Head excursions of rearward-facing child restraint systems in rear impacts.

OBJECTIVE: The aim of the current study was to quantify the head excursions of pediatric anthropomorphic test devices (ATDs) seated in rearward-facing child restraint system (CRS) models during rear impact sled tests and compare to roof heights of vehicles in the current fleet to assess the possibility of head contact against the vehicle roof. METHODS: Head excursions of ATDs seated in rearward-facing CRS models were analyzed from high-speed video data from 14 rear impact sled tests across two different series. Tests were conducted in rigidized vehicle seats from recent model year vehicles. Rearward-facing infant and convertible CRS models were tested with a variety of pediatric ATDs aged 12 months to 6 years in a variety of installation conditions (e.g., lower anchors or seat belt, anti-rotation features, etc). Maximum ATD head excursions in plane of the seatback were compared to previously measured roof heights of 87 different vehicles. RESULTS: The roof heights in all sedan seating positions (n = 58) and SUV/CUV/minivan seating positions (n = 60) were greater than the largest maximum ATD head excursions in plane of the seatback (792 mm). Head contact was possible in two of the pickup trucks which had roof heights of 730 and 775 mm. In all, 98% of vehicle seating positions measured in this study would accommodate all of the maximum ATD head excursions in plane of the seatback without contact. CONCLUSIONS: The risk of head contact against the vehicle interior roof appears low as maximum ATD head excursions in plane of the seatback were typically not great enough to reach the rooflines of the vehicles in the sample. Head contact appears possible in pickup trucks, where the window/roofline is directly behind the head restraint.

Linking the orthopaedic office-hospital continuum: results before and after implementation of an automated patient health history project.

This article introduces an innovative collaboration between an orthopaedic surgeon's office and the hospital to assure complete and accurate admission information without duplication. With the use of point-of-care software, the assessment process was re-tooled. This change involved the patient/family assuming responsibility for completing paper and pencil in-depth history and systems review that was then used as part of the evaluation process and inputted into the database allowing for more effective outcomes assessment. In this re-tooling process, the concept of "sharing" information with the partnering hospital was explored. In collaborative discussions, the nursing admission assessment was targeted as a process where there was significant duplication. In fact, much of the information required on the 4-page form was already assessed and documented in the office setting. Consequently it was agreed that the majority of the inpatient nursing history/admission assessment form would be replaced with the assessment completed by the professional office staff. Because of incompatible software, the systems could not be linked but a printed copy of the form was sent to the hospital. Results measuring satisfaction, timesaving, and compliance with JCAHO documentation standards were part of the evaluation. Patients and clinicians were satisfied with the process. There was a significant timesaving for the in-patient RN which facilitated more direct contact with the patient and family.