title: Paediatric lap-belt injury: a 7 year experience.
abstract: OBJECTIVE
  To highlight the injuries that result from lap-belt use and make recommendations for prevention, the recent experience of a regional paediatric trauma centre was reviewed.
  
  
  METHODS
  Retrospective review of admissions to Starship Children's Hospital from 1996 to 2003, with significant injury following involvement in a motor vehicle crash, while wearing a lap-belt. Patients were identified from two prospectively collected databases and discharge coding data.
  
  
  RESULTS
  In total, 19 patients were identified over the 7 year period. The morbidity sustained includes 15 patients with hollow viscus injury, 13 laparotomies, 7 spinal fractures, 2 paraplegia and 1 fatality. A total of 11 patients required laparotomy with a median delay of 24 h. Of patients in the present series, 58% were aged less than 8 years and thus were inappropriately restrained.
  
  
  CONCLUSIONS
  Lap-belt use can result in a range of life-threatening injuries or permanent disability in the paediatric population. The incidence of serious lap-belt injury does not appear to be decreasing. Morbidity and mortality could be reduced by the use of three-point restraints, age appropriate restraints and booster seats.
authors.affiliation: Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.
authors.forename: Michael
authors.initials: M
authors.lastname: Shepherd
authors.forename: James
authors.initials: J
authors.lastname: Hamill
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Segedin
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D017677:Age Distribution; D015984:Causality; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009104:Multiple Trauma / Q000453:epidemiology; D009520:New Zealand / Q000453:epidemiology; D011859:Radiography; D012189:Retrospective Studies; D012622:Seat Belts / Q000009:adverse effects*; D013124:Spinal Injuries / Q000453:epidemiology; D016019:Survival Analysis; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy