1. An Intro to Safely Transporting Native Children Bridget Canniff & Luella Azule NPAIHB Injury Prevention Program

2. Why SNAP? Low AI/AN restraint use Crashes can happen at any time Can help prevent injuries Can make a difference

3. SNAP ≠ certification training Today’s presentation: introduction to SNAP Even with full SNAP course, you will NOT be able to: Serve as a technical expert Teach SNAP Only certified CPS technicians can teach SNAP course

4. Guiding Principles Learn Practice Explain

5. Best Practices & Tough Choices Best practices Explain best practice options Tough Choices Sometimes, no clear answers Give options Vehicles not designed for child restraints Safer choices Tough choices should always be made by the parent/caregiver

6. The Cradleboard Important part of Native culture Fine for general use Always use child safety seat for transporting children

7. NHTSA Keep children in appropriate restraint as long as possible before moving them up to the next type American Academy of Pediatrics Keep kids in rear-facing restraints until age 2 or highest weight/height allowed by seat manufacturer Car Seat Recommendations

8. Read child seat manufacturers' instructions & vehicle owner's manual Important info on height & weight limits, how to install using seat belt or LATCH system All children under 13 should ride in back seat Children in rear-facing car seats should never ride in front of active passenger airbag Car Seat Recommendations

9. Motor Vehicle Crash Injuries Leading cause of death for American Indians & Alaska Natives More children ages 1-16 die from crashes than any other cause

10. Challenges to Crash Survival Non-use Misuse Use decreases as children get older Outdated or incorrect educational materials

11. Larger heads Smaller bodies Soft skull bones Rounded hip bones Weak stomach muscles Vehicles built for adults Why Restrain Children?

12. Keep people in the vehicle Hold where body is strongest Spread out crash forces Help body to slow down Protect head & spine How Restraints Prevent Injury

13. Some crashes too violent to survive Many factors determine outcome Restraints & airbags give best chance of survival You Can’t Survive Every Crash

14. Common Myths “I’m not driving very far” “It’s better to be thrown clear” “I can hold my baby in a crash” “Restraints are uncomfortable” “I’m a good driver, so I won’t get into a crash”

15. 33 states have primary seatbelt laws, 16 have secondary laws All 50 states have child restraint laws Some Reservations have their own Passenger Transportation Safety laws Seat Belt & Child Safety Seat Laws

16. What’s the seat belt law in your tribal community? A) Tribal law: primary B) Tribal law: secondary C) Community follows state law D) No law E) Unsure / Don’t Know Local Laws: Seat Belts

17. Does your tribal community have a child safety seat law? A) Yes: tribal law B) No: follows state law C) Unsure / Don’t Know Local Laws: Child Safety Seats

18. Studies show restraints reduce:  Injury severity by 60%  Hospital admissions by 69%  Treatment costs by 66% Use seatbelts! Use child restraints! You could save lives! Why Use Restraints?

19. Types of Child Restraints Infant (rear-facing only) Convertible (rear-facing & forward- facing) Forward-facing only (harness & combination) Boosters (belt-positioning) Special needs restraints Seat belts

20. Fits the child Fits the vehicle Used correctly every time What’s the Best Child Restraint?

21. Selection: right seat? Direction: front or rear-facing? Location: where is the child safest? Installation: right belt path/LATCH? Elements of Correct Installation

22. Select correct child seat for weight & height Place in back seat of vehicle Use only one method to install car seat Install car seat Tighten vehicle belt or lower anchor attachment (LATCH) Buckle child into car seat Installation Check List

23. Easy install Vehicles since 2000 Read the vehicle & CR manuals LATCH System

24. Post 2/27/14 LATCH After February 2014, car seats installed with LATCH should have MAXIMUM combined weight limit of seat + child = 65 lbs Requirement only apply to lower anchors, doesn’t include top tethers Belt positioning booster seats using LATCH are not included in the new requirements because: The seat belt is what is restraining child in booster LATCH only keeps seat in place when unoccupied, to protect other passengers

25. Seat Belt Components Anchor Webbing Latchplate Buckle Retractors

26. Reduce injury For use with seatbelts Children <13 in back seat Turn OFF airbag if CR must be used in front seat Airbag Systems

27. Consider These CR Issues Safety  Label  Expiration  History  Recall Compatibility Convenience Comfort

28. Read instruction book & vehicle owner’s manual for proper installation instructions Mail in seat registration card Important!

29. Harness straps Harness slots Retainer clip Belt path Harness adjuster Buckle Shell/ frame Seat Parts & Functions

30. Harness adjuster plate Labels Harness slots Seat Parts & Functions

31. Rear-Facing Seats 3-point or 5-point harness at or below shoulder Best Practice: Until 2+ years OR Until upper limit of CR’s height & weight recommendations

32. Large, heavy heads Small, flexible shoulders Bones not fully developed Why Rear-Facing Until Age 2?

33. Rear-Facing Convertible Rear-facing up to 30 pounds or more, then forward-facing Reclined position Harness at or below shoulder level

34. 2+ years or when child reaches height & weight limits of rear-facing seat Weight limits between 22-85+ pounds, depending on manufacturer Use until child’s ears reach top of seat Forward-Facing Seats

35. Belt Positioning Boosters Use with lap/ shoulder belt only Head restraint needed Shoulder belt positioners Use the 5 Step Test

36. The 5-Step Test 1. Child against the vehicle seat? 2. Knees bend at the edge? 3. Belt crosses shoulder between neck & arm? 4. Lap belt low across hips? 5. Child can stay seated for whole trip? If No to any  Booster seat is needed If Yes to all  Ready for adult seat belt

37. Reasons for Incorrect Installation Don’t understand dangers Don’t take time Instructions missing Don’t read instructions Restraints don’t fit vehicle

38. Misuse: Child Safety Seats

39. Retainer clip not at armpit level Loose harness Twisted harness or frayed/damaged webbing Restraint has been in a crash In seat belt too soon

40. Misuse: Seat Belts

41. Shoulder belt under arm Misuse: Seat Belts

42. Shoulder belt under arm Shoulder belt behind back

43. Lap belt too high Belt too loose Shoulder belt under arm Shoulder belt behind back Misuse: Seat Belts

44. Low restraint use in AI/AN communities Everyone should buckle up Selection, direction, location & installation important Best CR fits child, fits vehicle, used correctly every time Learn correct use, recognize misuse Practice = confidence Wrap-Up: What We’ve Learned

45. Additional Resources www.nhtsa.gov www.safekids.org www.nsc.org www.carseat.org

46. QUESTIONS? THANK YOU! Luella Azule (Yakima Nation/Umatilla) Injury Prevention Coordinator lazule@npaihb.org 503-416-3263