Safe Transport of Children

EMS Clinicians

Safe Transportation of Children in Ground Ambulances

In March 2017, the National Association of State EMS Officials (NASEMSO) announced the release of Safe Transport of Children by EMS: Interim Guidance. The guidance is a result of the work of NASEMSO’s Safe Transport of Children Committee, which is focused on examining current resources and pursuing research to develop specific and practical recommendations and promising practices for safely transporting children in ground ambulances.

While there are a variety of products available to secure children being transported in ambulances, the EMS provider (and the children being transported) must depend on the manufacturer for determining if the restraint would operate as intended in an ambulance crash. Unlike the child restraints (car seats) used in passenger vehicles, which must meet the crash standards defined by the Federal Motor Vehicle Safety Standard (FMVSS) 213, there are no crash-testing standards for these devices in the United States. NASEMSO is working with its partners to obtain funding to conduct the necessary crash-testing research to develop standards to be met by manufacturers (click here to learn more about NASEMSO's crash-test project). Until such research can be completed and standards developed, NASEMSO has issued Interim Guidance to maximize the safety of children in ambulances. This guidance is based on what is known at present and includes, in part:

  • All EMS agencies that transport children should develop specific policies and procedures that address, at minimum the following elements: methods, training, and equipment to secure children during transport in a way that reduces both forward motion and possible ejection.
  • The primary focus should be to secure the torso, and provide support for the head, neck, and spine of the child, as indicated by the patient’s condition.
  • A prohibition on children being transported unrestrained.
  • A provision for securing all equipment during a transport where a child is an occupant of the vehicle, with mounting systems tested in accordance with the requirements of SAE J3043.
  • To only use child restraint devices in the position for which they are designed and tested.
  • All device(s) (including a combination of devices) should cover a weight range of between five and 99 pounds (2.3 - 45 kg), ideally supporting the safest transport possible for all persons of any age or size.
  • Only the manufacturer’s recommendations for the weight/size of the patient should be considered when selecting the appropriate device for the specific child being transported

More information about the work of the NASEMSO Safe Transport of Children Committee can be found on the Committee’s webpage.