CATES: Kids in hot cars

By Carol A. Cates, MSN, MBA, RN

Chief Nursing Officer

Odessa Regional Medical Center

Every year about this time, I start writing about summer safety. Soon, I will talk about heat stroke, hydration, and safety with summer activities, just to name a few topics. Today, I am going to write about something I really wish I could stop writing about: kids dying because they are left in hot cars. Of all the summer safety related topics that I write about, this is the one that just breaks my heart. It breaks my heart because of all the awful things that can happen with accidents and kids, this one is completely preventable.

In 2022, 33 kids in the U.S. died from heatstroke after being left in vehicles. 2018 and 2019 tied for the highest numbers of car related heatstroke deaths at 53 kids each year. Texas is the worst state when it comes to heatstroke in cars, 138 kids have died in Texas after being left in cars since 1998. 8 of the 33 deaths last year happened in Texas.

Heatstroke is the second most common cause of death related to cars for kids, number one is car crashes. 87% of all children that die in cars are under age 3, with 57% being under age one. There are many reasons why, despite the awareness campaigns and laws put into place. Reasons include misperceptions about how hot cars can get and things that bring that heat down. Cars can get very hot inside, even when its not very hot outside.

In testing by the American Academy of Pediatrics in 2002, a dark-blue mid-sized sedan was used to test how hot a car interior could get in one hour. They found even with an outside temperature of 61 degrees Fahrenheit the internal temperature reached 105 degrees within an hour. In Houston in 2008, a 7-month old infant died of heatstroke when left in a car when the outside temperature was only 83 degrees. In another survey, over 40% of people believe that “cracking a window” will drop the temperature inside the car. The reality is that cracking windows has little to no effect on the internal temperature of a car.

The next reason is that kids and adults react very differently in hot environments. As adults we can sit in a hot car for a while and be uncomfortable but not get into trouble. But small children have a much larger body surface area to weight ratio than adults. Because of their big body surface area to weight ratio, kids are much less able to maintain their own temperature in an extreme environment, and the changes that result happen much more quickly. In a hot car, small children can have their body temperatures rise into the heatstroke range up to 5 times faster than an adult. Most of the temperature rise in cars happen in the first 20 minutes. That combined with the vulnerability of kids in how quickly their temperatures rise means even leaving a child in a car for a few minutes can be extremely dangerous.

In a study of 800 car related heatstroke deaths there were 3 main reasons that kids died in cars. The largest group, 54%, were kids that were forgotten in the backseat. The second cause, 26.3%, were children who got into cars on their own and were trapped, and 18.9% were children that were knowingly left in cars, with the adult thinking they would not be gone long enough for it to be an issue.

Knowing the reasons really helps better direct awareness, legislation, and even technology to help prevent kids getting left in cars. For instance, car manufacturers have started doing some interesting things to help with the forgetting problem and legislation is starting to require newer cars to incorporate that technology. For instance, in my 2019 model car, if I put something in the backseat, get in and drive and then don’t remove it at the next stop, I get an alert on my phone telling me to check my back seat.

But even without that technology, you can do things yourself to prevent children from being left in a hot car. For if you have a child in the backseat, particularly if you are doing something outside of the routine, put something in the backseat with the child that you won’t forget, like a shoe or your phone. Keep your car locked and keys out of reach when it is unattended. That keeps little ones from getting into cars. Never leave a child alone in a car, even if you think it will “only for a minute.” Distraction is very real, and that “minute” can easily turn into much longer than that.

A kid dying is always awful, but for something as preventable as a kid dying in a hot car, its particularly bad. Please help me spread the word to keep our kids safe this summer by making sure they are never left in a hot car.