Department of Health is a Smoke Free Workplace Safety Restraints in Vehicles Self Directed Learning Presentation Please use the page down button on the keyboard to progress through the PowerPoint presentation

2 Contents slide Safety Restraints – OverviewSafety Restraints – Overview 3 Safety Restraints – LegislationSafety Restraints – Legislation 4 Safety Restraints for Children in Remote Health VehiclesSafety Restraints for Children in Remote Health Vehicles 5 Child Restraints in Standard VehiclesChild Restraints in Standard Vehicles 7 Child Restraints in Standard Vehicles – Rearward FacingChild Restraints in Standard Vehicles – Rearward Facing 9 Child Restraints in Troop Carriers – Rearward FacingChild Restraints in Troop Carriers – Rearward Facing10 Seating the ChildSeating the Child15 Securing Clients on Stretchers - ChildSecuring Clients on Stretchers - Child16 Securing Clients on StretchersSecuring Clients on Stretchers17 Patient Harness – Model 417Patient Harness – Model Care and Maintenance of Safety RestraintsCare and Maintenance of Safety Restraints21

3 Safety Restraints - Overview There are a range of safety restraints used in remote health vehicles. These include:  Fitted seat belts in vehicles  Child restraints and booster seats  Stretcher harnesses and restraints Drivers of DoH vehicles have a legal responsibility to ensure all passengers within the vehicle are appropriately restrained. This presentation provides information about the use of child restraints and stretcher harnesses.

4 Safety Restraints - Legislation In accordance with the NT Traffic Regulations Schedule 3 Australian Road Rules (Rule 266), safety restraint requirements for children include:Traffic Regulations Under six months a suitable and properly fastened and adjusted rearward facing approved child restraint Six months to under four years a suitable and properly fastened and adjusted: –rearward facing child restraint or –forward facing approved child restraint with an inbuilt harness Four years to under seven years  a suitable and properly fastened and adjusted forward facing approved child restraint with inbuilt harness' or  a properly positioned approved booster seat restrained by a seatbelt that is properly adjusted and fastened Over seven years –adult seatbelt or –a properly positioned approved booster seat restrained by a seatbelt that is properly adjusted and fastened Note: –Children under four years must not be in the front row of a vehicle that has two or more rows of seats –Children aged four years to under seven years must not be in the front row of a motor vehicle that has two or more rows of seats unless all of the other seats in the row or other rows behind the front seat are occupied by children who are also under seven years of age

5 Safety Restraints for Children in Remote Health Vehicles To provide child restraints in accordance with the NT Traffic Act, each health centre must have at a minimum:  one child restraint for children under four years of age which can be positioned either in the rearward or forward facing position subject to the child’s age requirements  one booster seat for children aged four years to under seven years of age. Note: The child safety restraint and booster seat must be kept in the health centre and be available for use in health centre vehicles at all times.

6 Safety Restraints for Children in Remote Health Vehicles All child restraints and booster seats are tested to weight and height limits and must comply with the Australian Standard 1754:2004. Example: child restraint for children less than four years:  placed in the REARWARD position for infants less than 6 months  placed in the REARWARD or FORWARD position for children aged six months to under four years old Example: Booster seat for children aged four years to under seven year:  placed in a forward facing position Note: booster seats must not be placed on side facing seats

7 Safety Restraints in Standard Vehicles  A standard vehicle is one that has factory fitted anchor points for the specific purpose of securing child safety restraints  As each vehicle is potentially different, instructions for using child safety restraints in standard vehicles are not detailed in this presentation  For further information, see the Manufacturers instructions for how to install the child restraint or booster seat in a standard vehicle as required Note: The child restraint for infants less than six months must be fitted in the rearward facing position For children aged six months to under four years, the child may be placed in either a:  rearward facing child restraint or  forward facing child restraint with an inbuilt harness For children aged four years to under seven years the child may be placed in either a:  forward facing child restraint with inbuilt harness' or  booster seat restrained by a seatbelt

8 Safety Restraints in Standard Vehicles When fitting a child restraint or booster seat into a standard vehicle it is important to refer to the manufacturers instruction booklet to ensure the correct fitting of the safety restraint. This includes:  Adjusting the child restraint to the appropriate setting:  Child recline – rearward facing (must be used in this position for infants under six months)  Child upright – forward facing  Adjusting the position of the shoulder straps on the back of the child restraint as required.  Adjusting the length of the shoulder straps on the child restraint to ensure secure fitting. Only one or two fingers should fit between the child’s chest and harness.  Additional adjustment can be made once the child is positioned on the seat by accessing the adjustment strap.

9 Child Restraints in Standard Vehicles – Rearward Facing Note: Fit the child restraint in a rearward facing position for a child less than six months old.  Adjust the child restraint placing it into the rearward facing position  Connect the safety strap attached to rear of the safety restraint to a safety strap extension attachment.  Attach the extension attachment to factory fitted anchor point on the floor of the cargo section of the vehicle.  Tighten safety strap extension attachment until firm.

10 Child Restraints in Troop Carriers – Rearward Facing  Historically the RHB has used troop carrier style vehicles which have side facing seats in the rear compartment and in the case of emergency vehicles, side facing bench seat and a stretcher  The RHB fit-out of these vehicles included additional fixtures and anchor points for safety restraints for children less than four years of age to be placed in the rearward position on the rear side facing seat.  A child under four years, and able to be seated in the rearward facing safety restraint, may be transported in a RHB troop carrier that has been fitted with these fixtures and anchor points. Booster seats for children aged four to seven years must not be placed on side facing seats in troop carriers. Note: Some RHB troop carriers are designated as ‘people movers’. Without the installation of additional fixtures and anchor points, these vehicles with side facing seats in the rear compartment do not meet legislative requirements regarding the placement of child restraints. These vehicles will be replaced with an appropriate alternate vehicle when scheduled. Troop carriers designated as an ‘emergency vehicle’ will have the side facing seats in the rear compartment removed and replaced with a single rearward facing seat behind the driver’s seat.

11 Child Restraints in Troop Carriers – Rearward Facing  Instructions to fit safety restraints:  on a bench seat – only for troop carriers fitted with additional fixtures and anchor points for transporting a child under four years old and able to be seated in the rearward facing child restraint on the side facing seat. See following slides for details

12 Child Restraints in Troop Carriers – Rearward Facing  The Troopie is fitted with an anchor point on either the right or left side of the vehicle. This picture demonstrates the overhead anchor point for a child seat.  The child restraint MUST be fitted in a rear facing position with the overhead strap attached at the rear anchor point as shown.

13 Child Restraints in Troop Carriers – Rearward Facing  Ensure the seatbelts pass through all the correct guides on the child restraint.  The seat belts should be adjusted to ensure the seat is firmly secured - allowing minimal movement.  Make sure the buckles are firmly secure and not resting or rubbing on any part of the seat frame. (If the buckle is allowed to rest on a frame it may snap open in an accident).

14 Child Restraints in Troop Carriers – Rearward Facing  The child restraint should look like this once fitted.  A final check should be made to ensure that the child restraint is secured firmly. There should be almost no forward or sideways movement of the child restraint if secured correctly.

15 Seating the Child  Pressure should be applied to the child seat for final adjustment of the safety straps.  Make sure the child seat harness is correctly adjusted for size of the child.  Only one or two fingers should fit between the child’s chest and harness.  Children should not be wrapped in blankets and then strapped into the seat - this will not secure the child.  Always secure the child first and place any blankets over the child and harness.

16 Securing Clients on Stretchers - Child For transport of children on the Stryker stretcher, an appropriate rearward facing child restraint (baby capsule) may be attached to the Stryker stretcher. Instruction of how to attach the child restraint to the Stryker stretcher is provided during induction to the stretcher and is detailed in the Stryker Stretchers - Training & Competency Assessment Package: Competency 9 Baby capsule harnessing – restrain and remove.Stryker Stretchers - Training & Competency Assessment Package

17 Securing Clients on Stretchers  Remote Health carries a range of harnesses, safety straps and stretchers in emergency vehicles.  The information provided here can be applied to current equipment available.  The Model 417 client harness can be utilised for clients over 3 years / 14 kg.

18 Patient Harness – Model 417  Attach the harness to the harness mount points located on the main frame and backrest frame.  Lay the harness on the mattress with the torso straps on top and the outline of the man facing up (Figure A).  Lengthen the shoulder straps as much as possible.  Adjust the backrest as needed.  Transfer the client onto the stretcher.  Adjust the straps.  To shorten or lengthen a strap, grasp an adjuster and pull the tab to the desired length (Figure B). Figure A Figure B

19 Patient Harness – Model 417  Fasten the harness  Pull the shoulder straps over the client’s head (Figure C ).  Adjust the shoulder straps until they are against the client’s shoulders and the tang is positioned over the client’s torso.  Fasten the torso straps to the tang. Figure C  Adjust torso straps so tang is centrally positioned on the client’s torso.  Make sure shoulder straps are still snug against clients shoulders. Adjust as needed.

20 Patient Harness – Model 417  Fasten the chest restraint.  Fasten other standard client restraints.  When completed, recheck all harness fittings are still in correct position and not dislodged.  Unfastening the harness  Push the release buttons on the strap receivers  Pull the shoulder straps over the client’s head  Transfer the client from the stretcher.

21 Care & Maintenance of Safety Restraints Seat belts, harnesses, extension straps inspect for signs of cuts, abrasions, frayed or broken stitching, and signs of oil, acid or alkaline contamination Metal fixtures and bucklesinspect for signs of wear and tear check that the buckle fastens correctly and allows for adjustment of the strap. Seat belts, harnesses or straps clean with soap and water and dry out of direct sunlight Metal / plastic parts of safety restraints / booster seats clean with soap and water Safety restraint / booster seat covers - wipe over with soap and water and dry in the shade, or - remove cover and machine wash on the gentle cycle and dry in the shade. Refit the cover. Safety restraint harness buckle If the buckle is sluggish, ie an audible ‘click’ cannot be heard when it is engaged, remove harness buckle from the safety restraint, run under warm water, and repeat cleaning until a strong audible ‘click’ is heard. Refit the harness buckle. Replacement child restraints, booster seats, safety strap extensions and stretcher harnesses should be requested via the Internal Requisition process. If there is doubt regarding the functionality of the fixtures and buckles this should be discussed with the Transport Officer for replacement by the supplier. Note: Refer to the manufacturer’s instructions for detailed care and maintenance information.