Keeping Junior Safe on the Road

Road accidents happen as much as we hate to think about them and as much as we try our best to avoid them. You may be stuck in a massive holiday season-induced jam, your car crawling at a snail’s pace with your children in the back constantly asking “Are we there yet?” when suddenly, the driver of the car behind yours accidentally steps on the accelerator instead of the brake causing his car’s front bumper to ram into your car’s back bumper. Not a great way to start the holidays, right?

Although the above scenario doesn’t sound serious, real-life accidents can be far more costly – and we aren’t just talking about money. Annually, many people, especially children, are killed or injured in car crashes. But while accidents are sometimes beyond our control, we can do our part in minimizing or preventing the harm which occurs.

“We often read about a spike in road accidents during the holidays,” says Consultant Paediatric and Adult Orthopaedic & Trauma Surgeon Dr Ong Shong Meng. “But what saddens me the most is reading about children dying in accidents due to a lack of proper child seats and restraints. According to the Malaysian Institute of Road Safety Research, the usage of appropriate child seats and restraints could have reduced deaths in infants by about 70% and in children aged 1-4 by 54% while injuries in children aged 4-7 could have been lowered by 59%.”

“Children usually have it worse”

Asked about the injuries from which children commonly suffer in motor accidents, Dr Ong explains, “The consequences for kids may be much worse than adults. The head, neck and torso are commonly affected body parts, with head injuries being the most prevalent. Common types of head injury are concussion and skull-based fractures. These are most frequently seen in children aged 1-7.”

Other injuries include:

• Rib fractures e.g. lung and thoracic injuries to which children below 1 year old are more prone.
• Abdominal injuries i.e. small and large bowel injuries. These encompass injuries of the liver, spleen and kidneys. Kids aged 4-7 are most susceptible.
• Upper extremity injuries e.g. elbow and forearm fractures. Kids aged 1-3 are most at risk.
• Lower extremity injuries e.g. pelvic, femur and tibia fractures. Children below 1 are most vulnerable.

“Of all these injuries, head injuries are the most worrying. These children may experience neurophysiological issues which may affect their ability to read, write or interact.” This is where booster car seats and restraints come in.

Seat up!

“Having proper booster seats can make the difference between life and death. Parents need to select seats based on their children’s age and size, and of course, the seat must fit properly in their vehicle. Always refer to your vehicle owner’s manual for instructions on how to install booster seats and details like height and weight limits,” Dr Ong emphasises. “Also, remember that your children can use these seats for as long as possible, as long as their height and weight fall within the manufacturer’s requirements.”

Delving further, he says, “The type of seat varies with a child’s age.”

0-2 years: Rear-facing car seat. Infants and toddlers should be buckled into a rear-facing car seat in the back seat. In the event of an accident, a frontal crash component in rear-facing car seats causes the child’s head to move further into the seat’s cocoon while the side wings offer additional protection. Typically for infants/ toddlers who weigh 13 kg or less.

2-5 years: Forward-facing car seat. The child should use this until at least the age of 5 or when they reach the upper weight or height limit of their particular seat. Normally for kids weighing 8-18 kg.

5 years and above: The child must be buckled in a belt-positioning booster seat. For children who weigh 15-36 kg.

“But once the car seat belt fits a child properly, booster seats are no longer required. Parents can tell when the lap belt lies across the upper thighs while the shoulder belt lies across the chest.” He adds, “The safest spot for a booster seat is in the centre of the car back seat, rather than on the sides. Studies show that children seated in the centre rear have a 43% lower risk of injury compared to those in other parts of the car.”

Strap up!

Booster seats are important but so are restraints. Dr Ong offers tips:

• Seatbelt straps must be tight so much so that the seats cannot move more than an inch by themselves.
• Ensure there are no twists in the seatbelts and harness straps.
• The car seat’s base must be at the correct reclining angle.
• Carrier straps must be tight and the harness clip should be at the same level with the child’s shoulders or armpits.
• Buckle the child into the seat before placing a blanket over the harness.
• The straps should be snug with no more than 1-finger space.
• If there is a gap between the buckle and the child’s groin, place a rolled washcloth or diaper in the space after they have been securely fastened into the seat.

Dr Ong concludes, “Accidents may be inevitable sometimes but providing your children with the right booster seat and restraints can save their life. So, travel safely and wisely this holiday.”

Airbags: friend or fiend?

Airbags are meant to provide protection and restraint during accidents but they can also be life-threatening. He says, “It’s advisable for kids to sit in the rear, especially those below 14 years old. Airbags inflate almost immediately upon impact (as quickly as 20 milliseconds) and expands at about 257 km/h. Not to mention, children’s bones and muscles are still developing and can easily experience skull, cervical spine or brain stem injuries.”

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