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Curbside Help with Harnesses and Vests

Car seat check forms guide us through numerous aspects of conventional child restraint use, but they do not necessarily apply as well to checking harnesses and vests. Many child passenger safety technicians (and instructors) do not work with harnesses and vests enough to easily recognize misuse. Test your knowledge by identifying misuses in the following scenario. Scroll down for answers.

Read the "Correct Use Notes" below for assistance with this type of child restraint.

Scenario:

• Three-year-old Johnny has a fractured and casted leg. He arrives lying flat on the back seat, restrained with an E-Z-ON Modified Vest.
• The vest has been secured with the right outboard lap-shoulder belt, and the child's head is next to the passenger-side rear door.
• The child weighs 27 pounds and is 31 inches tall.
• The casted leg is not secured in any way.
• The shoulder straps are looped through the vest adjuster rings once.
• The back seat floor is filled with toys and groceries.

What are the misuses?

Correct Use Notes

(Illustration courtesy of E-Z-ON Products)

Helpful hints: First, follow the same basic routine as with conventional restraints: (1) follow the instructions, (2) use the correct harness or vest, considering the age and weight/height limits of the product and the needs of the child, (3) secure the child snugly in the product, and (4) attach the device tightly to the vehicle. Note especially any instructions about individual pieces or straps that may be required at certain ages, weights, or heights and for specific needs of the child when using vests and harnesses. (5) Secure items (groceries and toys) in trunk.

The E-Z-ON Modified M203 Vest instructions for use in family vehicles require that the:

• child's head be positioned as far away as possible from the vehicle door.
• vest be primarily used by children in body or leg casts or who have other medical conditions that require a semi-reclined or flat position on the vehicle seat.
• child weighs at least 20 pounds using casted weight.
• vest be secured with two seat belts if the child is over 30 inches tall.
• small parachute label, an identifying front feature of all E-Z-ON vests, be positioned over the child's heart.
• crotch strap be used.
• extremity belt be used when the child is over 30 inches tall. Position the extremity belt around the casted leg. It is helpful to position the casted leg next to the back of the vehicle seat. If both legs are casted, the extremity belt fits around both legs.
• shoulder strap adjusters be back-threaded.

Note: Complete instructions (from 2005) for the M203 (ages 2–5 yrs) and 101M2 (ages 5–12 yrs) modified vests are available at http://www.ezonpro.com/instructions.shtml. E-Z-ON instructions regarding the lower weight and age limits changed in 2008. This change is not reflected in the current website instructions or on the 2009 CD of manufacturers' instructions available from SafetyBeltSafe, www.carseat.org. Call 1-800-323-6598 for current instructions regarding lower weight and age limits.

Scenario Misuses: (1) The child's head is located too close to the door, instead of as far away from the door as possible; (2) The child's height requires use of the extremity belt; (3) Only one seat belt is being used when two seat belts should be used for installation of the vest for a child this tall; and (4) The shoulder straps are not back-threaded through the vest rings to lock and secure. (5) Toys and groceries should be secured in the trunk.

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Did You Know? Entanglement Issues**

Since 2005, various incidents have been reported in which forward-facing children were entangled in switchable retractor-equipped shoulder belts. Further injury was prevented by quick-acting parents who were able to cut the seat belt webbing to free their children from strangulation. In October and December 2008, two children (aged 5 and 13) died, strangled by the shoulder belt portion of their lap-shoulder belts when the switchable retractor accidentally became engaged.* This problem is not related to specific vehicle brands, models, or other types of shoulder belt locking systems. Many parents/caregivers of children involved in such incidents reported that they did not know how this switchable retractor lap-shoulder belt locked or how it could become a danger if within reach of their child.

This problem has occurred with children of varying ages in different types of restraint systems: forward-facing child restraints (CRs), boosters, or seat belts alone. Because of this range of scenarios, there is no single technological fix for this problem. It must be handled primarily as a behavioral issue, with children being taught not to play with any kind of seat belt and with efforts made to entertain them while riding.

The LATCH Factor

At least one child who became entangled was in a forward-facing CR installed with the LATCH system. In this type of scenario, the lap-shoulder belt with a switchable retractor is within reach of a curious child, who pulls it out, engaging the switchable retractor. If the belt becomes wrapped around the child's neck, any struggle or movement tightens the seat belt. This can happen whether the lap-shoulder belt is in the position where the CR is installed, is in an adjacent seating position, or is a ceiling-mounted shoulder belt dangling within the child's reach.

To try to prevent this problem, some manufacturers have come up with ways to fasten the lap-shoulder belt out of reach. According to a survey of manufacturers, reported in the 2009 LATCH Manual, General Motors brands, Chrysler brands, Honda/Acura, and Ferrari recommend fastening the seat belt behind the CR before installing it, so long as the belt buckle does not interfere with the installation of lower (LATCH) attachments. If the seat belt buckle or the LATCH attachments interfere with each other, it may help to release the unused belt from the buckle after the child restraint is installed.

Some other manufacturers, such as Chrysler in its 2007 Sebring instructions, have a slightly different method: routing the seat belt through the child restraint belt path and leaving it unlocked (loose). By leaving the retractor unlocked in this situation, the belt does not interfere with installation of the child restraint with lower attachments.

The LATCH Working Group stated, in a letter to NHTSA in December 2008, that its members agreed that fastening the seat belt loosely through the belt path when a CR is installed with the LATCH system is an acceptable way to move the lap-shoulder belt out of reach. Such usage is conditioned on both vehicle and child restraint manufacturers permitting such use and the seat belt not interfering with tight LATCH attachment.

Refer to Kids in Nontraffic Incidents in the Tech Update Spring 2009 issue, p. 3. Details of incidents can be reported to at KidsAndCars.org at email@kidsandcars.org or www.safercar.gov (fax) 913-327-0014 and to the NHTSA Auto Safety Hotline, 1-888-DASH-2-DOT.

Safe Ride News Publications will survey all manufac-turers on this topic to follow changing advice on this issue for the 2011 LATCH Manual.

Resource: www.nhtsa.gov. Select "Child Passenger Safety" in the blue box on the left, click on the "Keeping Kids Safe Inside and Out" logo on the lower right, select "Seat Belt Entanglement" in the blue box on the upper right.

**SRN March/April 2009

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Steps to a Recall

Part One: The Child Restraint Manufacturer (CRM) Perspective

Child restraint manufacturers have two main goals: to produce products and provide the best means for children to ride safely in vehicles. Child restraint manufacturers are obligated to assure their products meet the Federal Motor Vehicle Safety Standard (FMVSS) 213 and conduct many tests to self-certify to NHTSA that their products meet this standard. Defects may come to light through consumer complaints, manufacturers' ongoing quality testing, or from NHTSA compliance testing.

Editor's Note: The following description of the steps in the recall process is based on the 2009 Lifesavers Conference presentation, with John Riedl, Learning Curve (Compass) representing CR manufacturers in general. Part One is an explanation of how the process proceeds and is handled by the CRMs. Part Two, the NHTSA Perspective on the process will appear in the 2010 Spring Tech Update issue.

Step One: Investigating a Possible Defect

The CRM receives and reviews a notice of a NHTSA compliance test failure or a consumer's complaint. While not required to notify NHTSA whenever it receives a consumer complaint, the CRM is mandated to respond within 72 hours to NHTSA when it has been determined that there is an obvious defect.

The CRM usually does not notify consumers or retailers at this early stage, because the complaint needs to be evaluated. The CRM must determine first if there is a real problem with the product and then devise the right way to fix it. Publicizing a problem too early may cause people to panic and stop using the child restraint, causing a more unsafe condition.

The CRM's management and engineers immediately begin an investigation of the complaint or test failure. Further testing is done to see if the failure or problem can be duplicated. If any defect is found, the CRM moves quickly to contain the problem. The CRM must issue a recall if they determine a safety-related defect exists.

Step Two: Containing a Possible Problem at the Retail Level

In an effort to limit sales of possibly affected products, retail stores carrying those items are notified and instructed to remove the items from the shelf until the CRM can determine if there is a danger to child safety. Due to loss of sales, retailers only allow the CRM three days to take care of in-stock items. The retailers charge their loss of sales to the CRM.

If the problem requires a simple fix, such as replacing an incorrect label, the CRM sends crews to each retail store to complete the change and repair all in-stock affected items.

Step Three: Issuing a Recall

If the CRM determines a major problem exists, it may issue the recall itself without waiting for NHTSA's official process.

Before a recall takes place, NHTSA and the CRM agree on a plan to notify the public. A letter to consumers is generated using the CRM's database of the registration cards consumers submitted at purchase. Press releases are issued, information is posted at points of sale, and major magazines targeted at families with children are notified.

Step Four: Managing a Recall

All recalls are for safety-related defects or a non-compliance of a Federal Motor Vehicle Safety Standard. NHTSA and the CRMs work together for the safety of all and agree that not all recalls affect a CR's crash performance. Some deal with aspects of CRs that have no bearing on crashworthiness, such as carry handles. The consumer should continue to use the child restraint in question unless the recall notice specifies not to use it due to danger of injury or death. Using a recalled child restraint is usually better than using no restraint at all.

Keeping Recalls in Perspective

Recalls cost millions of dollars and may impact future retail price by as much as $60 per child restraint.

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When Best Practice and Real World Collide

Infant Inserts

A Columbus, Ohio, Child Passenger Safety Technician Instructor (CPSTI) reported to Tech Update that a new mother called to schedule an appointment for a car seat check because "something just didn't look right" with her baby in the seat she had researched and purchased. "Arriving the next day, she was concerned and worried about her 2-week-old, 6-pound child who was 18 inches long. The baby was riding rear facing in a convertible child restraint in a 2008 BMW 3281."

Several problems were quickly identified: the child's head was falling forward; harness straps, while in the lowest set of slots, were above the child's shoulders and were not snug; and the chest clip was not at armpit level. The seat belt was routed through the forward-facing belt path and, while the CR was also installed with LATCH, it still did not pass the 1-inch tightness test. The CPSTI commended the mother for recognizing something was not right and for all the reading and research she had done prior to the purchase. She continued, "I'm a new mother, too, so I understand your concerns. Working in child passenger safety, I have found that every car seat does not fit every child or every vehicle. Let's work together to see what we can do to make your child a little safer."

On-site printed instructions showed the seat was rated for children weighing 5 to 70 pounds and less than 57 inches tall. Further reading showed an entry stating, "you may find that the harness does not fit snug against your child. If this is the case, [the manufacturer's] infant insert may be required. Please call 1-800-8-XXXXXX and [the manufacturer] will ship you an insert and instructions." When shown this, the mother produced a foam wedge insert that she had ordered from the manufacturer, saying she did not know how to use it and had not brought any instructions with her. Unsure

whether to use the wedge under the child's bottom or behind the child's back, the instructor tried calling the CR manufacturer, but, since this was a Saturday event, the company was not open. She tried looking online for instructions for the wedge insert and finally made a phone call to another instructor, who said she would find the answer and get back to her.

That second instructor made four phone calls to other instructors; no one had had experience with this particular foam wedge insert and no one had instructions for it. All agreed that they would not recommend using the insert without correct instructions.

Meanwhile, the CPSTI educated the mom regarding the numerous problems with the CR fit for the child and with the installation in her vehicle. Mom preferred a center installation, which was not allowed in this vehicle using LATCH. Due to interference with the lock-off from the latchplate, the seat belt could not be pulled tight. The large size of the CR and limited space in the back seat made achieving a correct angle impossible. The child's shoulders were still far below the lowest harness slots.

The instructor decided that a different CR model was needed, but the only replacement seat available at the event was one that also had harness slots that were too high. Then she remembered two brand-new training seats she had just purchased for an upcoming CPS class and retrieved them from the store room. One seat was designed for children weighing 4 to 30 pounds. The newborn insert for that seat was supplied, and the instructions called for removing it once the child weighed 11 pounds. The seat belt in the center position provided a secure installation. The mom found the new child restraint easy to use and left with her child safer, promising to return the seat the next day. She arrived the next morning, having purchased another of the same infant-only seat, and replaced the instructor's CR inventory. The instructor advised the mom that the first child restraint might fit better in the vehicle when the child was close to 2 years old and facing forward.

Editor's note: Infant inserts are designed and tested in the CR by individual manufacturers as an optional feature to provide a better fit for smaller infants in infant-only and convertible child restraints. Some inserts are foam wedges to place under the padding, while others are flat pads that are placed above the CR pad so the child sits on it. Most manufacturers now supply the inserts with new CRs, so special ordering is not required. Some newborns will fit better with the insert and some without.

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Tools for Techs

Sign up for the new school bus listserv. If you have questions related to choosing and using child safety restraints on school buses, the new school bus listserv may be helpful. Monitored by top school bus CPS experts, the new listserv provides an excellent opportunity to learn more about the difficulties and solutions for helping younger children and those with special needs ride more safely on school buses. CPSforSchoolBuses-subscribe@yahoogroups.com

Sign up to receive NHTSA e-mail alerts on traffic safety marketing materials, including CPS information, at traffic.marketing@dot.gov. Insert "Subscription request for email alerts" on the subject line, and state in the body of the e-mail:"I would like to receive e-mail alerts on NHTSA traffic safety information and issues."

File a complaint about a vehicle or child restraint at http://www-odi.nhtsa.dot.gov/ivoq. Help parents/caregivers to understand their role in getting the complaint filed.

Join the latest communication style. Sign up to follow a blog, Facebook, or Twitter track.

Manufacturers have found social media to be the best way to reach new parents and parents-to-be.

Update your and other technicians' LATCH skills and earn CEUs. A new LATCH Update CD contains two PowerPoint presentations with detailed instructor notes that can be presented by instructors or experienced technicians at local or state meetings. The CD is now available at www.saferidenews.com.

Editor's Note: Edited and additional information in the article "Boosters to Fit the Child and the Vehicle" from the Tech Update, Fall 2009, issue has been posted to www.saferidenews.com. Please check this website edition for the most recent changes when working with parents/caregivers.

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KIM 2009 Conference Sessions

Bits and Pieces from Presentations (Paraphrased)

American Academy of Pediatrics: Rebecca Levin—Shared that the AAP's new approach to CPS is to encourage physicians to do CPS counseling based on developmental milestones and to know local CPS technicians to whom they may refer their patients' caregivers.

Audience comments: Supported the need for: 1) a low-cost booster for use in targeted low-income distribution programs, 2) an institutional infant-only CR to meet the needs of infants under 5 pounds, and 3) a backless booster for small adult use.

Britax: Sarah Tilton—Stated that a technician's job is to educate the parents, but let them make the choice regarding the use of nonregulated products. Advise parents that nonregulated products should never be placed under an infant or between the infant's body and the harness. She encouraged technicians to read user's guides, stating that we must lead by example and practice what we preach. Editor's Note: Refer to the 2007 National Child Passenger Safety Certification Training Student Manual, Chapter 9, Rear-Facing Child Restraints, p.127 regarding securing an infant in a rear-facing child restraint.

Chicco: Julie Prom Robbins—Asked that techs read instructions and check angle indicators attached to child restraints and, if the CR does not fit the child and the vehicle, recommend parents/caregivers use a different child restraint.

Combi: Vera Fullaway—Reported that Combi's Shuttle 22, rated birth to 22 pounds, is sold without its base for institutional use, but the Shuttle 33, rated birth to 33 pounds, is only sold with the base. Harnesses can be slightly above the shoulders, and the child's head must remain less than 1 inch from the top of the carrier. In 2010, a version of the Shuttle 33 with a lower weight limit of 3 pounds will be available.

Dorel Juvenile Products: Ryan Hawker-Described Dorel's newest "Air Protect" technology for side-impact protection that features air-filled side pads that release air to cushion a child's head and reduce crash forces. The Complete Air convertible CR has a 40-pound RF limit and 50-pound FF limit.

Graco: Carol Helminski—Reported that the new My Ride convertible is now available for rear-facing use from 5 to 40 pounds. This mirrors the American Academy of Pediatrics' recommendation to have children sit rear facing for as long as possible.

Merritt Manufacturing: Shayne Merritt—Demonstrated the new Churchill booster seat (65–175 pounds) for children needing extra support. It is installed with lower attachments and tether, with the lap-shoulder belt restraining the occupant, and has supporting pads that can be added to accommodate a child's specific needs.

Huggable Images: Announced the availability of a new 8-year-old dummy and a new, improved preemie dummy, which represents the size of a 4.5-pound premature infant. The infant dummy now flexes more like a real infant.

SafeGuard/IMMI: Charlie Vits—Stated that per FMVSS 213, when a CR or a vest restraint is installed on a school bus seat with a cam-wrap, the seat behind must not be occupied by an unrestrained passenger."

Safe Ride News Publications: Deborah Stewart—Stated that some vehicle manufacturer major policy changes, such as for Ford and GM, are published only in the LATCH Manual. Effective for model year 2009 vehicles, Ford, Lincoln, and Mercury allow use of all non-designated center seating positions for LATCH installations if the CR manufacturer permits. GM, on the other hand, in 2009 changed its policy so as to not allow the use of LATCH in any center, non-designated seating positions. This is a retroactive statement for all of its vehicle models.

Sunshine Kids: Russ Berger—Introduced the new Radian SL (SuperLATCH) with reinforced webbing for the lower attachments, a heavy-duty connector with four "pawls" (teeth) to hook onto the lower anchor bar, and an 80-pound lower anchor weight limit.

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Save the Dates!

March 5–10, 2010

Transporting Students with Disabilities and Preschoolers

March 7, 8 a.m. to 5 p.m.: NHTSA School Bus-CPS Training (6 CEUs available)
Orlando, Florida
Doubletree Hotel, Orlando
http://www.eduprogroup.com

April 11–13, 2010

Lifesavers Conference

Philadelphia, Pennsylvania
Philadelphia Convention Center
http://www.lifesaversconference.org

August 26–28, 2010

Kidz in Motion (KIM) Conference

Two Pre-Conferences: Issues related to premature and low birth weight infants; train-the-trainer session to teach the NHTSA school bus-CPS course
Fort Worth, Texas, at the Omni Fort Worth Hotel
Visit www.kidzinmotion.org or call 407-306-9824 for more information.
CEUs (approximately 10 to 15) will be available (see conference agenda).
kimconf@hiwaay.net

September 19–25, 2010

CPS Week — Make your plans!
(Primary Message: 4 Steps for Kids)

Seat Check Saturday, September 25, 2010
If you have any questions, contact Sandy Sinclair
at 202-366-2723 or sandy.sinclair@dot.gov

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Sign Up for Free Recertification Drawing

Sign up to be notified via e-mail whenever significant announcements or updates to the CPS Board website are made. Signing up also makes currently certified CPS technicians and instructors eligible to WIN a free CPS recertification—a $50 or $60 value from Safe Kids Worldwide. To read the rules for the drawing and sign up for the CPS Board e-mail list, visit www.cpsboard.org/elist.htm.

Be a Winner! Read the Tech Update!

Our WINNER for the December 2009 free recertification drawing is John Gonzalez, a CPST from Lubbock, Texas since 1998. He has always read the Tech Update. Congratulations John!

We thank Safe Kids Worldwide for making this recertification prize possible.

Comments about Tech Update?

Send comments or suggestions for Tech Update to Mary at mary@saferidenews.com.

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Tech Update is published by the National Highway Traffic Safety Administration and the Child Passenger Safety Board (www.cpsboard.org) for certified Child Passenger Safety Technicians and Instructors.

Articles marked with a double asterisk (**) have been modified with permission from pieces originally published by Safe Ride News Publications and are in the public domain.