Pediatrics: Consider Car Window Hammers for Your Office Emergency Response Kit

Patti L. Ellis, RN, CPHRM, Patient Safety Risk Manager II, The Doctors Company

The following case scenarios involve the use of a car window hammer device in the parking lot of a pediatric practice.

Scenario One

While waiting for an appointment to see the pediatrician, a mother standing outside of her vehicle allowed her two-year-old toddler to play with the car keys. The toddler accidentally locked himself in the vehicle. The office staff was immediately summoned and called 911. A bystander, who had observed the emergency situation, responded to the scene with his car window hammer. He asked the mother for permission to break the car window. The toddler was safely rescued from the vehicle and assessed by the pediatrician. No injuries were noted.

Scenario Two

A distracted mother on her cell phone accidentally locked her four-month-old infant and her car keys in her vehicle while waiting in the parking lot for an appointment with the pediatrician. The infant was observed to develop initial signs of distress and 911 was called. Prior to the arrival of emergency personnel, the office staff retrieved a car window hammer from the emergency response cart and broke the car window with the mother’s permission. The infant was safely rescued, assessed by the pediatrician, and determined to have no serious injuries.

The above scenarios are actual cases that occurred in a large multioffice pediatric practice group over a six-month period. Fortunately, both events had good outcomes thanks to quick thinking by individuals and readily available car window hammers.

As a result of the first scenario, the group’s director of risk management equipped each practice’s emergency response cart with a car window hammer. Having immediate access to the device allows office staff members to respond promptly, potentially avoiding patient injury.

When Seconds Count

All pediatric and family practices should consider including a car window hammer as part of their emergency response cart or kit. It is an effective patient safety and risk management strategy, especially given the recent COVID-19 pandemic, when parents were asked to wait in their vehicles until they were ready to be seen by the practitioner.

In the event an infant, toddler, or young child accidentally becomes locked inside a vehicle, a car window hammer can be a lifesaving tool—especially in hot climates, when seconds count in preventing serious harm or death.

According to the National Highway Traffic Safety Administration (NHTSA):

• Even in cooler temperatures, a vehicle can heat up to dangerous temperatures very quickly. An outside temperature in the mid-60s can cause a vehicle’s inside temperature to rise above 110° Fahrenheit. The inside temperature of the vehicle can rise almost 20° Fahrenheit within the first 10 minutes.
• Heatstroke does not occur only during the summertime or in the Sun Belt States. This deadly issue can occur at any time of the year, in any weather condition, in any community—for any parent.

Cold weather is just as dangerous. The risk of hypothermia during the winter season is also a concern if an infant, toddler, or young child is inadvertently locked inside a vehicle.

Being Prepared

Store the car window hammer device on the emergency response cart or kit in a centralized location within the office. Ensure that all staff members are knowledgeable about where the hammer is stored and how to use it in the event of an emergency. As part of the response protocol, include initiating a 911 call for assistance and assessing the immediate medical needs of the infant, toddler, or young child. Consider including a scenario involving a car window hammer as part of the office’s emergency preparedness training.

Because of the potential for vehicle damage, it is advisable—whenever practical—to obtain consent from the parent or caregiver before using the device to break the car window. As an alternative, give the device to the parent or caregiver to use.

Documentation and Education

Document the event and clinical assessment of the patient in the patient’s record. Report it to the practice manager and/or facility risk manager as a patient safety event and to the safety committee for its risk management trending and analysis report. It is important to recognize and acknowledge staff members for their heroic efforts when these situations occur.

Finally, consider including car safety as part of new parent education. New parents, in particular, can feel overwhelmed and become easily distracted. The NHTSA has an excellent resource guide for parents, Keeping Kids Safe. Healthcare practitioners should make the guide available to all parents and caregivers of infants, toddlers, and small children.

For additional information, contact the Department of Patient Safety and Risk Management at (800) 421-2368 or by email.