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Hot cars can be deadly to children, and there have already been 18 children who have died from vehicular heatstroke this year in the United States. This devastating statistic includes seven children in Texas.

A child’s temperature increases three to five times faster than an adult’s, putting them at higher risk of dying from heatstroke. Heatstroke can occur when a child’s temperature reaches 104 degrees, with death following at 107 degrees. It is important to remember that heatstroke can occur in outside temperatures of 57-60 degrees, even when parked in the shade. Parents frequently insist that this could never happen to them, but it does happen – even to the best of parents.

According to Dr. David Diamond, a University of South Florida psychology professor, it can happen to anyone. The science behind forgetting a child in a car involves competing parts of the brain. The basal ganglia, the brain’s center, is the part of the brain that allows us to operate on autopilot. The frontal cortex and hippocampus allow us to think consciously and prepare for future events.

When you drive somewhere and you do not normally have a child, your basal ganglia can actually suppress your hippocampus, allowing your brain to run on autopilot without planning for the needs of a child in the car. Diamond says the basal ganglia takes you on your normal route, where you may not usually have a child. This is comparable to a situation where you drive home from work and forget to stop at the grocery store or cleaners – something many of us have experienced.

Multiple individuals and organizations around the country—including some vehicle and car seat manufacturers—are attempting to develop devices and phone apps which may help you remember your child in the car. These may be helpful if used routinely, but only in conjunction with other safe practices such as placing a visual reminder in the car (a shoe or purse in the back seat), or developing a plan of action for days when the routine will be knowingly broken. The Trauma Center at St. David’s Round Rock Medical Center offers the following safety tips for protecting children from heatstroke in a car.

Never leave a child in a car unattended for any length of time – whether the car’s engine is running or not. Rolling down the windows makes little difference in the temperature of the car and preventing heatstroke. While at home, keep your keys out of reach and your doors secured so that children cannot slip outside and play in the car.

Make a habit of leaving something in the backseat such as your purse or briefcase so that you will always remember to check for your child in the back seat. More than half of the children who died from heatstroke were “forgotten” in the car by the caregiver – often times because something in their routine changed.

Attempt to stick with a normal routine of drop-off or travel. As mentioned above, your brain has the ability to run on auto-pilot and suppress other parts of the brain that might remind you of a child in the back seat. When changing the routine, make a conscious effort to remind yourself that the child is in the car – leave a needed item in the back seat, set a reminder on your phone or have the other parent call you to ensure the drop off happened.

If you see or hear a child alone in a hot vehicle, assess the child – are they responsive or showing signs of heatstroke? The warning signs of heatstroke can include red, hot skin that may be moist or eventually dry (because they have already lost all of their fluids through sweat); a strong rapid pulse (at first), progressing to a slow weak pulse; a throbbing headache; dizziness; nausea; confusion or agitation.

If the child is in distress, call 911 immediately and find a way to get the child out of the car – even if breaking a window is necessary. A few minutes can mean life or death.

If the child is responsive and not in distress, stay with the child and call for help. Send someone to quickly find the parents if possible. If the parents do not arrive immediately, call 911. Break into the car if the child begins to show any sign of distress and remove them from the vehicle. Spray or pour cool water (NOT ice water) over the child’s head and body. If the child is unresponsive and doesn’t appear to be breathing, begin CPR. Continue rescue efforts until EMS arrives.

The death of a child in a hot car is so unthinkable to most parents that they don’t plan for the possibility, but it can happen to anyone. Keep in mind these tips, especially during a change in routine or caregivers, and never leave your child alone in a car for any reason. Always remember to Look Before You Lock! 


– Kristen Hullum, MSN, RN, Trauma Injury Prevention Coordinator at St. David’s Round Rock Medical Center

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