Baby Buggy or Baby Catapult?
BACCH Annual Scientific Meeting
Cardiff. 16th and 17th September 2014.
Dr. Vanessa Impey
Specialist Registrar in Community Paediatrics
vanessa.impey@nhs.net
Guy’s and St. Thomas’ NHS Foundation Trust
Dr. Daniel James
GP Registrar – danieljames@nhs.net
Guy’s and St. Thomas’ NHS Foundation Trust
#babycatapult @danielsjames
Case History typical of anecdotal evidence
• 10 days old baby
• Travelling in buggy on London
Underground
• Fell from buggy on stairs
• Mechanism of fall
• Injury: skull fracture with
underlying haematoma and
infarction
Dr. Vanessa Impey, Dr. Daniel James. BACCH Annual Scientific Meeting September 2014. Baby Buggy or Baby Catapult? Introduction
What is the extent of the problem?
Literature Search
• 14 Papers in the English Literature concerning
injuries related to buggies/prams/pushchairs.
• 5 of these concerning accidental deaths from
asphyxia (in 1990s)
• 1 Non-Accidental Injury Case Study where a
baby was shaken in a buggy
• 7 Case studies/prevalence studies about
injuries related to falls from buggies
Recurring
Themes
Injuries sustained on
falling from buggies
Head Injuries
Improper use of straps
Stairs/Escalators
• 1 prevalence study of injuries on escalators
Dr. Vanessa Impey, Dr. Daniel James. BACCH Annual Scientific Meeting September 2014. Baby Buggy or Baby Catapult? Aims
How to find out more?
Contacted Transport for London
Freedom of Information Act
incident reporting systems
Were TFL aware of a problem?
Yes and No
How did TFL respond?
Posters on buses
Request for further recommendations
Dr. Vanessa Impey, Dr. Daniel James. BACCH Annual Scientific Meeting September 2014. Baby Buggy or Baby Catapult? Methods
London Buses
• 677 buggy-related injuries on buses over a 2 year period.
London Underground
• 1164 under 16yrs injured 2008-2012
• 110 of these injuries were buggy-related (10%)
• 72 babies ejected from buggies (inadequately secured)
– 54 taken to hospital by ambulance (75%)
– 52 head injuries (72%)
– 17 <6months (23%)
• At least 6 descriptions of head injuries indicating CT
Recurring
Themes
Injuries sustained on
falling from buggies
Head Injuries
Improper use of straps
Stairs/Escalators
Dr. Vanessa Impey, Dr. Daniel James. BACCH Annual Scientific Meeting September 2014. Baby Buggy or Baby Catapult? Results
Moving Forward
• Is this a snapshot of a national problem?
• TFL has responded to the authors'
suggestions
• Health Visitor advice locally to include
use of buggy straps and safety on public
transport and stairs
Dr. Vanessa Impey, Dr. Daniel James. BACCH Annual Scientific Meeting September 2014. Baby Buggy or Baby Catapult? Discussion
Wider Issues
No buggy manufacturer advocates carrying
children in a buggy – strapped in or not
Stokke Never use the stroller on escalators iCandy
Maclaren
Mothercare
Never lift your pushchair
Never leave child in Remove your
or use on escalators or
the buggy when ascending
or descending stairs or
escalators or when
child and fold the
pushchair when
stairs when your child is
in pushchair
ascending or
the
travelling on other forms of
descending stairs or
transport
Quinny
escalators
Taking
BabyJogger
children up or down
Never use stairs or
steps, stairs or escalators in a
escalators with your child in stroller could be dangerous
the pushchair
and should not be attempted
Dr. Vanessa Impey, Dr. Daniel James. BACCH Annual Scientific Meeting September 2014. Baby Buggy or Baby Catapult? Discussion
Wider Issues
Discrepancy between safety and practicality
TFL – Plan a route using escalators … lifts and ramps
Buses: Hold on to your buggy
Dr. Vanessa Impey, Dr. Daniel James. BACCH Annual Scientific Meeting September 2014. Baby Buggy or Baby Catapult? Discussion
What lessons are there?
What recommendations can you suggest?
Vanessa Impey: vanessa.impey@nhs.net
danieljames@nhs.net
Daniel James:
#babycatapult @danielsjames