Infant injuries from child restraint safety seat misuse at British Columbia Children's Hospital.

BACKGROUND Child restraint safety seats (CRS) are used to prevent injuries or deaths among child passengers involved in a motor vehicle crash. When used outside of a motor vehicle, CRS use could potentially place an infant at risk of injury. The objective of the current study was to describe the proportion of CRS misuse injuries among infants <12 months old and associated factors presenting to the British Columbia (BC) Children's Hospital Emergency Department over 5 years (1997-2002). METHODS The Canadian Hospital Injury Reporting and Prevention Program (CHIRPP) was the source for the emergency department injury surveillance data used in the present study. BC Children's Hospital is the participating CHIRPP site in British Columbia. A search of individual level patient records was conducted to capture all injuries from CRS misuse taking place during the study period using a predetermined code for 'child car seat-related injuries'. A retrospective analysis of 87 infants <12 months old, who presented at BC Children's Hospital for CRS-related injuries between January 1997 and December 2002 was performed in order to describe the epidemiologic and background factors related to injury occurrence. RESULTS Infants aged 0-4 months accounted for approximately 59.7% of cases (52/87). Among all infants, falls were a common mechanism of injury resulting from CRS misuse (98.8%, 86/87). Falls from elevated surfaces (e.g. chairs, tables, counters) were also common among infants presenting to the emergency departments and accounted for 43% of all falls (37/86). CONCLUSIONS Injury prevention efforts should be focused on reducing CRS outside the motor vehicle setting and preventing placement of the CRS at an elevated surface. Educating caregivers on the dangers of falls resulting from CRS misuse in a variety of care settings is also recommended.