The use of passenger compartment safety measures has not led to decreases in paediatric morbidity or mortality in our population of patients. A retrospective review in an university, tertiary care, level I trauma centre was conducted among all patients admitted to the Trauma centre at Louisiana State University Health Science centre School of Medicine in Shreveport between July 1, 1991, and December 31, 2000, who were younger than 16 years and involved in a motor vehicle crash. Main outcome measures were intensive care complications, postoperative complications, and mortality. We reviewed the experience of all paediatric patients involved in motor vehicle crashes and transported to the Trauma centre at Louisiana State University Health Science centre School of Medicine in Shreveport from July 1, 1991, through December 31, 2000. A total of 191 patients met these criteria. There were 8 deaths, and only 1 of these patients was restrained. There were significantly more injuries in those patients who died compared with those who survived (Modified Injury Severity Score, 29 vs 9; P<.001). We compared the use of restraints in our cohort with the use of restraints in the US paediatric population. Only 20% of our patients were restrained vs 68% of the general paediatric population. This difference was significant (P<.001, chi2) test). In our population of patients, death was a relatively infrequent occurrence. All patients who died presented in extremis. No patient died as the result of a complication. The rate of seat belt use in our population of patients was low. The exact reason for why we were unable to detect any survival benefit with seat belt use is unclear and demands further investigation. (Author/publisher)
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