4-23-2008 Chat Transcript (Transporting Babies and Premature Infants with Ann Brunzell and Chicco's Julie Robbins)


Admin - CPS Technician Emeritus
skipspin: The main topic is Transporting Babies and Premature Infants Our guests will be Ann King, RN, CPN and Julie Robbins from Chicco. Time permitting, we will also field questions on Chicco products in general, however, questions regarding preemies and small infant issues will have priority.

skipspin: Julie Robbins, formerly known as Julie Prom, has over 20 years of professional experience in injury prevention and traffic safety. Julie has been a CPS Technician Instructor since 1997. She also successfully completed the Safe Travel for All Children special needs curriculum. Julie served a two-year term on the National Child Passenger Safety Board and was involved in developing both the CPS Technician standardized curriculum and the CPS Technician Renewal Course. Prior to her consulting work, Julie spent eight years as Minnesota's Child Passenger Safety Program Administrator. Currently, Julie works with Chicco as their Community and Advocate Relations Manager. Julie has six children and three grandchildren. Her children range from 7-28 years old. Her grandchildren are 8, 5, and 6 months. With all these children in her life, she has over 28 years first-hand experience with at least one child in a safety seat in her family vehicle and she is still counting.

skipspin: Ann (King) Brunzell is a Registered Nurse Certified in Pediatrics that has worked in Grand Island Nebraska for 27 years in the field of pediatrics. She has been a Certified CPS instructor since 1999, and is also certified as an instructor for the Safe Travel for All Children special needs curriculum. She has presented at many state, regional and national conferences on the topic of child passenger safety. Her most recent passion has been to help secure the premature infants for their safe travels and she was the passion behind the team who started the NICU Safe Travel from the Start pre-conference to the KIM Conference last year. This will be repeated and continued this year in Denver July 9-10th. She can be reached at work 308-398-6584 or email safekids@sfmc-gi.org

skipspin: This chat is moderated. Any questions and comments submitted will be forwarded to a moderator for approval. We will be taking advance questions first. Thanks!

skipspin: With the number of preemies coming home under 5lbs increasing, and with the younger preemies surviving more often than in the past only causing this number to rise, should car seat manufacturers be required to test all seats from 2 or 3lbs instead of 5... not just for safety in protecting these small bodies, but to allow a better fit of the harnesses?

AnnBrunzell: OK, bear with me, it's Ann here!

AnnBrunzell: This is the first time I've done this!

skipspin: No problem!

JRobbins: There are no appropriate dummies available to do such testing at this time. I would be interested in seeing some good data on how many babies are discharged under 4lbs, 3.5lbs, and 3lbs

AnnBrunzell: I'm so excited just reading who is on this chat!

AnnBrunzell: Let me clear something up first---before we dive in...

AnnBrunzell: Rule #1

AnnBrunzell: There is no spell check, and nurses do not spell well. =)

AnnBrunzell: Also note that many of you know me as Ann KING

AnnBrunzell: I got married March 7th, so I'm Ann Brunzell now, so you are NOT confused.

AnnBrunzell: Let's talk about this problem

AnnBrunzell: Not the marriage of course, the question. =)

skipspin: Congratulations. You are not alone on the spelling. We will also give both of our guests the opportunity to edit any comments and answers before the transcript of this chat is posted on the forums.

AnnBrunzell: Most of you know I became involved in this HOT NICU issue of transporation secondary to total frustration about more and more babies going home from the hospital sooner and sooner, smaller and smaller.

AnnBrunzell: Some of you know that I am 50---dear heaven, I even typed it!

AnnBrunzell: But some of you might recall that it was an "unwritten rule" that babies just did NOT go home until they were 5#'s.

AnnBrunzell: It was felt that this was a fairly stable time for them, they were eatting well by then, and just doing better.

AnnBrunzell: IF they survived to that weight, they just didn't go home before than very often.

AnnBrunzell: This is NOT the case now as you all know or you would not be on this call.

AnnBrunzell: Julie points out that car seat manufactures are very interested in the data to support how many children are going home and at what weight.

AnnBrunzell: We'll talk more about this, but for now, just know that this is very important information.

AnnBrunzell: Many of you are technicians, and if you are not, we'll lose you for a little while, so hang on...

AnnBrunzell: You have to understand the Federal Role Module as it was in the previous curriculum...go back in time with me for a minute.

AnnBrunzell: CRS manufactures use the test dummies to certify their child restraints.

AnnBrunzell: They have to in order to meet FMVSS 213 which dictates those dummies.

AnnBrunzell: Julie, I always say the newborn is 7#, but is that exact?

AnnBrunzell: As such that it is, it's not less than 5's.

AnnBrunzell: You CAN NOT force a car seat manufacture to do anything, nor should we.

AnnBrunzell: They have very solid science and federal regulations that they absoutely must meet.

AnnBrunzell: I will tell you that I have asked MANY manufactures about why they select 5# as their lower limit, since we only have a federalized dummy at 7#

AnnBrunzell: It's where their crash testing comfort level ends. The dummies represent an average.

skipspin: I think that leads well into our next question: Is there a standard 'car seat challenge' procedure that all hospitals follow? Also, in regards to angle tolerance testing; Is there a standard across the board, or do all hospitals have different standards?

AnnBrunzell: Most of you know that there is an AAP guideline for the safe transportation of Premature children that is up for current revision right now.

AnnBrunzell: In that document, it is recommended that you preform testing to determine the tolerance of a premature infant to sit in a car seat.

AnnBrunzell: The BIGGEST problem I am experiencing in the field and I am sure all of you are too is that there is not a lot of standardization to this testing.

AnnBrunzell: What we as nurses and physicians feel like we want is some sort of cut and paste protocol to the actual testing preformance.

AnnBrunzell: This type of document DOES NOT exist.

AnnBrunzell: The new revision of the AAP policy will have more language in it, but it will not outline specific paramenters...

AnnBrunzell: The reason why---

AnnBrunzell: is that guidelines are very astrigent and very evidenced based.

AnnBrunzell: At this time, those documents do not exist. More research is DEEPLY needed, quality IRB approved, etc.

skipspin: Thanks!

skipspin: Are you ready for another question?

AnnBrunzell: However, another reason is that Dr. Bull has always expressed that she feels the neonatolist should be involved in the parameter setting that is in each testing protocol.

AnnBrunzell: Not yet

skipspin: ok, no hurry

AnnBrunzell: She does not know me very well, does she! HA!!!

AnnBrunzell: It's killig me to type instead of talk! Go ahead and laugh if you know me!!!

AnnBrunzell: Anyway---

AnnBrunzell: What is meant by that is that you should be involving your physicians

CPSDarren: It appears the chat room is having technical difficulties. Apologies if you are disconnected and need to rejoin.

AnnBrunzell: I can tell you that this is a problem, as many of us do not work in places where there are neonatologists, and some barely have pediatricians and none of them are educated even to this testing.

CPSDarren: I have sumbitted a support request and I hope they can resolve the issue. Sorry Ann!

AnnBrunzell: MANY CPST's are the ones leading the way in this arena for their hospitals.

skipspin: We know that some of you are having difficulty and getting disconnected. We are doing our best to fix the problem. If you do get disconnected, please just log back in. Thanks!

AnnBrunzell: There are however many hospitals with great protocols working fabulous for them.

AnnBrunzell: The best advise I can give you is to try to connect with one of them and DON'T reinvent the wheel!

AnnBrunzell: take their policies and guidelines or protocols to your physicians and see how they feel about blessing them and making them yours.

AnnBrunzell: Also, I'll put a plug here for the CPSforhealthcare listserve, of which many of you are on.

AnnBrunzell: But we have a resource sharing section there and you can connect with someone to help you at just about any phase of this integration of this you are in.

AnnBrunzell: Networking with one another is our best friend for right now until we have other more solid protocols to follow.

AnnBrunzell: We are very excited and waiting with baited breath to see the new revision of this AAP guideline.

AnnBrunzell: They keep saying it will be "soon", but truely, we do not know when.

AnnBrunzell: Before we go on...

AnnBrunzell: I want everyone to know that we are doing a PRE-KIM conf. NICU transportation focus 1.5 day's of JUST this topic entirely!

AnnBrunzell: Please attend this if you are involved in this issue!

AnnBrunzell: We did it as a first last year and it was HUGELY recieved!

AnnBrunzell: We are expanding on that for this year.

AnnBrunzell: go to the KIDZ IN MOTION conf. website to get a download on the pre-conf and registration info is there. It is July 9-10th Denver.

AnnBrunzell: OK, next question

CPSDarren: http://www.kidzinmotion.org/

AnnBrunzell: Thanks Darin

skipspin: The next few questions are in regards to car beds. I will post them all now, and you can answer them in the order that makes the most sense.

AnnBrunzell: K

skipspin: What are the guidelines for recommending a car bed for discharge? Only for preemies who don't pass the breathing challenge? Do many children need car beds, and does the hospital help the parents get them and use them correctly? Are car beds ever recommended for low weight only, even if the baby passes the breathing challenge?

AnnBrunzell: See my 17 yr old daughter has taught me some text things! =)

skipspin: the next question will be for Julie!

AnnBrunzell: OK...

AnnBrunzell: WOW---those are loaded questions!

AnnBrunzell: Here is the deal...

AnnBrunzell: The proven track record for safety is with a rear facing child restraint. We simply don't have a lot of real world studies with car beds.

AnnBrunzell: Soooooooooo while they are extremely important options (car beds), when possible, we should use a traditional car seat.

AnnBrunzell: That is standard info in your curriculum, should not be new info

AnnBrunzell: To be able to tell if a child NEEDS a car bed, the testing in a car seat for tolerance should be completed.

AnnBrunzell: If they "fail" the test, then a strong consideration for a car bed should be made.

AnnBrunzell: It was interesting that one year at Lifesavers when I moderated a session on this topic, I asked what percentage of babies failed testing.

AnnBrunzell: I got everything from 1% to 30% in estimates which if you think about it really it should not be that variable.

AnnBrunzell: That lead us into looking into the actual preformance of the testing, during which we found HUGE variances that would definately have contributed to why the babies pass in some hospitals (or when some nurses did the test) vs. others.

AnnBrunzell: We discuss this at much greater length at the pre-KIM conf., so I'm not going into this right now. It's incredibly interesting.

AnnBrunzell: Which reminds me...Chicco is the sponsor of the Pre-KIM NICU transportation session! Go Julie!!! Thanks so much! :}

skipspin: Here is our question for Julie

skipspin: Re: the KeyFit infant insert: I had a parent write in a post earlier this week that she didn't like the way her baby fit in the KF harness at 12 lbs. after she took the infant insert out. She felt the lap belts were too high on the abdomen and the crotch strap was too far away, leaving space for the baby to slouch. I recommended a wash cloth between the baby and the crotch strap. (Sorry for the long background!) Why must the insert be removed at 11 lbs.? Can it be used for longer as long as the harness fits securely?

AnnBrunzell: Anyway, to get back to the question, there is also a HUGE variance we have learned in the methodology each hospital might have with regards to who preforms the testing, how it's "read", interpretation, and or intervention and follow up.

AnnBrunzell: That said...

skipspin: sorry. Go ahead Ann. I was multi-tasking

AnnBrunzell: Not all NICU's have CPST's there to instruct on the proper use of the Car Bed (or the car seat for that matter).

AnnBrunzell: ...and this becomes extremely problematic.

AnnBrunzell: as you can all see.

AnnBrunzell: We have to be realistic here. Healthcare will not always take this responsibility on.

AnnBrunzell: Depending upon the size of the hospital, it's simply impossible to be honoest.

AnnBrunzell: Their liability risk is perceived much differently from many angles.

AnnBrunzell: Some other creative ways people have dealt with this are:

AnnBrunzell: Having some level of "advocacy" training for NICU staff so that they ARE educated to the basics of the car bed, etc.

AnnBrunzell: Training discharge escorts

AnnBrunzell: On call systems with local techs

AnnBrunzell: Visits at hospital supports Inspection Stations.

AnnBrunzell: Having vehicle simulators at the NICU to test on and teach parents installs

AnnBrunzell: to dedicated CPS Staff support hospital wide (my dream!)

AnnBrunzell: Again, the networking with like sized institutions seems to be the most help for all of us

AnnBrunzell: We again will go into this in much more depth at Pre-Kim

AnnBrunzell: Staff training is a whole other topic!

AnnBrunzell: The wonderful staff at Riley Childrens Automotic Safety are developing a 4 hour training for NICU staff

AnnBrunzell: ...that will come out and correlate with the release of the new AAP guideline

AnnBrunzell: and we are all extremely excited to learn more about this.

AnnBrunzell: I do not know when it will be released, but I don't think too much longer.

AnnBrunzell: We hope to have it reported on for pre-Kim

AnnBrunzell: OK, I think I'd Julies time to type! WHEW!

AnnBrunzell: Next Question

skipspin: Ann- you get a short break.

skipspin: This questions is more for Julie

skipspin: Julie Robbins, formerly known as Julie Prom, has over 20 years of professional experience in injury prevention and traffic safety. Julie has been a CPS Technician Instructor since 1997. She also successfully completed the Safe Travel for All Children special needs curriculum. Julie served a two-year term on the National Child Passenger Safety Board and was involved in developing both the CPS Technician standardized curriculum and the CPS Technician Renewal Course. Prior to her consulting work, Julie spent eight years as Minnesota's Child Passenger Safety Program Administrator. Currently, Julie works with Chicco as their Community and Advocate Relations Manager. Julie has six children and three grandchildren. Her children range from 7-28 years old. Her grandchildren are 8, 5, and 6 months. With all these children in her life, she has over 28 years first-hand experience with at least one child in a safety seat in her family vehicle and she is still counting.

AnnBrunzell: ;)

skipspin: Re: the KeyFit infant insert: I had a parent write in a post earlier this week that she didn't like the way her baby fit in the KF harness at 12 lbs. after she took the infant insert out. She felt the lap belts were too high on the abdomen and the crotch strap was too far away, leaving space for the baby to slouch. I recommended a wash cloth between the baby and the crotch strap. (Sorry for the long background!) Why must the insert be removed at 11 lbs.? Can it be used for longer as long as the harness fits securely?

JRobbins: No the insert may not be used longer. It is only certified to 11lbs, based on crash testing. I will try to post a chart of dummies used in 213 and when they are required. This may be helpful in understanding the limitations of testing, certification, etc.

BuckleUp: Does the Chicco KeyFit have the same lower wt. limit of 4# with or without the infant insert?

JRobbins: Yes

BuckleUp: It's apparent the Chicco infant insert does not address the gap between the buckle and the infant? So how do you address this situation when it comes up? Do you recommend a washcloth?

JRobbins: With most babies the insert does address this gap. If it doesn't, a washcloth used properly as outlined in the curriculum and AAP guidelines would be okay.

skipspin: And this question might interest both of you:

skipspin: What are your thoughts on "foam" inserts intended to help keep premature infants (and even full term infants) breathing? One such as the Happi insert http://www.auckland.ac.nz/uoa/about/news/articles/2008/02/car_seats.cfm that was developed by researchers in New Zealand. Do you feel these are safe?

AnnBrunzell: Hold the fire a minute...

skipspin: no problem :)

AnnBrunzell: I'm currious how many of you feel the buckle stalk is too long on the Chicco used with the insert on a 4-5 # infant

AnnBrunzell: Keep in mind that Julie is EXTREMELY open and cares a GREAT deal about their child restraints.

AnnBrunzell: What I will tell you is if you are seeing this, it is MOST helpful is you can snap a photo of it and forward it to Julie.

AnnBrunzell: Then she can tell exactly what is happening.

JRobbins: Thanks, Ann. You are correct photos are VERY helpful.

skipspin: If anyone has an answer for Ann's question I will approve them if submitted.

AnnBrunzell: By the way, most infant seats I've worked with have this potential.

AnnBrunzell: So please DO DO DO DO share your thoughts with any manufacture.

AnnBrunzell: We will NOT get to a place where we can fit children better without our important feedback.

starlightCPST: Compared to other seats on the market, the Chicco is great. I feel much more comfortable putting a 4 lber in a Keyfit than I do a 5 or even 6 lber in an Evenflo or Graco.

AnnBrunzell: Julie, submit your email so they can email you directly if they deisre.

AnnBrunzell: Again, we are not saying one car seat is better than another here in this forum, but rather as always, the focus is on the fit.

JRobbins: My email address is julier@chiccousa.com

skipspin: Julie, a few technicians have some follow-up questions that are Key-fit specfic

starlightCPST: Can babies under 11 lbs NOT use the insert? I thought it was a requirement.

AnnBrunzell: Julie, can you talk about the insert a little more and how it seems to fit the premies so well?

JRobbins: Here's my answer to the "foam insert" question: Chicco does not allow the use of any aftermarket products with any of its products that weren t specifically manufactured by Chicco for Chicco products. We test all of our inserts and accessories.

AnnBrunzell: What I want to point out about the insert is this.

AnnBrunzell: Look at the insert closely if you will next time. Take it out and see how it molds into the crack of the seat

JRobbins: It is not REQUIRED to use the insert. As Ann pointed out, what is important is PROPER FIT. IF the child can fit properly without the insert, then it is fine to take it out.

AnnBrunzell: There ia a small area that is where the buttocks sits and the design of this inserts sort of lifts the buttocks up

AnnBrunzell: which then reclines the back angle a little

AnnBrunzell: and that is why the premies seem to fit so nicely in it.

AnnBrunzell: Crash dynamics is EXTREMELY important, but so is breathing! =)

AnnBrunzell: It's a very fine line balancing those for a CRS manufacture.

AnnBrunzell: Our input if you work in this area with the CRS manufactures is just critical.

AnnBrunzell: Many of them are now lowering limits to 4# and that's fabulous!

AnnBrunzell: Fit for a premie is the same by the way as any child.

AnnBrunzell: Same parameters., it's just a lot more of a challenge.

AnnBrunzell: Then add that there is NOT federalized dummy and you have a real hot bed for them.

JRobbins: I would like to hear and see cases where a baby under 11lbs fits better without the insert. My 6-mo, 15lb granddaughter needed the insert until 11lbs to achieve the best fit. I'm talking about the bottom insert, not the head support.

starlightCPST: and to confirm, pool noodles may *not* be used at all with the Keyfit? What if something is needed?

AnnBrunzell: Again, great example of info Julie would LOVE a photo with.

AnnBrunzell: Give us a little more detail, do you have a case we could trouble shoot though? What kind of car?

AnnBrunzell: Was it a preemie?

AnnBrunzell: Foot down, still too upright?

AnnBrunzell: I have never seen it in my practice.

JRobbins: There is 15 degrees of adjustment with the KeyFit, noodles should not be needed. I have been installing the KeyFit in hundreds of seating positions and have yet to find a vehicle where the foot does not work to get the KF back far enough. Please look at the foot in its fully extended mode and you will see why you should never need noodles.

AnnBrunzell: That has also been my personal experience.

skipspin: Okay, are we ready for another question?

AnnBrunzell: Yes

starlightCPST: I work in a baby store, the Keyfit 30 is my most common install. I had an issue in a Pathfinder, I think. This was a few weeks ago.

AnnBrunzell: I suggest when you get those, again, please take a photo if possible so Julie can trouble shoot with you specifically.

JRobbins: What sort of issue?

starlightCPST: it just didn't have the recline it needed.

skipspin: Julie, feel free to continue. I am going to go ahead and post the next question for Ann to get started on.For premature infants going home on (various) monitors, what steps can be taken to ensure that the equipment that must be carried and/or is attached to baby is secure, does not interfere with the safety/use of the seat and does not become a projectile?

JRobbins: The Pathfinder has a fairly flat vehicle seat compared to most. Are you saying that with the foot fully extended, you could not get the bubble between the lines?

starlightCPST: Julie, it may not have been a pathfinder, and I can't go back and check, since my records are at work (I avg 50 seats a weekend, I can't remember it all!) But, yes, whatever vehicle it was, I could not get the bubble in the lines( GREAT feature, btw)

JRobbins: Was the seat too far back as opposed to too upright?

starlightCPST: not that i recall.

AnnBrunzell: This is an interesting topic, and I know I sound like a proken record, but at the pre-KIM last year we had a monitor company come in and he will be returning this year with new education about software to use in monitors that assist with read outs and trending, etc. and it has been facinating to learn more about just the monitoring capabilities. One thing we asked the company about last year was if they would consider coming out with home monitors and equipment that had at least some sort of anchorage that we could use in the seat belt or to a tether location on the floor or something. Obviously, it's a huge problem as this necessary eqipment in a crash could be a very dangerous flying missle for the child or the parents. Right now, the recommentation is to try to place it in as secure a location as you can on the floor, cover it with pillows or something, however that does not happen. Again, anything we come up with will not be crash tested and be aftermarket. more...

AnnBrunzell: Again, monitor companies had NO idea we needed such a thing---the ability to secure it in a vehicle.

AnnBrunzell: They just did not think of it.

AnnBrunzell: I know many people try to secure them to a buckled seat belt when possible.

starlightCPST: julie, i can look up the records and contact you more about this. i know others have lots of questions for you, too.

JRobbins: There are a few trucks with very flat vehicle seats, like installing it on a table. In those vehicles, it may be difficult to get the seat upright to 46 degrees and the child is too far back. In that case, we suggest installing the KF without the base.

AnnBrunzell: Again, we don't have crash testing results to know how it would work in a crash

skipspin: Would you suggest that a CPST that doesn't have any additional special needs training advise parents of preemies or other babies with special transportation needs? It seems that many times, while a CPST doesn't "know it all," that they know much more about the safe use of a car seat than the highly-trained nursing staff.

AnnBrunzell: I suggest that you set your policies for education with the assistance of your nursing supervisor and try to be realistic.

AnnBrunzell: Keep in mind...

AnnBrunzell: in a hospital, it's an entirely different animal!

AnnBrunzell: Untrained personel should NOT be giving eduacation in an area out of their league, however---

AnnBrunzell: you are going to ask me who is considered "trained" and at what level...

AnnBrunzell: and this is something each hospital must decide for themselves, for example...

AnnBrunzell: Many hospitals have done 2-4 hour staff specific NICU trainings and want only those "advocates" to do the testing and educating.

AnnBrunzell: I do not feel that you need to be special needs trained to educate, but I DO support that at least one person who is managing your program in your NICU IS special needs trained, or a few of them to help eduate the rest of you.

AnnBrunzell: To be that "hospital programed based" senior checker so so speak.

AnnBrunzell: You do learn a lot in this class and I'd highly recommend anytone to take it.

skipspin: To all our technician guests, we will be open for your questions very shortly- so if you have questions you;d like to ask Ann or Julie please submit them now!

AnnBrunzell: However, you don't spend 8 hour on NICU issues

JRobbins: MHO: The CPST and the nurse/doc should be working with the family together.

AnnBrunzell: That is correct!

AnnBrunzell: It is a family unit and will take all of your education to make for the best decisions.

skipspin: How much are nurses taught about car seats? Our nurses have always made sure we had one. For our 2nd child, our nurse reminded us to put the handle down. How much does the normal nurse know about child passenger safety? Do you think they should be taught more?

AnnBrunzell: Again, very variable from jhospital to hospital.

AnnBrunzell: I'd like to say as nurses we "know it all", but that's the problem, many of us taught car seats to parents based on our own personal use.

AnnBrunzell: With over 90% misuse, that's not the best model to follow anymore.

AnnBrunzell: Again, there are various state wide "short courses" to help hospitals determine what level of education their nurses might need.

JRobbins: The best practice for everyone, nurses, CPSTs, parents: READ and FOLLOW the mfr instructions.

skipspin: {snowbird25ca} Are there any plans to make the keyfit available in Canada? Recent recommendations from TC mean that babies being released below 5lbs will now be going home in carbeds regardless of ability to pass the carseat challenge.

AnnBrunzell: I personally believe the education should follow the hospital guidelines for what they are going to allow nurses to do.

AnnBrunzell: Just a minute...

AnnBrunzell: I have something important to say here...

AnnBrunzell: Drum rollllllllllllllllllll

skipspin: *slap* *slap* *slap*

AnnBrunzell: The best education you can give nurses is to teach them to learn and follow the manufactures instructions, teach them how to show parents how to use the manual!!! Make the cdrom with manuals available at the hospitals for staff!!! Amen, i feell better!

JRobbins: The Chicco KeyFit and KeyFit 30 have passed Canadian standards and should be on store shelves by Fall. Certification is a long process. :)

AnnBrunzell: OK next question :)

skipspin: {skaterbabscpst} How you do suggest a non-hospital tech go about correct potentially dangerous misinformation given out by nurses?

AnnBrunzell: We might want to open it up soon, as I have to leave this forum in about 10 or so minutes.

CPSDarren: I believe Julie has to leave in about 10 minutes also, so we will end after another question or two

AnnBrunzell: I highly suggest she talk to the nursing supervisor or that area and try to explain the situation and offer to be part of the educational solution, try to find out what the hospital policy is and offer to help.

skipspin: Next is a question for Julie. She has to leave ina few minutes- so I'm going to post it now

crunchierthanthou: has the 22 lb keyfit been discontinued? does chicco have any plans to expand beyond infant seats in the CPS market?

skipspin: {snowbird25ca} Can you tell me if the CDN version of the keyfit will have a 4lb minimum weight limit?

JRobbins: No, the KeyFit has not been discontinued at this time. However, it is only available as a travel system.

Kecia: SafeRide News has stated that it's ok to use a rf CR even though the infant's shoulders may be below the bottom slot. How critical is it that shoulders be at or above the bottom-most slot?

JRobbins: About the dummies: The newborn dummy is 7.5lbs. Here is a pdf of the chart, if it works to post it here:

JRobbins: Guess it didn't work. How should I post it?

CPSDarren: is it available as a link?

skipspin: You can email it to me and I can post it with the transcript

skipspin: if you can't get it to work now. That's more Darren's department.

CPSDarren: That's a good idea we can attach it to the transcript

JRobbins: You can search for it in the CFR, it is in Technical Procedure TP-213, page 57

JRobbins: Yes, the Canadian KFs will have the 4lb minimum

JRobbins: Harness slot use: FOLLOW the MFR instructions!

BuckleUp: Ann - What percent of the babies at your hospital get released below 4 lbs.? What percent between 4 and 5 lbs.? Can preemie babies be larger than 5 lbs.? And if so - how much larger?

skipspin: Let's all say a big THANK YOU to Julie for being here! Ann will be staying with us for a while longer.

AnnBrunzell: Right now, we are seeing the more common weight of discharge right at 3-8# or 3-10 as I suspect you all are too!

CPSDarren: Thank you very much Julie and Ann!

AnnBrunzell: Julie you rock~~!!

crunchierthanthou: thanks, Julie!

azgirl71: Thanks Julie!

daycaremom2002: Thank you!!

skaterbabscpst: Thank you, Julie

JRobbins: Actually, I can stay for another 25 min

AnnBrunzell: I'd guess 80% of ours are just under 4# theses days

David Bennett: Thanks Julie and Ann!!

courtfrog2: Thanks Julie!!! Thanks Ann

Judi's DH: thanks julie

chloespurple: Thank You!!!

markf1971: great!

CPSDarren: As a reminder, if you need CEU credit, please make sure you have a valid email address in your User CP profile at Car-Seat.Org. Also make sure your name and tech/instructor number are in the last profile field where prompted.

CPSDarren: Confirmation of CEU credit will be emailed in a week or two and a transcript will be posted on the forums in around that time as well

keri1292: Thanks!

courtfrog2: Thanks! Very interesting topic... I appreciate it

CPSDarren: Okay- perhaps another question or two for Julie and anyone who wants to stay until she has to leave for her flight?

AnnBrunzell: Remember to join the cpsforheatlhcare list serve if you want more and or attend pre-KIM!!! it's a HOT topic!

skipspin: Yes, we are OPEN for questions. Ask them now!

CPSDarren: http://health.groups.yahoo.com/group/CPSforHealthcare

skipspin: Julie, do you know if Chicco has any plans for expanding it's car seat line-up with other types of car seats?

JRobbins: Yes, the KeyFit Strada booster is due out this summer, finally. :)

AnnBrunzell: Hey team, I have to run! Have a mom here! Reality strikes!

AnnBrunzell: Thanks for the opportunity!

CPSDarren: Thank you Ann!

skipspin: Okay, thanks so much for being here Ann!

Kecia: Thank you Ann!

daycaremom2002: Thanks Ann.

SusanB: Muchas Gracias, Ann!

crunchierthanthou: thanks Ann. :)

crunchierthanthou: can you tell us anything more about it? like the dimensions or whether it can utilize the LATCH system?

markf1971: thanks Ann!

skaterbabscpst: Thanks!

JRobbins: It will not have LATCH attachments. It is a highback with removable backrest. Don't have all the dimensions right now. It is planned to be unveiled at the KIM conf.

skipspin: This is the last call for questions for Julie.

JRobbins: Any more questions?

skipspin: Here is some info about our next CEU chat:

skipspin: Thursday, May 15, 10AM Central time. The main topic is Side Impact Protection for Children. Our guests will be Dr. Laura Jana and Sarah Tilton from Britax Child Safety. Time permitting, we will also field questions on Britax products in general, however, questions regarding side impact issues will have priority. A thread for advance questions will be posted in the Announcements forum a few weeks before the event.

CPSDarren: Thank you again Julie!

CPSDarren: Apologies for our technical disconnect issues. I hope they get that resolved before the next session!

skipspin: Yes, than you so much for joining us! We look forward to having you again!

JRobbins: Please remember that you can email your questions to me directly at julier@chiccousa.com or call me at 317-867-3872. I do appreciate hearing constructive criticism and praises and PHOTOS. :)

CPSDarren: And don't forget to visit http://www.chiccousa.com !

skipspin: This chat will be n-moderated in a few monites for those who wish to stay and chat

Kecia: Thank you Julie! Have a safe flight!

skaterbabscpst: Yes, thank you and be safe on your trip!

Jeanum: Thank you!

JRobbins: Thank you all for your questions and feedback!

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