Car Seats
Conventional restraint devices may not always be the option for safety in transportation (10). Alternative car seats can be purchased for children with special needs. There are two commonly used types of special needs car seats: the Britax Traveller Plus (for more information, see http://www.snugseat.com/) and the Columbia car seat.
Both include seat depth extenders, adequate positioning pads, five-point safety straps, and an appropriate restraint system. The Carrie Car Seat comes complete with head support, harness and safety belt straps, and foot supports. At times, a child is sent home from the hospital in a spica cast or one that limits the fit in a safe manner for travel. The Hippo Car Seat is for transporting children with hip spica casts, broomstick casts, and Ilfeld splints. For those children whose postures require more than a lap belt and shoulder harness, an easy-on vest is recommended. It can be used in upright sitting in the rear seat or in side-lying in the back seat. Models can accommodate ages 2-12, depending on size and weight.Children with tracheostomies should avoid using child restraint systems with a harness tray/shield combination or an armrest. Upon sudden impact, the child could fall forward and cause the tracheostomy to contact the shield or armrest, possibly resulting in injury and a blocked airway. Five-point harnesses should be used for children with tracheostomies (18).
Transporting wheelchair occupants can be a challenge for many, especially school bus supervisors. Research and accident data show that wheelchair tiedowns and occupant restraint systems (WTORS) can reduce the possibility of injury by preventing the wheelchair occupant’s head from hitting the vehicle interior (20) Several commercially available systems exist that secure the wheelchair to the vehicle, including a four-point belt system, a “docking” station, and a “T” bar configuration. It is also recommended that wheelchairs face forward to avoid collapsibility should there be a collision. In addition to the wheelchair seatbelt and shoulder or chest harness, the standard lap and shoulder belt anchored to the vehicle or the restraint system should be used (2,3).