Car seat test for healthy 35-37 weekers

Specialties Ob/Gyn

Published

I have a question for all of you who take care of well babies along with their moms.

When the baby is a healthy near-term (35 or more weeks gestation) who spends their admission without requiring special nursery care, do you do a car seat test on the ones born before 37 weeks gestation (AAP Guideline)?

If you do perform a car seat test:

Who performs the test (RN, Respiratory Therapist, etc.)?

If the test is performed in a Well Baby Nursery setting, who watches the baby during the test? (Well Baby Nurseries are often too busy for one nurse to care for babies and watch a car seat test properly.)

How long is the baby in the car seat?

How low do you allow the O2 sat to drop and still consider the test passing?

How long can the O2 sat be down and still consider the test passing?

If they fail the car seat test, do you test them in a car bed and make them go home in a car bed if they pass the car bed test?

Any other information would be very much appreciated!

Thanks,

Tiki

Up Vote Up Vote ×

We do do car seat challenges on all NBs

Guidelines/routine:

1) baseline color, HR, RR and O2 sat recorded prior to placing NB into car seat

2) place NB into car seat, with cardio resp monitor and O2 monitor on and place car seat at 45 degree angle

3) record HR

Discontinue for:

1) HR

2) apnea > 20 secs

3) central cyanosis

4) O2 sat 20secs

Document any interventions needed to resolve any of the above

Car seat challenge should be done 30-60 mins after last feeding

If our car seat tech is out, or this is needed over the weekend, RN's can do.

All hospitals should do this. Car seat safety is a priority.

Hope this helps.

Up Vote Up Vote ×

Thank you soooo much obnursesteff! Your post really did help an awful lot. We are doing these tests on

Tiki

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I learned something here. Car Seat challenges are something with which I have no experience. Thank you for this informative thread.

Up Vote Up Vote ×

we also do car seat tests on all babies born under 37 weeks. It's been awhile since I've done one or looked at the policy so I can't offer specifics, but the nurse caring for the baby (we don't have a well baby nursery) is responsible for the test. We test for an hour or as long as the drive home is, if the parents live longer than an hour away, I think. If the baby fails they go home in a car bed. Sorry I can't give you more specific answers but hope this helps anyway.

Up Vote Up Vote ×

We didn't do car seat checks when I worked postpartum.

How do you deal with the liability?

What if you give a passing grade, the family has a car accident, the car seat wasn't up to par, and the baby gets injured?

Couldn't you be sued?

I think you could unless the parents sign a waiver. Even though you are not a mechanical engineer or whatever, you gave the parents the impression that the car seat was okay and they rely on that.

Anybody's ward addressed this?

Up Vote Up Vote ×
Specializes in Maternal - Child Health.
We didn't do car seat checks when I worked postpartum.

How do you deal with the liability?

What if you give a passing grade, the family has a car accident, the car seat wasn't up to par, and the baby gets injured?

Couldn't you be sued?

I think you could unless the parents sign a waiver. Even though you are not a mechanical engineer or whatever, you gave the parents the impression that the car seat was okay and they rely on that.

Anybody's ward addressed this?

It is my understanding that the purpose of the car seat test is simply to evaluate the baby's respiratory status and oxygenation while strapped into the car seat, not the protective value of the seat in an accident. Some preemies lack the muscle tone to sit in a standard seat without compromising their airway.

Up Vote Up Vote ×
Specializes in ER.
I learned something here. Car Seat challenges are something with which I have no experience. Thank you for this informative thread.

Me too...I didn't realize they did it on ALL

Up Vote Up Vote ×

Wow...I've never heard of this...5 years ago I took home my health 36 weeker (C section do to pre eclampsia) without any tests.

Up Vote Up Vote ×
It is my understanding that the purpose of the car seat test is simply to evaluate the baby's respiratory status and oxygenation while strapped into the car seat, not the protective value of the seat in an accident. Some preemies lack the muscle tone to sit in a standard seat without compromising their airway.

exactly, we're testing the baby to see how well s/he responds to being in the semi-upright position that the car seat puts them in, not the car seat. We monitor them on the cardiac/repsiratory monitor to ensure they don't have an apneas, bradys or desats. We do also ensure that the parents know how to properly strap the baby into the carrier part of the car seat, but that is as far as we go as far as the actual car seat is concerned. Out local fire depts do car seat checks and we encourage every parent to go to make sure their car seat is installed correctly.

Up Vote Up Vote ×

that's makes sense - thanks for the replies :)

Up Vote Up Vote ×
+ Add a Comment