car seat challenge/test

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For those of you that work in a newborn nursery, how many are performing a car seat challenge/test for babies that are born

Thanks!

Specializes in NICU.
We tell parents, "When the nurse tells you your baby is placed in an open crib, you need to bring the car seat in."

We let them know the most of the car seat challenges are completed on night shift and if they get it out of the way, they won't be here all day long on the day of discharge.

That is a good idea! I'll have to pass that around our unit.

We mostly do car seat challenges at night too, that way parents aren't denied holding their baby if they come in during the challenge. It is an awfully long day when there is still the challenge and education unfinished on the day of discharge--both for the parent and the nurse!!

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Specializes in motherbaby/ special care nursery.

We used to do the car seat challenge test for 60 minutes for babies under 2500 gms or less than 37 weeks gestation. I went to a class in 2009 and became certified as a child passenger safety technician and since then we have been following the AAP guidelines and testing for 90 minutes. THe babies needing the test are brought in the nursery and the corificeat that the parents have is brought in and the infant is positioned in the car seat and the corificeat is placed in a playpen so infant is safe while being tested. If the baby doesn't pass, we try again the next day and if they still don't pass and is otherwise ready for discharge , we will issue a car bed . I have retested in a car seat after a months time and they have always passed after that. the retest has been done in the dRs office by me. I was hoping to find info regarding testing on any baby who has a weakened muscle tone also.

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Specializes in Nurse Leader specializing in Labor & Delivery.

It's funny- within days of this thread starting, our facility also changed its policy to 90 minutes in response to the AAP recommendation.

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Specializes in NICU.

We test kids who are less than 37 weeks. Generally, they don't meet weight requirements for most convertible seats, so we don't let them test or discharge with one of them. They have to bring in a seat for which they meet the weight requirements. We also decline seats that are recalled, greater than 5 years old, or used from someone other than a family member. This can cause problems for families with extremely limited resources. We have trained car seat technicians who complete these tests. They also do car seat educationw with parents.

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I'm not a nurse yet but they must have changed the guidelines...back in 2006 they did the challenge for 3 hours!!! My twins were STARVING as they had to do it hungry and then they missed like 2 feedings (they were 36w but were IUGR)...

the funny thing was we were only 15 minutes from the hospital they tested them for 3 hours and my son had one brady 5 minutes from the end and they still sent him home in a car bed!

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The 90-120 min thing is new. Our car seat techs just a few weeks ago went to a siminar stating it has changed, so we just changed our policy.

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We test kids who are less than 37 weeks. Generally, they don't meet weight requirements for most convertible seats, so we don't let them test or discharge with one of them. They have to bring in a seat for which they meet the weight requirements. We also decline seats that are recalled, greater than 5 years old, or used from someone other than a family member. This can cause problems for families with extremely limited resources. We have trained car seat technicians who complete these tests. They also do car seat educationw with parents.

I'm guessing you look at the car seats expiration date, also?:yeah:

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Specializes in NICU.

Manufacture or expiration date....whichever the seat has. The standard they use is 5 years unless otherwise marked.

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Specializes in NICU, Post-partum.

Car seats, as I stated before, are a necessary part of the discharge process. It is very, VERY important to look up current guidelines and not ASSUME that a more senior nurse knows what they are...LOOK THEM UP AND PRINT THEM OUT!!!

Use critical thinking...think about the PURPOSE of the car seat challenge...it is to identify babies who are at risk!!!

The test needs to be a minimum of 1 hour. By the time the baby is loaded up in the hospital and the parents go downstairs, take all of their stuff, put the baby in and make the slow trip home...an hour has probably gone by.

However, 90 MINUTES IS NOT SUFFICIENT if the parents live two hours away!!!!! The baby needs to stay in for 2 hours or however long their trip is...we tell the parents if they live further away, they need to STOP at three hours, take the baby out, feed it, let it rest, then put it back in the corificeat.

Our facility will NOT issue a carbed if the infant fails a car seat challenge. Nor will we discharge an infant. Failing a car seat challenge is indication of a potential problem folks! Use critical thinking!!!! What happens if you discharge the parents with a carbed and a month later they decide to "try" out the corificeat and something happens to the baby? Legally, I would wager the hospital wouldn't have a legal leg to stand on because who is going to repeat the car seat challenge? Do you tell parents it needs to be repeated if they are going to transition? Or do you expect the pediatrician to do it?

Also, parents need to be told something very, very important!

If the car seat is in a car where it has been involved in a car accident to where the impact is enough to deploy the airbags, the CAR SEAT NEEDS TO BE REPLACED!!!! It is designed to take ONE impact.

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