Carseat In A Medical Emergency?

Carseat In A Medical Emergency?

Posted on the TCS List on Thu, 5 Oct 2000 04:34:31 +0100

David Deutsch

A poster wrote:

WHY the child doesn't want to get in her carseat, and so far she has come up with: the little girl doesn't like to be in it physically. BUT, how do you get a child in a carseat in a TCS-way, when there is no other common preference? For example, a doctor's appointment, dental appointment (not routine, but because there is an acute medical need)?

So let's see: What's an example of an acute medical need? Say ... your toothache is raging; or else arterial blood is flowing freely despite the tourniquet. OK. The situation is urgent. Run, don't walk, to the car and get yourself to the hospital. There's no one at hand to look after the child? OK, take her with you and GO.

But you're postulating, for some reason, a parent who doesn't want to do this.

Why? Well obviously, first, says the parent, the child has to get her pullover on (in case it's cold at the hospital).

Um...

... and she has to get her shoes on (because there might be a sign at the hospital saying “no shoes, no shirt, no service”).

The child has to have her hair combed (because what will people in the ER think of the parent whose child looks a mess? surely that's obvious?).

She has to get into the carseat (well, it's the law, isn't it?).

And, of course, she must take her violin and practice it on the journey (this is especially important because if she's not introduced to it at this early age, she will never catch up). Don't forget the sheet music and the holder.

All this, whether the child wants to or not.

So, who's being irrational in this story, the child or the parent? Of course there are common preferences to be found. I'd say to that parent: Forget the pullover, the shoes, the comb, the carseat, the violin and the sheet music. Apart from the child and the car keys, stop only to pick up a few handy toys and let her sit in the normal seat for once! Drive to the hospital. Just don't crash, and no jury will convict you of the carseat offence. In the unlikely event that a policeman sees this heinous offence and stops you, show him the wound and he'll lead you through the traffic with siren blaring, and you'll get there faster than if you had used the carseat. And anyway, what if you do get convicted? It was an acute medical need wasn't it? Pay the damned fine and think yourself lucky!

And afterwards, once the parent's sense of perspective has been improved by surviving this crisis, she may feel more relaxed about the car seat issue even when there isn't a medical emergency – not to mention all the other issues. If so, she will find that in non-emergency situations, there are even more solutions available, given a little creativity.

Or what if there isn't a friend/neighbor to run errands? I'm just wondering here...

Well, what if, in addition to no friends, neighbours or delivery services, there aren't any food shops either – and NO other common preference? Then the parent has to eat the child. Right?

Comments

"Just don't crash" implies

"Just don't crash" implies that the whole course of the journey is set by the driver with the child; it does not take into account actions of other road users (for example, the drunk driver). Yes, the chances are that this will pan out fine; but there are chances that it will not.

"And afterwards, once the parent's sense of perspective has been improved by surviving this crisis, she may feel more relaxed about the car seat issue even when there isn't a medical emergency"

And what about afterwards when they are looking at the bloodied corpse of their child that has been flung out of the front window the the car? You'll never be relaxed about anything else in your life. Yes, life is all about weighing risks. That's not a risk that I would take with the life of a child.

risk assessment

Many- most?- parents risk the mental health of their children many times every day.

Yes, keeping children alive from day to day brings the hope that they will be able to surmount the mental challenges being set in place in the course of a typical childhood, being forced into car seats and eating spinach and into bath and bed and school and all that.

But if there is a way to keep children alive and not force intolerable situations upon them, thus helping them to retain and develop their ability to think clearly about problems-- why would you not want to do so? The way lies in the will and creativity of the parents.

carseats aren't negotiable

You said: Apart from the child and the car keys, stop only to pick up a few handy toys and let her sit in the normal seat for once! Drive to the hospital. Just don't crash, and no jury will convict you of the carseat offence.

Um, are you joking? Putting a safety device like a carseat in the same class as uncombed hair is one of the most blatantly irresponsible things I've seen on a parenting site in a long time.

I have a personal rule that my car doesn't start until everyone is wearing a seat belt. Everyone, child or adult, *must* be wearing a safety restraint.

I think children must be taught that sometimes in an emergency they need to follow instructions from a trusted adult and accept that sufficiently persuasive explanations will have to wait until later.

sanity rears it's ugly head

Eliza writes: I think children must be taught that sometimes in an emergency they need to follow instructions from a trusted adult and accept that sufficiently persuasive explanations will have to wait until later.

Bravo...well said!

Some folks here are clearly insane! why would you risk the very life of the people you are seeking to raise so democratically by placing them in such an obviously dangerous circumstance? Allowing a child to ride in a car unrestrained can possibly be classified as child neglect and is a crime!

Carseats - ok as long as baby doesn't NEED anyone holding them

In the case of an emergency in which the child needs an adult to hold them, monitor them, whatever, I might call 911 or else if I am already in my car I might hold them. If the child can safely ride in the carseat I would do that, but sometimes it's possible it might be injurious to the child to put him in the carseat if he is bleeding profusely or in danger of stopping breathing, whatever. Sometimes you have no choice, if you have the choice, use the carseat, if the carseat seems dangerous or child won't ride in it and it is an emergency, just get to the ER. I had to carry my son in the car without a carseat when the airline lost our carseat, and nothing happened. Also my mom nursed me while driving all the time and nothing happened. I think the chances of a car accident are pretty slim but you should be safe in whatever way you can, and weigh the pros and cons of your options at the time. I don't think this article is meant to advocate against carseats in general, just if the child is hurt and is struggling and you need to get to the doctor or hospital immediately. As someone who has driven quickly in an emergency before I can attest to both the unlikelihood that you will crash during an emergency and to the importance of being able to observe your child. If your newborn is in a carseat in the back seat and you are taking him in because you can't wake him, if you are alone, who will observe him in case he chokes and stops breathing!?

There is NEVER a reason NOT to...

There is NEVER a reason why you should not use a carseat for your child.

Period.

If your child is in that much imminent danger, you need to call 911. The EMT's will stabilize the child at your home, and will then transfer them to the hospital IN THEIR CARSEAT in the ambulance.

If the child's carseat is lost by the airline, rent one from the rental car agency at the airport, or have one parent stay with the child at the airport while the other parent runs to the store to purchase a replacement.

There is ALWAYS another option, and the parent should BE THE PARENT and advocate for their child's safety, after all it is their LIFE on the line.

To even suggest that the parent SHOULD be more lax about carseat usage after a serious event like this is heinous and negligent.

Child safety seats are mandatory for a reason! You can NOT control the other driver's on the road. You can be the best driver in the world, but if there is a drunk driver on the road who decides to plow into YOUR vehicle there may be nothing YOU can do to prevent it.

As a mom of 3 who has had to make several calls to 911 for sick and injured kids, this article disgusts me.

gotta go but inconsolable baby

There have been numerous occasions when my son needed me but we had to be somewhere. So in the car we would bundle. Admittedly not an emergency. And with adults buckled in the front seat and my child in my lap, off we would go. Right. Everything went fine. In those days, I used the carseat usually but there were times I decided not to. Yes, knowing the heinous risks we were taking. The alternatives would have been piercing screams that make travel painful and mostly unbearable or seldom going anywhere. My child loves rides now but there was a time this was not so.

carseats

Wow. Six months ago, we took the half mile or so trip to the supermarket, and didn't make it there. I was driving the speed limit on a dry and sunny day down a straight road, and a teenage driver blew through a stopsign, hit my van on the driver's side, and we flipped over 4 times according to witnesses.

Miraculously, we all survived. Seeing how everything in our car was scattered in a 20 yard or so radius from where the van ended up, I highly doubt that either of my children would have survived the crash if they were not snugly harnessed in correctly installed carseats.

Sorry, but I'd rather hear piercing screams from an upset restrained child than never hear any sound from them again.

Your article is blatantly irresponsible at best, and your advice could easily be deadly at worst.

trust and carseats and the law

From a comment above:

"...children must be taught that sometimes in an emergency they need to follow instructions from a trusted adult..."

Whoa! Right there! that part about "trusted adult"... my observation and conjecture is that children do listen to and follow advice (and want to help!) trusted adults, especially in emergencies.

Does it follow that if children do not listen to and follow the advice of and, in the case of this article and the situation of a force 10 emergency, do what is asked of hir, that there are issues about mistrust in the parent-child relationship?

If a child has been forced into the car seat at seemingly (to the child, by hir lights) the whim of the parent in the past, how is the child to know that this time it is very important to comply? The volume of the yelling? (in my experience, it is very hard to think when someone is yelling at you, let alone to understand the content of the words being yelled) The presence of distress? The spurting of the blood?

The point is that the habit of trust and creativity in the best of times is going to help in the worst of times as well.

I hear of people driving laboring women to the hospital under trying conditions-- do you suppose a woman with a baby crowning is sitting with her seatbelt on? A relative of mine made that trip in the back of station wagon, the baby born upon arrival to the ER. Another relative birthed the baby at home as the emergency technicians came in the door. I wonder if that newborn was forced into a car seat in the back of the ambulance for the ride to the hospital?

Accidents happen- lucky me, to survive one when quite young and before there were even seatbelts in cars, yes I flew right out the open window I was standing next to- and we do our best to avoid them. Keeping children in bed so that nothing could happen to them isn't a good solution; riding in cars with restraints is a good way to minimize risk. Making it pleasant for all will help parents' credibility with children- when parents consistently demonstrate their love and concern for their children (none of that 'I hit you because I love you' stuff or the equivalent) then children are likely to demonstrate the same, within their frame of reference and knowledge-set, imo.

We understand the importance of following laws, on many levels, and share that with our children as they grow and come to create that knowledge for themselves in their own way. By not forcing things upon our children, we help them to retain their ability to learn so they can create that knowledge- that is what I understand from TCS theories.

Quite simply, if the child

Quite simply, if the child has been in a carseat since day 1 (as is required by law) and has never been allowed to ride in the car WITHOUT a carseat, and knows that it is simply 'the way a child travels in a car'...then why would they argue about it during a stressful emergency?

If, on the other hand, the child has been allowed to decide for themselves when they will sit in a carseat, the chances are quite high that, noticing the parent's desire to just 'get going' they will parlay that into a refusal to sit in a carseat simply because they don't always have to.

Frankly, this whole 'philosophy' strikes me as an abdication of parental responsibility and seems to want to strike down the idea of parenting altogether -- which every animal that gives birth to young that need caring for engages in (and which this site seems to wish to do away with for some reason).

one pessimist's comments

"Well, what if, in addition to no friends, neighbours or delivery services, there aren't any food shops either – and NO other common preference? Then the parent has to eat the child. Right?"

Or the child could eat the parent, which raises the question of how she'll survive on her own. Anyway, tens of thousands of people per day do starve to death. Even in developed countries, some people go hungry.

I agree that it is not within one driver's power to avoid all crashes, and that the worst risk is not a fine, but death. I have my own story of a fellow Animorphs fan whose brother didn't wear a seatbelt and died in a car crash.

I've also heard that seatbelts are not a private matter: you're not risking only your own safety. In an accident, your body might hurt others while flying through the car. Also, the ambulance personnel might have to make decisions about whom to help when -- if you're in a worse state than you would have been without a seatbelt, you might be taking resources away from others. (I guess one could carry a statement that she doesn't want help, but I haven't heard of any such idea yet.) And there's the old question of whether death is a private matter at all, if it causes such suffering to one's parents...

BTW, AFAIK, little kids (and I think this can mean as old as 3-6 years) do understand things from the parent's tone of voice. So telling someone this young that their behaviour is hurting others, in a tone of voice that implies everything's all right, would not be very helpful.

Carseat for child = Seatbelt for adult

While I agree with some of the sentiments on this website, the idea of letting a child ride without restraints in a car is just too dangerous to go without comment.

I don't like having to put my son in a carset, and it can be stressful for him at times. But it also used to be stressful to try to talk my husband into putting on his seatbelt; he objected, it didn't feel comfortable, he didn't like it, he didn't need it, whatever. After ten years of argument about this issue I finally gave up and decided he could go without a seatbelt and we'd be more at peace with each other.

Fine and dandy. Until another driver ran a red light right in front of our car and we couldn't stop in time -- then my dear stubborn husband flew into the windshield and bashed it with his head. Ambulance, etc., to the hospital we went. To this day, I'm not sure that his memory and other mental processes were not affected by the accident.

The problem with letting someone you love, of any age, do their own thing for the sake of a relationship is that the other person can be hurt or even killed as a result of their decision.

I believe that the physical health and life -- not just the momentary happiness -- of the precious person is paramount.

This is a thoughtful article, but when the stakes are that high, you really have to weigh the possible consequences and -- as someone else wrote here -- "be the parent". Maybe even of someone you love who *isn't* a child, like an older adult or even a spouse, if they are not acting responsibly. I still wish I had been more willing to argue with my husband about wearing his seatbelt.

Community health

Keeping children in bed so that nothing could happen to them isn't a good solution; riding in cars with restraints is a good way to minimize risk. Making it pleasant for all will help parents' credibility with children- when parents consistently demonstrate their love and concern for their children

Not a good idea!

I personally think that is horrible advice! Sometimes, despite your best efforts to find a common preference, your child will have to do something they absolutely do not want to do because it is for their safety. Childseats in a car are absolutely nessecary and for the safety of your child, not the parents' convenience! He or she may cry and be upset, but they will recover, I promise. Its much better than letting your child be unrestrained and them being injured or even killed because you didn't want to make them do something they didn't want to do.

We avoid carseats with babies

I've had experience with children, through a stage of not liking car-travel as babies. So if we HAD to go somewhere in a car, I'd sit in the back right next to the baby and nurse as my husband drove. This helped the baby not mind being in the car-seat.

But for the most part, we learned it was usually possible to just avoid car-travel. While wearing Baby on me in the sling, I could go for walks to nearby places in the neighborhood which gave us a lot more fresh air (and gave me more exercise) than riding around in the car did.

I think the fact that we just laid off on unnecessary car use may be the reason that, by toddler-hood, amenable to car-seats and car-travel. I think it's true that when we show respect for our children's preferences and feelings, this lays a foundation of trust that enables them to cooperate with us in emergency situations.

Susan

All of you security nitwits

Understand that there's more to this live than avoiding death and injury. Everybody eventually dies.

You know ? With or without seatbelts, with or without spinach, if you do what you want every day of your life or if you spend every day following someone else's scripts, you will die.

I understand that some of you are more than happy to do what they're told, and spend their life trying to avoid dieing.

Try and understand that other people don't care about who dies when. We've got better things to do than sit around worrying when the time's up, and how much it hurts.

It's best this way, you can be the accountants and grocery baggers and indescript clerks society needs. But a society isn't made entirely of grocery baggers and clerks and accountants.

And like it or not, you will have to accept there are people who don't follow scripts, who live and die by their own head, and who basically play a different game.

Sometimes they paint the highway in their blood and brain matter. Sometimes they end up writing the scripts the rest of your follow. There'd be nothing for you if there weren't actual people there, somewhere.

All of you security nitwits

Understand that there's more to this life than avoiding death and injury. Everybody eventually dies.

You know ? With or without seatbelts, with or without spinach, if you do what you want every day of your life or if you spend every day following someone else's scripts, you will die.

I understand that some of you are more than happy to do what they're told, and spend their life trying to avoid dieing.

Try and understand that other people don't give a shit about who dies when. We've got better things to do than sit around worrying when the time's up, and how much it hurts.

It's best this way, you can be the accountants and grocery baggers and indescript clerks society needs. But a society isn't made entirely of grocery baggers and clerks and accountants.

And like it or not, you will have to accept there are people who don't follow scripts, who live and die by their own head, and who basically play a different game.

Sometimes they paint the highway in their blood and brain matter. Sometimes they end up writing the scripts the rest of your follow. There'd be nothing for you if there weren't actual people there, somewhere.

Frankly, I'm disturbed by

Frankly, I'm disturbed by the notion that parents should love some abstract notion of "taking children seriously" more than they love their children. Should be willing to allow their children to fly free in a rolling car. I'm particularly baffled by the idea that a simple decision not to be involved in a collision is all it takes to avoid one.

"Just don't crash" is a nice idea, but it didn't help me very much when I -- stopped dead at a red light -- was rear-ended last Spring by a pickup truck hauling a trailer.

Fortunately I was uninjured, because I was belted in. And anyone in my car would have been, as well -- and any child would have been in a properly designed and installed car seat, whether it liked it or not.

That you've "taken your child seriously" is little consolation when you see him flying through the windshield.

But maybe it's sufficient consolation to Deutsch, who does not have to live with other people's grief.

ok i was reading this site

ok i was reading this site and thinking i'd work on this... but i'm sorry, the carseat is non-negotiable. people who think a child should get a say in this probably allow their children to play with knives since they WANT to. whatever... weirdos!

What on earth are you

What on earth are you drivelling on about? Do you think that not using car seats makes you a cool and subversive person or something?

"Try and understand that other people don't give a shit about who dies when."

You don't care when your child dies? If they're three, and they die you "don't give a shit"? Hey as long as you aren't conforming, then that's okay!

"And like it or not, you will have to accept there are people who don't follow scripts, who live and die by their own head, and who basically play a different game."

Fine. Please go get in a car accident. It would probably save the life of a child.

Are you stupid?

Child restraints are mandatory because there are people so foolhardy and irresponsible as to believe that they are in control at all times. The risk of death to a child in a crash because they are unrestrained is greater than the risk to an adult. If children are introduced to child restraints as infants (I don't know of a hospital that will let a baby leave without one), there is no emotional trauma associated with their use. The presumption that placing a child into a carseat is terribly time consuming is ridiculous. 15-45 seconds, depending on the carseat and parents level of practice (tip: use one and you'll get good at it!) A child loose in the car is even more of a distraction and a hazard during a medical emergency, thereby increasing your chances of having that crash you mentioned. I speak from experience: I have 3 children and I work for the Highway Patrol in my state. Many people are affected when a child is seriouly injured or killed in a crash: the troopers, paramedics, docotrs and nurses, witnesses, grandparents, siblings, not the mention the parents. Look at the mangled and broken bodies of babies that died because their parents were too lazy to buckle them up. Did I mention that homicide charges are commonly pursued when a child is killed in a crash because they are unrestrained? That's certainly worth the time for those parents who don't love their child enough to fasten them in. Mothers change all sorts of behavior when the get pregnant: quitting smoking, eating better, Lamaze classes, all to bring their child into the world healthy. Just because the child is birthed doesn't mean that task is complete! I suppose you are against childhood immunizations because your child hates getting shots too?

Err....?

"... and she has to get her shoes on (because there might be a sign at the hospital saying “no shoes, no shirt, no service”)."

But surely, if there's no service without shoes, putting the shoes on makes sense?

"The child has to have her hair combed (because what will people in the ER think of the parent whose child looks a mess? surely that's obvious?)."

Well, yes. What will the people think of a parent whose child arrived carseatless (presumably seatbeltless) and looks a mess? Maybe neglect. Maybe Social Services. But that's okay, because they'll understand when you explain you're following the advice of a childless physics professor who believes that one day we'll all be resurrected in a big interstellar cloud.

"Just don't crash"

So that's where thousands of people a year are going wrong! They forget to not crash!

Car seats

I'm agreeing with a lot of things I read on this site. This one I do not. I am starting my training for EMT and the last thing I want to have to do is pick a baby up that wasn't buckled in properly. But, as another poster said, if from day 1 they always ride in that seat, and they know it isn't an option, if they have never been able to leave without the seatbelt on EVERYONE, if mama doesn't make a deal out of it and just says, "let's go for a ride" and buckles baby in, then hopefully, by the time an emergency hits, baby is used to it and doesn't fuss. My youngest HATED the seat for the first 3 months of his life, but I had big bubby or big sissy, or myself sit back there and make googly faces, play with toys, sing, or for me, nurse him while we were driving. He learned that the seat meant seeing new things, playing, and yum yums. By 3 months, he got excited when he was strapped in.

Not all children are accustomed to car seats

You don't have to have a car seat to leave hospital with a baby. I walked home with one in a sling. Also if one doesn't drive or use a buggy, then the use of a car seat is very rare and the child will not "get used to being strapped in".

I would however force my child into the straps in order to get to hospital in a medical emergency. Not going to hospital is not an option. Not being strapped in is illegal and dangerous far beyond the upset of the child. And I believe children do understand exceptional circumstances and will understand in hindsight once the emergency is all over.

slings are good

If the hospital was not too far, and the little one absolutely refused to get in the carseat, tensed his body and would not budge, i would put the baby in a sling and put my own seatbelt on. I would not leave the baby loose in the backseat, or put him in an adult seatbelt that really won't do anything, but could actually harm him in an accident.

Like another reader said, not all children are forced into carseats everyday, so not all children are used to it. Most of the time, I walk or take a bus with my kids. I find they are so much more settled in the bus, where I can give them my full attention.

Depends on the sling.

The belt needs to go around the adult and not the child. This is fairly easy with a strappy babybjorn style thing, but if the belt goes over both of you, when thrown forward, the belt will cheesewire the child, crushing their spine and internal organs.

Choice vs. obedience

I have only just discovered TCS, but I think the comments to this article are very illustrative of one of the major themes of TCS: choice vs. obedience.

Many of us are raised to obey. The authority instructs; we comply. Deus imperat. End of story. It is a very simple and comfortable habit to acquire.

It takes quite a leap to go from obedience to choice. How can you evaluate alternatives when you're used to others choosing for you? What if you choose poorly? Are you not then responsible for your own misery in a way you would not be if you simply obeyed?

The carseat issue is a brilliant test case because it strikes the hammer directly on the obedience reflex. Rather than engaging in cost-benefit analysis, weighing the risks of different approaches, the mind is short-circuited: "carseats are mandatory". Then we start selectively looking at evidence to confirm the propriety of this view: "so-and-so's baby died from not being properly restrained". Ultimately we work ourselves into such a state of righteous indignation that we start hurling ad hominem insults at the author.

Stop! Think! Isn't it possible to imagine circumstances where foregoing a carseat would be the lesser risk? Perhaps, as an earlier commenter wrote, the baby is non-responsive and barely breathing and it will be significantly faster to drive two blocks to the hospital than to await 911. In that case you must have the baby near at hand in case CPR is necessary; securing it in the backseat would place the baby out of reach.

Yes, it is possible a drunken teenage felon could sideswipe you on the two-block ride to the hospital and the infant could die. The question is, how does that risk compare to the risk of the infant suffocating to death for want of timely intervention?

Clearly, carseats are preferable in the vast majority of cases. But sometimes they may not be, and being able to make sound choices like that under pressure is an essential parenting skill. TCS teaches us to make rational choices rather than languish passively in the obedience oubliette.

Keep writing, David Deutsch and Sarah Fitz-Claridge. The TCS web site is by far the most intriguing and useful look at parenting I have found so far.

Car seat

Dear Mr. Deutsch,

What shall I say to my son? He is nine years old and a paraplegic, as a result of a car accident when he was two. An accident in which he was not in a child safety seat.

I was, you see, "taking seriously" his objection to riding in a seat. So I allowed him to sit in the regular seat.

My determination to "just don't crash" was of little help when another car crossed against the light at forty-five miles per hour.

My son knows about the accident. He knows that I was "taking him seriously".

Now -- how do I today, while "taking him seriously", answer him when he says, "But Daddy, you were the grownup. You knew better than I did what was safe"?