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Preventing Heatstroke Deaths of Children Left in Hot Cars


Pediatric vehicular heatstroke, or PVH, is when an infant or child dies due to being left inside a hot car.   Heatstroke is characterized by a body temperature above 104 degrees F with associated lethargy, seizures, or coma.  It is more likely to develop in infants and children because they cannot regulate their body temperatures as well as adults.   Sweating exacerbates this problem by causing a loss of salt and water.  Without quick intervention, death is the most likely outcome.

Unfortunately, such tragedies are regularly reported in the news, and the numbers are not improving.  According to U.S. statistics, 829 children have died from PVH between 1998 and 2019.  On average, 38 child heatstroke deaths occur each year, including 23 cases in 2022.  In some cases, the child has been forgotten, and left in the hot car.  Other cases are more intentional such as when a parent makes “a quick stop inside of a store.”  38 percent of these deaths, however, occur because a child enters a car that was left unlocked.

Recent national campaigns aim to increase awareness of this problem.  Car manufacturers and car seat companies have also developed some solutions.  But, can more be done to prevent these fatalities?

Education

Pediatric vehicular heatstroke is a worldwide problem.  In the United States, a few organizations have taken steps inform and alert the public:

  • The National Highway Transportation Safety Administration (NHTSA)  initiated a campaign with the tagline Look Before You Lock.”   The intent is to encourage parents to follow a “vehicle exit routine” that includes checking the backseat before walking away.  They also urge parents to keep parked car doors locked, and prevent children from playing inside of parked cars.
  • The National Safety Council (NSC) offers a simple online course to educate parents and caregivers about this issue.
  • Kids and Cars.org compiles heatstroke deaths by year, provides safety tips and information, and suggests ways that bystanders can help.

Causes

Even good parents can make the mistake of leaving a child inside of a car.  PVH often occurs because a caregiver forgets that a child is sitting in the backseat of their vehicle.  It may also occur because a child was left unattended inside a parked car.  In these latter cases, parents wrongly assume:

  • The skies are overcast with clouds, so the car won’t become so hot inside.
  • The car will be cool enough if the windows are open.
  • It’s okay to leave the child in the car, since I’m “only doing a quick errand.”

Heatstroke can even occur when the outdoor temperature only reaches 57 degrees F

Safety Measures

Due to pressure from consumers and advocacy groups, some automakers and car seat manufacturers have explored ways to translate education into action.  Many companies are now using innovative technology in their products.

Rear Seat Reminders

How does such preventative technology work?  One type tracks the opening of  rear car doors.  If opened at the beginning of the trip, was the door opened again at the trip’s end?

Rear seat reminders in some GM car models use door sensors that detect when a rear car door is opened or closed.  The sensors recognized when the vehicle is has been turned or driven.  Upon reaching the destination, a chime sounds, and a dashboard notification comes on that reads:  Rear Seat Reminder. Look in Rear Seat.

General Motors has offered such prevention systems since 2016, and other automakers have followed suit over the past several years.  All car manufacturers have agreed to add rear monitoring systems as a standard feature by 2025.

Vehicle Activity Sensors

Hyundai has employed sensors that detect rear seat activity when the engine is turned off.  Vehicles that are equipped with these sensors alert the car owner with lights, horns, and text messages.  This technology is available as an option in most Hyundai 2022 SUVs.

Car Seat Sensors

  • Some car seats made by Evenflo use Sensorsafe technology.  The Evenflo Advanced SensorSafe Epic Travel System connects to a car’s diagnostic port via the car seat’s “smart chest clip.”  A repetitive chiming sound goes off if the child is left in the car seat after the engine has been turned off.

Image of car seat buckle with evenflo sensorsafe system

  • The Elepho eClip Baby Reminder attaches to the car seat, seat belt, or diaper bag.  It sends alerts to a smartphone via bluetooth, and monitors the car’s internal temperature.
  • Another safety option is the Driver’s Little Helper Sensor System which can be installed inside a car seat.  This device is  placed under the car seat padding, then attached to a battery pack and linked to a phone app.  The app sends notifications once the car shuts off.  If no one responds to the notification, Driver’s Little Helper sends a warning text or email.

Apps

The traffic app Waze includes a setting that reminds a driver to check the back seat upon reaching a destination.

The Backseat is another app with the goal of preventing PVH.  It activates when the driver begins a trip, and after the car speed increases above 20 mph. The app then sets a reminder alarm that sounds when the car engine shuts off.  If the driver ignores the alarm, a louder alarm sounds, accompanied by repeated phone notifications.  The app can also alert additional phone contacts if this feature is set up.

New Laws

Although more manufacturers are stepping up, some advocates and lawmakers say the effort isn’t enough of a response to heatstroke fatalities.

The Hot Cars Act of 2022 was presented to Congress in May 2021, and is still under review.  If passed it will mandate reminder technology in all new vehicles.  Janette Fennell, president of KidsAndCars.org, applauds this:

“Every vehicle you buy today either automatically turns your headlights off or reminds you.  Why is it more important to not have a dead car battery than a dead child?”

In addition, some states have specific laws regarding how long a child may be left inside of a car unattended, many with legal ramifications.

Awareness

The National Safety Council and the National Highway Traffic Safety Administration urge citizens to recognize National Heatstroke Prevention Day every year on July 31. They offer resources, including:

What Can Parents Do to Prevent PVH?

There are a variety of safety measures that parents and caregivers can implement to prevent these tragedies:

  • Place bags or other needed items in the back seat so that area of the car is checked.
  • Arrange for daycare employees or other caregivers to call if the child does not arrive as expected.
  • Keep parked car doors locked and windows closed

If, however, an infant or child is left in a hot car, he or she must be assessed immediately.  Check for responsiveness, and call 911.  

Last Word

With public awareness, expanding safety measures, and new legislation, we can all hope that child heatstroke in cars will come to an end.

“The worst thing any parent or caregiver can do is think that this could never happen to them, or that they are not capable of unknowingly leaving their child behind,” per Janette Fennell, founder and president of KidsAndCars.org.  “This can and does happen to the most loving, responsible, and attentive parents;  no one is immune.”

More information can be found here:

Sources:

  1. https://www.noheatstroke.org/
  2. https://www.nhtsa.gov/campaign/child-safety
  3. https://training.nsc.org/hot-cars/
  4. https://www.kidsandcars.org/how-kids-get-hurt/heat-stroke/
  5. https://www.wsj.com/articles/auto-makers-advocates-wrestle-with-how-to-prevent-hot-car-deaths-11565092304

Photo: Creative Commons

Sources

  1. Paediatric hyperthermia-related deaths while entrapped and unattended inside vehicles: The Canadian experience and anticipatory guidance…, www.ncbi.nlm.nih.gov
  2. Assessing parental awareness and attitudes toward leaving children unattended inside locked cars and the risk of vehicular heat strokes, www.sciencedirect.com
  3. 2021 Child Hot Car Deaths, www.kidsandcars.org
  4. Hot Car Fatalities Are Year-Round Threat, www.consumerreports.org
  5. NHTSA Reminds Parents to Look Before You Lock, www.nhtsa.gov
  6. Kids in Hot Cars…, www.nsc.org
  7. Heatstroke…, www.kidsandcars.org
  8. Prevent Child Deaths in Hot Cars, www.healthychildren.org
  9. Rear Seat Reminder: How It Works and Why You Need It, www.kbb.com
  10. Guide to Rear-Seat Reminder Systems, www.consumerreports.org
  11. Driving directions, live traffic & road conditions updates, www.waze.com
  12. Pediatrician-Designed Safety App Reminds Parents to Check the Back Seat, thenewswheel.com
  13. https://www.kidsandcars.org/wp-content/uploads/2014/08/2009-05-18-Janette-Testimony.pdf, www.kidsandcars.org
  14. State Laws…, www.kidsandcars.org
  15. Steps to Prevent Heatstroke, protect2.fireeye.com
  16. Child Heatstroke Prevention: Prevent Hot Car Deaths, www.nhtsa.gov
  17. Child Heatstroke Prevention: Prevent Hot Car Deaths, www.nhtsa.gov
  18. Child Heatstroke Prevention: Prevent Hot Car Deaths, www.nhtsa.gov
  19. Where's Baby? Look before you lock!, protect2.fireeye.com
  20. Safer Car Vehicle Safety, Ratings and Recalls, www.safercar.gov
  21. IU Webmaster redirect, www.ggweather.com
  22. USA TODAY…, www.usatoday.com

Medically Reviewed by

Dr. Alexander began her pediatric career at Elizabeth Pediatric Group of New Jersey in 2000, and has practiced at Pediatricare Associates of New Jersey since 2005. After graduating from Kalamazoo College and Michigan State University College of Human Medicine, she completed her pediatric training at Overlook and Morristown Memorial Hospitals. She is board certified in General Pediatrics. In addition to pediatrics, Dr. Alexander pursued her interest the culinary arts with study at the French Culinary
Institute. In 2007, she opened Global Palate, LLC, catering small group events for six years. Dr. Alexander has also been a professional writer and editor since 2018, engaging in a variety of medical editing and writing projects.