Serious injury is associated with suboptimal restraint use in child motor vehicle occupants

Aim: To investigate the relationship between restraint usage and injury outcome in child motor vehicle occupants aged 2-8 years. Methods: Retrospective case review of all child occupants presenting at the Children's Hospital at Westmead between July 2002 and January 2005 subsequent to a motor vehicle crash. Injury severity was assessed in terms of the Abbreviated Injury Scale (AIS), by age and type of restraint. Results: Data were collected for 152 child occupants aged 2 and 8 years. While nearly all children (94%) used some restraint, most (82%) used a suboptimal form of restraint. Injury severity between optimally restrained children and suboptimally restrained children differed significantly (Fisher's exact test, P < 0.001), with suboptimally restrained children receiving a greater proportion of moderate to severe (AIS 2+) injuries. No optimally restrained child sustained an AIS 2+ injury. Conclusion: A total of 82% of child occupants aged 2-8 years involved in crashes were suboptimally restrained. All children who sustained serious injuries were suboptimally restrained. There is a need to encourage correct use of the most appropriate restraint for child motor vehicle occupants in order to reduce the number and severity of injuries in these road users.