Car seats and the car seat test

VUMC Policy Click Here

The American Academy of Pediatrics recommends and Tennessee State Law requires all children under the age of four years to be placed in an approved car seat when riding in an automobile.

Parents should obtain a car seat for discharge and be able to demonstrate the correct use of the car seat at discharge. Local resources are available for car seat rental.

The car seat test

Within the week before discharge, infants less than 37 weeks gestation at birth should have a "car seat test" to document their ability to safely tolerate the trip home. Infants being discharged on oxygen or with a tracheostomy or other compromising condition may also need a car seat test.

The infant’s own personal car seat should be used. The car seat test should begin at least one hour after the last feeding. The infant should be monitored in the car seat for one hour. The infant passes the car seat test if he/she has no apnea (> 20 second cessation of respiratory effort), bradycardia (heart rate < 80 bpm), or desaturation (SpO2 < 88% for > 30 seconds) during the test. Results of the car seat test should be documented in the patient’s chart.

Car beds

A baby who fails the car seat test, or has special circumstances such as Pierre-Robin anomaly, can usually ride safely in a car bed. The case managers try to have car beds available or they can be ordered overnight from Cosco, Inc. (1-800-544-1108) They are no more expensive for the family than a regular car seat and convert to a seating position when the infant is more mature.

References:

American Academy of Pediatrics. Safe transportation of premature and low birth weight infants. Pediatrics 1996; 97 (5): 758-760.