Buckle Up – Seat Belts Save Lives
By Peter Pappas, MD, FACS // November 25, 2013
BUCKLE UP EVERY TIME
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BREVARD COUNTY • MELBOURNE, FLORIDA – For decades, wearing a seat belt has been synonymous with automobile safety. The simple phrase “buckle up” is part of our everyday life and the attention is well-deserved.
For all of the technological advances in transportation safety and trauma care, seat belts and appropriate child restraints offer the single best chance of survival in a crash for us and our loved ones.
Vehicle crashes remain a major source of traumatic injury. The National Highway Transportation Safety Administration (NHTSA) estimates that properly worn lap and shoulder seat belts can reduce the risk of death for front seat passengers in an automobile crash by 45 percent and serious injury by 50 percent, with the risk of death or injury for light-truck occupants reduced by 60 percent or greater. For infants and toddlers, use of child safety seats reduces the risk of fatal injury and death by greater than 50 percent as well.
These grim statistics apply to our home as well. Here on the Space Coast our community’s trauma center at Holmes Regional Medical Center has cared for nearly 400 patients involved in motor vehicle accidents over the past year. For these patients, risk of death was twice as high without a seatbelt and hospital length of stay twice as long.
Air bags are also an effective safety device and have been credited with saving over 6,500 lives since 1990. An air bag without a seat belt though, can be ineffective and hazardous. Air bags are most effective when paired with properly worn lap and shoulder belts.
PROPER SEATBELT USE CRITICAL
Seat belts clearly do save lives and buckling up should be a routine part of automobile occupancy. Shoulder belts should be worn across the chest and away from the neck for both men and women. A shoulder belt should also never be worn behind the back or under the arm.
Lap belts should lie across the hips and below the belly. To minimize upper body injury in a front seat, keep at least 10 inches between your breastbone and the steering wheel or dashboard.
LOVE YOUR KIDS AT HOME–BELT THEM IN THE CAR
Choosing how to transport a child should be based on their age, height, weight and body development. The American Academy of Pediatrics and NHTSA advise that infants ride in rear-facing car seats until they meet the maximum weight or height requirement for that particular seat. Before transitioning to a seat belt, children should be approximately 4’9” and/or 80 pounds.
Additionally, if a child is unable to sit in the vehicle with their back straight and their legs bent at the knee, then they are not candidates for safety belt use.
With child safety seats designed to meet the same federal standards, proper installation is what makes the difference. While one should always refer to the car safety seat manufacturer’s manual for specific rules on installation, there are some general principles that should be kept in mind. For infants in rear-facing seats, shoulder straps should be threaded at or below shoulder level and the seat reclined to 45 degrees.
Reclining the seat will help protect against the infant’s head falling forward and cutting off the airway. Given the speed and power with which air bags can deploy, a rear-facing car seat should never be placed in front of one.
The rear center seat is considered the safest location and it is recommended that children ride in the rear until they are 13. Forward-facing seats are recommended once a child has reached the height and weight limits for rear-facing seats. Harness straps for forward facing seats should be threaded through the slots at or above shoulder level.
KEEP AIRBAGS ON
Proper seat belt use is especially important for pregnant women. As the abdomen grows, the seat should be positioned to keep a distance of about 10 inches from the breast bone to the steering wheel.
Air bags should not be turned off, but should always be used in conjunction with seat belts.
If the pedals become too difficult to reach, car dealers may be able to install pedal extenders.
The old phrase of “buckle-up” is as true and urgent today as it ever was. Safety on the road and in our vehicles is a responsibility we all share.
Through the simple act of buckling up and proper use of child safety seats, we can all take a huge step towards keeping ourselves and our loved ones safe on the road.
ABOUT THE AUTHOR
Dr. Peter Pappas MD is a Trauma Surgeon with the Trauma Center at Holmes Regional Medical Center. Originally from Orlando, Dr. Pappas went to medical school and did his general surgery residency at the University of Miami/Jackson Memorial Hospital in Miami, and completed a fellowship in Surgical Critical Care and Trauma at Orlando Regional Medical Center. He is board certified in General Surgery and Surgical Critical Care and has an active interest in research, education and injury prevention.
