What is the procedure for performing a car seat test, also known as an Infant Car Seat Challenge (ICSC)?

From the Guidelines

To perform a car seat test, parents should read the vehicle instruction manual and child restraint device instructions carefully, then install the safety seat and test it for a snug fit and any compatibility problems with the vehicle seat or seat belt. This is based on the guidelines issued by the American Academy of Pediatrics, as reported in the American Family Physician journal in 2002 1.

Key Steps for the Car Seat Test

• Read the vehicle and child restraint device instructions carefully to ensure proper installation and use.
• Install the safety seat according to the manufacturer's instructions and the vehicle's manual.
• Test the safety seat for a snug fit to prevent excessive movement during travel.
• Check for any compatibility problems with the vehicle seat or seat belt to ensure safe and secure installation. The car seat test is crucial for ensuring the safety of children during car travel, and by following these steps, parents can help prevent accidents and injuries. According to the American Academy of Pediatrics guidelines 1, this test is essential for selecting and using the most appropriate car safety seats.

From the Research

Car Seat Test Procedure

To perform a car seat test, the following steps can be taken:

• The test should be performed for 90 minutes or the anticipated duration of the trip home, whichever is longer 2, 3.
• The test can be performed in a normal newborn nursery (NBN) or special care nursery (SCN) 2.
• Infants who fail the car seat test can be tested in a car bed 2.
• Pulse oximetry saturation values can be used to determine test failure, with categories of test failure based on saturation values (90-92% or <90%) 2.
• The test can also monitor for respiratory immaturity and the risk of adverse cardiopulmonary events in the upright position 4.

Failure Criteria

The failure criteria for the car seat test can vary, but common thresholds include:

• Bradycardia of <80 bpm for >10 seconds 4.
• Desaturation of <90% for >10 seconds 4.
• Oxygen saturation <90% 2, 3.

Implementation

The car seat test can be implemented in a community hospital or neonatal intensive care unit (NICU) 2, 3.

• Education of health professionals about the problem and its management is important for successful implementation 3.
• Development of an effective hospital policy and procedure for testing at-risk infants is also crucial 3.
• Logistical difficulties and liability concerns can be overcome with appropriate planning and support 3.

Testing Parameters

The testing parameters for the car seat test can include:

• Duration of testing: at least 90 minutes 4, 3.
• Inclusion criteria: all preterm neonates born <37 weeks' gestation 4.
• Failure criteria: bradycardia of <80 bpm and desaturation of <90% 4.