Riding home safely with a child in a cast or brace
Guidance from a pediatric occupational therapist and a child passenger safety technician
A cast, brace or bulky bandage can change how a child sits in a car seat. It can also change where a belt crosses the body. A seat that fit your child yesterday may not fit after treatment. Plan the ride home before your child leaves the hospital. Bring the restraint your child usually rides in. Ask the staff to watch your child sit in it. [1, 2]
Look at the fit with the cast in place
The car seat harness or the seat belt must sit the way the maker says. It shouldn’t lie over a cast in a way that keeps it from fitting snugly. Don’t loosen straps, add cushions or alter the restraint to make it fit. The injury may also make the usual sitting position painful or unsafe for medical reasons. Tell your child’s doctor exactly what keeps your child from sitting normally. [1, 2]
Ask about an approved way to travel
Many children with medical needs can still ride in a standard restraint if it fits correctly. Some need a special seat or travel setup for a while. Ask the hospital to refer you to a certified child passenger safety technician with special needs training. [1, 2]
Find out who can supply the equipment, show you how to install it and check the fit before you go. A cast is never a reason to ride without a restraint. [1, 2]
Expect things to change
Swelling can go up or down. A cast may get swapped for a new one. Each time something changes, recheck the fit and the doctor’s limits on positioning. Ask if pain medicine affects how closely your child must be watched on the ride. [1, 2]
Your child may not be able to ride safely in the restraint you have. If so, tell the discharge team before you leave. They can set up another safe option. [1, 2]
A checklist before discharge
- Can my child sit safely in the usual position?
- Who will check the restraint with the cast on?
- What travel equipment or service can we get if it doesn’t fit?
Bring the seat to the discharge talk
Take your child’s current seat with you when you meet to discuss going home. [1]
Sources and further reading
- 1American Academy of Pediatrics, safe transportation for children with special health needs
- 2NHTSA, hospital discharge recommendations for children
Here you’ll find general education from pediatric rehab and child passenger safety. Ask your child’s care team about your child and the restraint. Put the same questions to a certified child passenger safety technician trained in special needs.
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