title: Transporting children with special health care needs: comparing recommendations and practice.
abstract: OBJECTIVE
  We compare the use of the American Academy of Pediatrics (AAP) guidelines for the safe transportation of children with special health care needs (CSHCN) with reported and observed practices.
  
  
  METHODS
  This observational study was based on a convenience sample of vehicles exiting the garage of a tertiary children's hospital. Certified child passenger safety technicians with a health care background and specialized training in the transportation of CSHCN gathered the driver's demographic information and the child's reported medical condition, weight, age, clinic visited, and relation to the driver. The safety technicians observed the car safety seat (CSS) type, vehicle seating position, and if the child required postural support.
  
  
  RESULTS
  During the study, 275 drivers transporting 294 CSHCN were observed. Overall, most drivers complied with AAP recommendations by using a standard CSS seat (75.4%). Among the seats evaluated, 241 (82.0%) were the appropriate choice, but only 75 (26.8%) of 280 assessed had no misuses. Approximately 24% of the drivers modified the CSS, and 19.4% of the children would have benefited from additional body-positioning support. Only 8% of medical equipment was properly secured.
  
  
  CONCLUSIONS
  Although most drivers seemed to choose the appropriate seat, many had at least 1 misuse. Drivers complied with most AAP recommendations; however, some deviated to facilitate care of the child during transport. Discussions with parents or caregivers about the proper transportation of CSHCN and referrals to child passenger safety technicians with special training may improve safety, care, and comfort in the vehicle.
authors: Section of Developmental Pediatrics, Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. joeoneil@iupui.edu
authors: Joseph
authors: J
authors: O'Neil
authors: Janell
authors: J
authors: Yonkman
authors: Judith
authors: J
authors: Talty
authors: Marilyn J
authors: MJ
authors: Bull
mesh_terms: D000293:Adolescent; D000328:Adult; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D019988:Children with Disabilities; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D015370:Infant Equipment / Q000592:standards; D008297:Male; D008875:Middle Aged; D017751:Safety Management / Q000592:standards*; D012622:Seat Belts / Q000592:standards; D014187:Transportation of Patients / Q000592:standards*; D014481:United States; D055815:Young Adult