The American Academy of Pediatrics provides recommendations for the safe transportation of a child with special health care needs. The presence of a special need is not a valid reason for not restraining the child.
In general:
(1) A child should be transported in the rear seat. There are exceptions where transport in the front seat may be appropriate, in which case the front passenger airbag should be attached with an on-off switch.
(2) Travel seats or restraints should be models that have been tested and approved. It is not appropriate to use substandard, makeshift or untested devices. All devices should be used in accordance with manufacture's instructions.
Special Need |
Transportation Requirement |
tracheostomy |
safety seats should not have a tray or arm rests that could be struck by the tracheostomy tube |
apnea or oxygen desaturation |
oximetry monitoring during transport |
respiratory support |
oxygen tanks should be secured so as not to become a projectile in a crash; oxygen and battery supplies should be sufficient to last at least twice the planned trip duration |
prematurity |
do not use a car safety seat with a shield, tray or armrest which could be struck by the child's head; restraining straps should take into account the child's smaller size, with shoulder straps lower to prevent crossing the infant's ears; padding may be placed on the side to maintain posture |
neuromuscular disorder |
apply pads under the legs to prevent slipping forward; apply pads for lateral support to maintain posture; head and neck control may require tilting the car seat backward |
spica cast |
modify child seat to accept the cast |
full body cast |
special restraints to allow the child to travel supine; keep the head away from side airbags |
prone or supine position |
use special care safety seat or special restraints to safely secure the child; keep the head away from side airbags |
difficult behavior |
restraints appropriate to needs; rear doors should have child-proof latches/locking |
wheelchair |
transfer to car seat if possible; if transported in chair then all 4 wheels should be locked; remove any tray that could be impacted during a crash; the restraint system should include head, upper torso and lower torso (do not have a head band independent of other restraints) |
significant medical condition |
transport by ambulance; emergency care kit; sufficient supplies to last at least twice the planned trip duration |
Specialty: Emergency Medicine, Critical Care
ICD-10: ,