense of security. So ensure that you purchase a car seat before the little one arrives.
• Even after months of using it, every three months it's wise to inspect the car seat, looking out for worn belts, signs of damage especially cracking.  It only takes a minute
• Ensure that the car seat covers are kept clean and free of dust, so as to provide your child a clean and safe mode of travel.
• Never place a rear-facing car seat in the front seat when there is an active frontal airbag. Keep your baby rear-facing for a minimum of 1 year and (9 Kilograms).
• Most convertible car seats allow a child to remain rear-facing to (13-18Kgs) (unless they outgrow it by height first), so you may keep them rear-facing longer if your seat allows.
• Make sure that the harness fits snug on your child, the car seat fits snug in your vehicle, and that your vehicle seatbelts are locked properly.

Finally please give driving your complete, unimpaired attention and wear your own seatbelt all the time, after all car occupancy safety is dependant on the driver.