Adult Safety Belt


Adult Safety Belt, Seat Belt, Car Restraint, Unrestrained Passenger, Seat Belt Use in Pregnancy, Lap belt, Air Bag

  • See Also
  • Background
  1. Seat Belts were first patented by an english engineer for a glider in the 1880s
  2. Car Seat Belts were not used widely in the U.S. until the 1950s and not mandated by law until the 1960s
  • Epidemiology
  1. Seat Belts reduce risk of MVA related deaths in teens and adults by 50%
  2. Of fatal U.S. MVAs in 2015, >50% of deceased teens were unrestrained
  3. Children ages 4 to 7 years old are prematurely transitioned to Seat Belts in 25% of cases
    1. These children should instead be transitioned to Booster Seats first
  4. References
    1. (2017) NHTSA Occupant Protection in Passenger Vehicles 2015 Data
  • Technique
  • Correct fitting of adult auto safety belts
  1. Use Child Safety Seat if adult belt does not fit
  2. Indications
    1. Weighs more than 80 pounds (36 kg)
    2. Child standing height over 57 inches (145 cm)
    3. Child Sitting Height over 29 inches (74 cm)
  3. Proper fit
    1. Legs bend over edge of seat
    2. Buttocks firmly placed against seat back
    3. Lap belt fits tightly over upper thighs
    4. Shoulder belt crosses mid-clavicle and mid-Sternum
      1. Never use without Shoulder belt
      2. Risk of child submarining under Lap belt
  • Technique
  • Children
  1. See Child Safety Seats
  2. Children <13 years old should NOT ride in front seat due to airbag deployment risk
    1. Airbags are associated with Closed Head Injury and Cervical Spine Injury in children <13 years old
    2. Other associated injuryies include Eye Trauma, as well as Burn Injury (chemical or Thermal Burn), facial abrasions
  • Technique
  • Pregnancy
  1. Do not disable Air Bags for pregnant patients
    1. Move seat back as far as possible (at least 10 inches between Abdomen and Air Bag)
    2. Deployed Air Bags save maternal lives
      1. Safe in pregnancy given enough distance between Air Bag and Abdomen
    3. Schiff (2010) Obstet Gynecol 115(1): 85-92 [PubMed]
  2. Seat Belt use is critical
    1. Many pregnant women fail to use Seat Belts despite their protective effects
      1. Fetal death is most commonly due to maternal death in Blunt Abdominal Trauma
      2. Protecting the mother is the best way to protect the fetus
    2. MVAs affect 2% of pregnant women (accounts for 50% of all Traumatic injuries in pregnancy)
      1. Maternal (U.S.): 368 maternal deaths per year
      2. Fetal: MVAs account for 82% of fetal deaths
    3. Properly positioned Seat Belts decrease the risk of fetal injury while keeping their mothers safer
      1. Uterine injury and fetal risk does increase if belts are incorrectly placed across the dome of the Uterus
      2. Relative Risk of fetal loss if unbelted: 2.8
      3. Fetal outcomes
        1. Properly restrained women: 29% adverse fetal outcomes
        2. Improperly restrained women: 50% adverse fetal outcomes
        3. Klinich (2008) Am J Obstet Gynecol 198(4): 450 [PubMed]
  3. Proper 3 point Seat Belt application in pregnancy
    1. Apply belts as snugly as possible while still maintaining comfort (remove belt slack)
    2. Lap belt
      1. Place under pregnant Abdomen
      2. Should fit snugly over thighs
    3. Shoulder harness
      1. Keep Shoulder harness off Uterus
      2. Harness should sit between Breasts
      3. Crosses midline of clavicle
  4. References
    1. Hyde (2003) Obstet Gynecol 102:279-86 [PubMed]
  • Prevention
  • Miscellaneous
  1. Seat Belt use protects other occupants in car
    1. In accident Unrestrained Passengers become missiles
    2. Unrestrained Passengers strike belted passengers
    3. Unrestrained Passenger raises risk of death for others
    4. Cummings (2004) JAMA 291:343-9 [PubMed]
  • References
  1. McClung, Ruttan (2019) Crit Dec Emerg Med 33(3): 3-11