“We're seeing a large amount of counterfeit or non-compliant car seats come on the market, and they are a real safety hazard because they don't meet the testing standards,” said Sharon Evans, trauma injury prevention manager at Cook Children's Health Care System.

Evans says the health care system has seen more than 15 counterfeit car seats since 2021.

The Hidden Cost of "Cheap" Seats

Experts from Cook Children's Health Care System, Viviana Esparza, program coordinator at the Center for Community Health, and Evans warn that while fake seats save money upfront, they fail when it matters most.

“The health and wellbeing of our children is of highest concern,” said Esparza. “The cost of a car seat doesn’t compare to the safety of a child.”

While counterfeit seats appear to be bargains, the price difference is often deceptive. Evans and Esparza recently encountered a knockoff Doona car seat at a safety event that cost $300, compared to the $650 retail price for a legitimate model.

“Often, parents are buying these from third-party sellers on TikTok Shop and Amazon,” Evans explained.

Red Flags: How to Identify a Fake

When shopping for car seats, Evans advises parents and caregivers to watch for counterfeits of popular brands. These knockoffs are often cheaper than their legitimate counterparts anddo not meet regulations to protect a child in the event of a car crash. 

Look for these warning signs:

• Materials: The plastic shell may feel thin, flexible, or even hollow.

• Harnesses: The chest clip may be missing, or the harness straps may not conform to U.S. width standards.

• Missing Documentation: Instructions may be missing or provided only in foreign languages.

• Lack of Labeling: Legitimate seats must have side labels with installation guides, weight limits, and manufacture dates. Fakes often have no labels or labels with poor grammar and typos.

Three Steps to Ensure Your Seat is Safe

• Buy Direct: Buy directly from the manufacturer or a reputable retail store.
• Call the seat manufacturer: They can help you determine if it’s a knockoff and will sometimes ask you to submit photos.
• Certified Child Passenger Safety Technician (CPST): Take your car seat to be checked by a certified child passenger safety technician. They are trained to help determine if it’s fake. 

Where to Get Help

Evans recommends parents and caregivers with a new car or booster seat, schedule a free inspection with a CPST.

• Visit freecarseatcheck.org and click “Book your appointment”
• Find a child passenger safety technician at safekids.org
• Find an inspection station through The National Highway Traffic Safety Administration

If you discover the seat is a fake, stop using it immediately. Report the seller to the retailer and file a report at StopFakes.gov or with NHTSA.

Related Stories:

• Expert Tips for a Safe Spring Break: Car Safety
• Going Beyond the Bedside to Keep Kids Safe on the Road

It’s a big milestone for parents of young children to turn their car seats to face forward. Some may wonder, when is the appropriate time to do so? Is it when the child wants to look out the window? Is it when the parent wants to see the child? This milestone should be delayed for as long as possible because safety is the top priority. Keep your child rear-facing to help prevent severe injuries during a crash.

“Keep them rear-facing until they reach the maximum weight and height of the car seat,” said Sharon Evans, trauma injury prevention coordinator at Cook Children’s. “Rear-facing is the safest way they’ll ever travel.”

Car crashes are a leading cause of injury and death in children ages 1 to 13. Every year children are rushed to the emergency room to be treated for car-related injuries.  

Check your car seat’s manual -- the most important piece of information will be determining the maximum weight and height limit of their rear-facing car seat. Most car seats will go to 40 pounds rear-facing so your child could be 3 or 4 years old before you turn them around.

Keeping your child rear-facing also protects their spinal cord in the event of a car crash. When they’re rear-facing during a crash, the impact will cause the car seat to dip, protecting their spine and neck.

“You’re keeping their head, neck and spine all in alignment,” Evans said. “The majority of the crash forces are taken on the back of the car seat and less of the crash forces are not transferred to the child.”

Parents may worry that their child’s feet are touching the vehicle seat when the car seat is rear-facing.

“You would think that there is a chance that they would be more prone to having a broken leg, but what we found through research and the American Academy of Pediatrics says that there is no increased risk,” Evans said.

If a child is facing forward during a crash, that is a lot of force to put on a child’s spine and neck.

“If you have that sudden stop, the pressure and force put on their neck can cause severe spinal cord injuries,” Evans said. “During that stop, their head and their arms are all going to come forward and that force can cause broken arms and legs.”

Check the harness straps are at or just below their shoulders and the retainer clip always needs to be at the armpit level, Evans said. Make sure the straps are snug with the pinch test.

After outgrowing a rear-facing car seat, children will move to a forward-facing car seat until at least age 5 based on the weight and height limit for the car seat.

The next seat is a booster seat, which is used until the seat belt fits properly, usually around ages 9 to 12, according to the Centers for Disease Control & Prevention.

FREE CAR SEAT CHECKS

Parents and caregivers can bring their vehicle and car seat for a free car seat check with the Cook Children’s Center for Community Health at 682-885-2634 or go online to freecarseatcheck.org.

Certified technicians will inspect your car seat free of charge and show you how to correctly install and use it. Some locations now offer virtual inspections.Top of Form

The National Highway Traffic Safety Administration maintains a directory of many inspection stations.

Always refer to your specific car seat manufacturer’s instructions (check height and weight limits) and read the vehicle owner’s manual on how to install the car seat using the seat belt or lower anchors and a tether, if available.

More information & resources:

• Car Seat Safety (for Parents) - Cook Children's (kidshealth.org)
• Register your car seat and sign up for recall notices to receive safety updates
• Car Seat and Booster Seat overview from the NHTSA
• Car seat recommendations from the NHTSA
• Child Passenger Safety | Injury Center | Centers for Disease Control & Prevention
• Child Passenger Safety | Pediatrics | American Academy of Pediatrics (aap.org)

“I'm aware of eight fake car seats that have been found by car seat technicians at hospitals in the Dallas-Fort Worth region over the past several months,” said Sharon Evans, trauma injury prevention coordinator for Cook Children's Medical Center. 

One of those fake seats was found at Cook Children's this past fall when a family was preparing to take their child home from the Neonatal Intensive Care Unit (NICU). 

“I was teaching a class one night with a family and they brought in the car seat and I was just kind of looking at it like, hmm, something's not right,” said Christie Clemons, NICU child passenger safety tech and instructor. "The more I looked at it, the more I determined this was not an okay car seat.” 

Clemons has been a car seat technician for 10 years and says she's never seen anything like the one that showed up in her class that day. After asking a few questions, Clemons learned the family had purchased the seat on the internet. 

Evans said she became sick to her stomach when she heard about it because the family had been using it, not knowing the difference. 

“I just really worry that if a child's in a crash, they're gonna be severely injured or killed. We know there wasn't a retainer clip, which in the United States, most have a chest clip or a retainer clip. But then as we started looking, the webbing is thinner. The buckle where you snap it together is hollow. I could bend the plastic. I could bend the whole seat. The way the straps are attached. I don't think they would hold during a crash. I'm really afraid the child would be severely injured or die,” Evans said.

So how can parents know whether a car seat is counterfeit or fake?

“There should be a sticker on the car seat that says it meets or exceeds, or it conforms to federal motor vehicle safety standard (FMVSS) 213,” Evans said. 

Clemons says you also want to look for the manufacturer, model number as well as height and weight requirements which are required to be on the car seat by law. 

“The stickers have to be on the car seat to meet FMVSS 213,” Clemons said. “And you don't have to spend a lot of money to get a really great seat. You just need to make sure that it meets the standards that are out there.”

Both Evans and Clemons hope parents will look for these safety standards when shopping online and in stores because if the unthinkable happens, a quality car seat could save a child's life.  And they encourage everyone to look for these safety standards regardless of the retailer. Even when shopping at a big name brand store.  

“None of us want to think about being in a crash, but if you listen to the news every morning,  there's a high chance you will be,” Evan said. “Unfortunately, the number one way kids are injured or killed is in a car crash.”

One of the best ways you can ensure your car seat is safe and installed properly is to sign up for a free car seat check. Cook Children's and Safe Kids North Texas offer virtual car seat checks at freecarseatcheck.org.  

Skylar Jones, 15, is the first patient to undergo CAR T-cell therapy at Cook Children’s. She was just 9 years old in 2014 when she was diagnosed with B-ALL. Despite undergoing intense chemotherapy, Skylar’s cancer relapsed in 2017 and again in March 2021.

CAR T-cell therapy was approved by the Food and Drug Administration (FDA) for use in refractory and relapsed B-ALL in 2017. Cook Children’s began offering the treatment for those who qualify in November 2020. For Skylar, the timing was perfect and meant she would not have to travel outside of Fort Worth and away from her long-time physicians at Cook Children’s to receive this potentially life-saving treatment.

“Had she relapsed six months earlier, we would have had to go out of town for this,” said Deby Jones, Skylar’s mother. “So for Cook Children’s to have this now and for families to not have to move to get this treatment for their kid, I mean, there’s tons of families that will benefit from this.”

Skylar’s necessary but difficult chemotherapy treatments wreaked havoc on her body. Mouth sores, headaches and rashes were common side effects. An infection required part of her lung to be removed, and the impact of chemotherapy on her bones and joints made it impossible for her to play basketball, her favorite sport.

When Skylar relapsed a second time in March, it was clear that chemotherapy was no longer the most effective course of treatment in her case. Her cancer required a different approach. This made her a good candidate for CAR T-cell therapy.

“CAR T-cell therapy is a treatment option for children with refractory B-ALL, meaning they haven’t responded to initial treatment, or kids whose cancer has relapsed,” said Holly Pacenta, M.D., a hematologist/oncologist with Cook Children’s Cellular Immunotherapy Program.

In this cell-based immunotherapy, the patient’s own T-cells, which help the body fight infection, are harvested from their blood and sent to a lab where they are reprogrammed into CAR T-cells to target their leukemia. The CAR T-cells are then reintroduced into the patient’s blood stream. From start to reinfusion, the process takes about four weeks.

The therapy begins with a procedure called leukapheresis where the healthy T-cells are removed from the patient’s blood. This takes about four to six hours and the patient is able to go home from the hospital the same day. Once the lab receives the cells, it takes a few weeks to reprogram them into CAR T-cells. Just before the CAR T-cells are reintroduced, the patient undergoes a short round of chemotherapy to lower the number of other T-cells in the body. This gives the CAR T-cells a better chance to activate inside the body to kill cancer cells. After chemotherapy, the patient returns to the hospital to be infused with their new CAR T-cells and is able to go home the same day.

Unlike chemotherapy and radiation, which affects the fast growing cells in the body, this treatment is a targeted approach that kills only the B-cells. The duration of treatment is shorter, too.

“B-ALL cells have specific markers that aren’t located on many other cells in the body, which is the part about it that’s unique,” Dr. Pacenta said. “The reason this has been so successful is because we are able to target one marker on leukemia cells to fight the disease.”

The remission rate after CAR T-cell therapy is 80%.

“Every patient is different, but we know that, in some children, this can be a long-term cure, meaning they don’t need to receive any additional treatment,” Dr. Pacenta said. “Some research studies have found that the CAR T-cells will persist in a patient’s body for as long as three and a half years, but it’s likely that the cells will be around for much longer.”

For Skylar, CAR T-cell therapy was as different from chemotherapy as night and day. She was fortunate to not experience any of the side effects associated with the therapy.

The side effects of CAR T-cell therapy include allergic reaction during and immediately following the infusion. In the weeks after, patients are closely monitored for neurotoxicity, as well as cytokine release syndrome, where the immune system becomes overactive due to the multiplying CAR T-cells releasing large amounts of chemicals called cytokines into the blood. These side effects can be very severe, with some patients requiring admission to the intensive care unit.

Now three months post infusion and Skylar's cancer is in remission. She will undergo more testing at six months post infusion, which will give her a better idea of her potential for long-term remission.

As for the possible impact of this type of cell-based immunotherapy on cancer, doctors are hopeful it could one day replace traditional treatments.

“I think there may be a day in the future where cellular therapy does replace chemotherapy, surgery and radiation for people with cancer,” Dr. Pacenta said. “But I think we are still a ways off. This therapy has been very successful initially but we still have a lot of work to do.”

The family of Michael Stuyvesant knows he beat the odds on a hot June day six years ago when he survived being accidentally left in the mini-van parked outside their Garland home.

Michael, 3 years old at the time, experienced brain swelling, seizures and other trauma caused when his body overheated. He was hospitalized for 10 days – three of them in intensive care – and then spent almost a month in a rehabilitation facility. Michael had to relearn skills such as walking, eating and playing.

His father says Michael still deals with short-term memory loss. But the Stuyvesants count themselves lucky that he didn’t die in the accident. On average, 39 children in the United States suffer fatal injuries every year from what’s known as pediatric vehicular heatstroke, a tragic and preventable danger. Four children have died so far in 2021 as of mid-June.

Eric Stuyvesant wishes his vehicle had been equipped with a device to remind him that Michael was asleep in the car seat that day in 2015. Some type of alarm “would have saved a lot of anguish, tears and heartache,” he said.

Legislation introduced last month in the U.S. Congress would require automakers to install technology that detects a backseat occupant, and then alerts the driver. The Hot Cars Act would make the technology a standard safety feature in every new passenger vehicle. The legislation calls for sensors and warning systems in an effort to protect unattended children and pets.

Here’s an example, a rear-seat reminder: If someone opens and closes a car’s back door within 10 minutes of starting the ignition, an alert will activate later whenever the vehicle shuts off. The alert chimes and a message on the instrument panel tell the driver to check for backseat riders. Supporters of the Hot Cars Act draw comparisons to other technology mandated over the years for auto safety, such as seatbelt reminders and levers for emergency release in trunks.

Chad Hamner, M.D., pediatric surgeon and trauma medical director at Cook Children’s, believes in the potential benefit of such devices whenever parents and caregivers unintentionally leave their little passengers behind.

 “It’s not a sign that you’re an unintelligent person or forgetful. It just happens,” Dr. Hamner said. “We get in a routine or we’re thinking about other things. It’s natural human behavior.”

When it comes to excessive heat, infants and young children are particularly at risk. Their bodies heat up five times faster than an adult in the same environment as a result of a larger surface area relative to body mass for heat exchange with their surroundings. Infants are at exceptional risk as they also have an immature temperature regulatory system.

What happens during heatstroke? Dr. Hamner said profuse sweating leads to loss of water and electrolytes, which can rapidly produce dehydration. A severely dehydrated child can’t maintain adequate blood pressure to support the delivery of oxygen and nutrients to their vital organs. According to Dr. Hamner, eventually heat stroke results in cardiovascular collapse and damage to muscles, the kidneys, the intestines and the brain. In the emergency department, the staff works fast to bring down the body temperature and replace lost fluids and lost electrolytes.

 Symptoms of hyperthermia include rapid pulse, shallow breathing, flushed skin, high fever, vomiting, dizziness, confusion and loss of consciousness. Organs start shutting down when the body core temperature reaches 104 degrees, said Sharon Evans, trauma injury prevention coordinator at Cook Children’s.

“Usually by the time the child is found (in a hot car), they‘re dead. They rarely even make it to the hospital,” she said.

Texas leads the nation in the most fatalities, with 132 since 1998, including five last year. Evans said public awareness campaigns in the state have made a difference. But she also favors the implementation of more technology, such as devices that detect motion or breathing in the back seat. She supports the Hot Cars Act.

Experts want caregivers and bystanders to know: 

1. Never leave a child unattended in a vehicle, not even for a second, even with the windows cracked and the air conditioning on.
2. Create a habit of checking the back and front seats before you walk away from the vehicle.
3. As a reminder, place something essential -- your purse, briefcase, shoe or other personal items -- next to the child during the drive.
4. Teach your children that a vehicle is not a play area. Keep the doors locked, even if the car is in the garage. Keep the keys out of reach.
5. If you see a child alone in a car, try to get him out. Call 911.

State law in Texas gives liability protection to anyone who forcibly enters a locked vehicle (by breaking a window, for instance) to reach a vulnerable person inside who faces imminent harm. State law also protects the confidentiality of anyone who calls to report suspected child abuse or neglect.

Statistics kept by the advocacy groups KidsandCars.org show July as the deadliest month for pediatric heatstroke. Even in milder weather, the temperatures inside a vehicle can quickly climb to a hazardous level. Studies found that in just 10 minutes a car’s internal temperature rises 19 degrees. To put it another way … 80 degrees outside, but a sweltering 99 degrees for anyone inside the vehicle.

KidsandCars.org keeps track of pediatric vehicular heatstroke in three main categories: A caregiver forgets the child (55% of cases), the child gets into the car on his or her own (26%), and someone leaves the child in the car deliberately (14%). A common thread in many instances is a deviation in the family’s routine on the day of the accident.

That’s what happened to the Stuyvesants on June 10, 2015. Eric Stuyvesant normally dropped off Michael at daycare and then drove his wife Michelle to work. But this particular day, to get Michelle to work earlier, he drove her to the office first with the intention of stopping off at daycare on the way back. But the phone rang, autopilot kicked in, and he forgot about Michael.

“I drove down to my regular exit, drove home, finished my phone call, went in the house and cooked my breakfast,” Stuyvesant said. “About 45 minutes later I remembered we hadn’t been to the babysitter.” He found his son “barely hanging on.”

He rushed Michael into a cold shower, gave him mouth-to-mouth resuscitation and put an ice pack on his carotid artery while waiting on paramedics to arrive. At the hospital, doctors put the boy into a coma to reduce swelling in his brain. Recovery wasn’t easy.

Stuyvesant and others emphasize that heatstroke accidents can happen to anyone. Because of what his family went through, Stuyvesant now makes the case for all new cars to come equipped with the features that the Hot Cars Act endorses.

“If we have technology in our vehicles that remind us that our cell phone is plugged in, our headlights are on, our turn signal has been blinking for awhile, we ought to have technology that remind us we forgot where we are and we need to turn around and go to the babysitter.”

“Just because it says crash tested doesn’t mean it’s been reviewed or approved by any regulatory agency,” said Sharon Evans, RN, trauma injury prevention coordinator at Cook Children’s.

Previously, non-regulated car seats were seen most in areas like California and New York. But according to Evans, these products are now showing up in North Texas.

Here’s what you need to know:

• To be approved by the National Highway Traffic Safety Administration (NHTSA), car seats must meet all the criteria to be able to state they meet or exceed FMVSS 213.
• Unregulated products may be found at well-known stores and online, so it is important for parents to check if the product is approved by the car seat manufacturer to be used with your specific car seat.

“The problem occurs when a parent buys a car seat that meets FMVSS 213, but adds accessories, which are not regulated. These products can alter the way the car seat works in a crash, or the accessory can become a flying missile, like a snap-on mirror,” explains Sharon Evans, trauma injury prevention coordinator at Cook Children’s. “I think parents feel that if it’s being sold by a big name retailer, it has to be safe, but often it isn’t.”

Evans big concern is that many car seat accessories claim to be “crash tested,” even though they are not regulated and do not meet the criteria by NHTSA.

The car seat manufacturers realize this is a problem and many now make non-regulated products such as seat protectors, water-resistant pads or covers for their specific car seats. If parents are going to add something to the car seat, it is important to verify the car seat manufacturer states the accessory is safe to use with the specific brand and model of the car seat.

“Accessories and non-regulated products are designed, made and sold by car seat manufacturers and anyone else who wants to,” Evans explained. “Even though the product may say ‘crash tested’ or meets NHTSA standards or FMVSS 213, however, there are no standards for these products. The product may be crash tested but we don’t know how and we don’t know if the product was tested in specific car seats and/or what car seats.”

What to look for:

• Make sure car seats are labeled with FMVSS 213. This means the product is approved by the NHTSA.
• Non-regulated products often have a similar label of FMVSV 213. These products are not federally registered, and cannot claim to effectively restrain the child or claim to prevent injury.
• Regulated products and accessories will state: Meets or exceeds all federal standards for car seat safety (FMVSS 213 Federal Motor Safety Standard for USA).

“Parents need to be really careful with car seat accessories, because you run the risk of your child being injured due to something like a footrest or head strap,” Evans said. “Unfortunately, some companies are intentionally using confusing labels to sell their products, so it’s really important that parents know what to look out for.”

The National Highway Traffic Safety Administration provides child passenger safety that can be found here. 

“We usually see a cluster of patients from crashes in the three to four days before and after Christmas,” said Sharon Evans, trauma injury prevention coordinator at Cook Children’s. “People are stressed, and it’s the height of travel season. We don’t know what it will be like this year due to the pandemic, but we know this time of year is especially dangerous.”

Since 2015, an average of 12 car wreck victims were admitted to Cook Children’s between the dates of Dec. 20-30. Out of those, three were typically not restrained with a seat belt or car seat.

“If a child is properly restrained in a car seat, we may see some cuts and bruises, but they usually ok,” said Evans. “The ones who are much more seriously injured tend to be children in seat belts who are too small and should be using a booster seat.”

In Texas, children are required to remain in a car seat until they are 4 feet 9 inches tall or 8 years old. Experts like Evans say that is the bare minimum, and it’s more important to pay attention to a child’s size than their age since seat belts are made for adults and don’t fit small bodies properly.

“When children are using a seatbelt prematurely, the belt doesn’t fit across the center of their shoulders like it should and kids will tend to put it behind their back or under their arm,” she explained. “Now, their entire upper body is unrestrained. In a crash, this means the child folds over the seatbelt.”

She says these children can suffer cervical spine injuries, as well as serious internal injuries to the spleen, liver and intestines. This is why it’s so important for children to remain in a car seat or booster seat until they fit into a seat belt. Also, any child under 13 years old should ride in the backseat.

“There are no do-overs,” said Evans. “A lot of times we see families who say their child was really tired or fussy and didn’t want to get into the car seat or they wanted to lay down. We understand how that can happen, but families need to know that kind of normal decision can affect your life forever.”

Most Dangerous State

A recent report released by Go Insurance’s partner nonprofit, Go Safe Labs, shows Texas is the least safe state in the country for children in vehicles. Between 2015-2018, Go Safe Labs found that 1,172 children were injured or killed in traffic accidents in the state, with 55% in rural areas and 45% in urban areas.

Further data from the Texas Department of Transportation shows it’s been more than 20 years since the state has seen a day without a death on its roads. November 7, 2000, marked the last time that happened. Since then, more than 70,000 people have lost their lives on Texas roads, with an average of 10 people dying every day.

“You hear about wrecks every time you turn on the news and I think we’ve almost become desensitized to them,” said Evans. “You have to remember, it could be you and it could be serious.”

Due to the COVID-19 pandemic, this holiday season could see more deaths than usual.

According to a study by the Center for Transportation Safety (CTS) at the Texas A&M Transportation Institute (TTI), the number of Texas traffic crashes in April dropped by nearly 50% compared to 2017-2019 averages. While there were fewer crashes, researchers say there was a 50% increase in traffic fatalities. They believe the data is evidence that the risk of death and injury is greater when roads are more clear, likely because people tend to drive faster with fewer cars on the road.

“There’s no way to predict what will happen this holiday season, if there will be more people on the road or less,” said Evans. “But one thing I know for sure is accidents don’t take a day off.”

What Can Parents Do?

If you are traveling with children, make sure they are restrained properly. According to Safe Kids North Texas, four out of five car seats are installed incorrectly. For this reason, they offer free car seat checks to ensure your child’s safety. Due to the COVID-19 pandemic, car seat checks are being offered virtually only at this time. You can easily sign up for a check online by clicking here.

This was the first pediatric vehicular heatstroke death in Texas in 2018 and the sixth incident in the United States this year.

Police say the child was left for multiple hours inside a hot car in a high school parking lot where temperatures reached 100 degrees. The father was reported to work at the school as a teacher. Police says investigators believe the baby's death was accidental.

A child dies from heatstroke about once every 10 days from being unattended in a hot vehicle. Heatstroke is the leading cause of non-crash vehicle fatality for kids 14 and younger. In more than half of these deaths, the caregiver forgot the child was in the car or the child climbed into an unlocked car to play and couldn't get themselves out.

“What’s heartbreaking is that this is a serious public health issue that is 100 percent preventable,” said Dana Walraven, Community Health Outreach manager at Cook Children’s and Safe Kids Tarrant County Coordinator. “Every mom and dad out there must realize it can happen to you. Texas leads the nation in child heat-related car deaths.”

Heatstroke, or hyperthermia, occurs when the body isn’t able to cool itself quickly enough and the body temperature rises to dangerous levels.

Young children are particularly at risk as their bodies heat up three to five times faster than an adult’s. When a child’s internal temperature gets to 104 degrees, major organs begin to shut down. And when that child’s temperature reaches 107 degrees, the child can die.

Because of this, and because cars heat up so quickly – 19 degrees in 10 minutes – tragedies can happen faster than you think. Symptoms can quickly progress from flushed, dry skin and vomiting to seizures, organ failure and death.

“Heat is much more dangerous to children than it is to adults,” Walraven said. “When left in a hot vehicle, a young child’s core body temperature may increase 3 to 5 times faster than that of an adult. This could cause permanent injury or death.”

Safe Kids recommend the “ACT” method to prevent tragedy to your child or to a child you see left in a car:

• A: Avoid heatstroke-related injury and death by never leaving your child alone in a car, not even for a minute. And make sure to keep your car locked when you’re not in it so kids don’t get in on their own.
• C: Create reminders by putting something in the back of your car next to your child such as a briefcase, a purse or a cell phone that is needed at your final destination. Another idea is to take off one of your shoes and place it in the backseat. This is especially important if you’re not following your normal routine.
• T: Take action. If you see a child alone in a car, call 911. Emergency personnel want you to call. They are trained to respond to these situations. One call could save a life.

Click to learn more about vehicle/car safety here

It was a horrible reminder of the deadly consequences of what can happen when a child is left alone in a car.

Texas leads the nation in children dying from hypethermia after being left alone in an automobile with 55 deaths since 2010. Since 1998, 744 children have died nationally as a result of vehicular heatstroke.

For the Trauma department at Cook Children’s, statistics are much more than numbers. They represent very real, too often tragic consequences.

“Every time we hear of a child dying in a hot car, it’s heartbreaking for all of us,” said Sharon Evans, Trauma Injury Prevention coordinator at Cook Children’s. “It’s especially devastating because these deaths are preventable.”

Evans admits to frustration that these deaths continue to occur, but she’s encouraged by a law that could save children’s lives.

The "HOT CARS Act of 2017" would require the U.S. Department of Transportation to enforce that all new cars would be equipped with various alert systems to remind adults a child is in the back seat. The bill is currently attached to another that has passed the House and Senate committee. It’s awaiting a vote on the Senate floor.

To learn more about the hot car legislation, click here.

Already this year, two children have died after being left alone in a car. A 1-year-old child died in Miami in February when the temperature was 81 degrees and a child died this month in North Charleston, S.C., when it was 84 degrees outside.

“We’ve seen children die in the winter months before,” Evans said. “There is never a safe time to leave your child in a car. We hope people will take extra precaution and know that there's never a safe way or time to leave a child in the car.”

Hyperthermia, also known as heatstroke, is the leading cause of non-crash, vehicle-related deaths for children. It occurs when the body isn’t able to cool itself quickly enough and the body temperature rises to dangerous levels.

Young children are particularly at risk as their bodies heat up three to five times faster than an adult’s. When a child’s internal temperature gets to 104 degrees, major organs begin to shut down. And when that child’s temperature reaches 107 degrees, the child can die.

Because of this, and because cars heat up so quickly – 19 degrees in 10 minutes – tragedies can happen faster than you think. Symptoms can quickly progress from flushed, dry skin and vomiting to seizures, organ failure and death.

“It truly doesn’t have to be a ‘hot’ day in Texas for a death to occur,” said Dana Walraven, Community Health Outreach manager at Cook Children's. “The temperature inside a vehicle can quickly climb over 20 degrees hotter than outdoor temperature. So even a cool day in Texas can become dangerous very quickly. Since children’s body heat rises three to five times faster than adults, it’s important to know that temperatures can become deadly any time of year.”

For More Information About This Topic:

• Hot Cars Act
• Vehicle/Car Safety
• Trauma Services at Cook Children's
• Community Outreach at Cook Children's

Watch the story here.

Last month alone, eight children were taken to Cook Children’s Emergency Department after being hit by cars while walking or riding bicycles. The same number of children were injured in February.

“Over the past couple years, we’ve seen the numbers increase,” said Sharon Evans, Trauma/Injury Prevention Coordinator at Cook Children’s. “We can’t say why this is happening, but we do know children do not have the cognitive skills to cross a street safely by themselves until they are at least 10.”

According to a new study released by the University of Iowa, 10 may still be too young. Researchers suggest children may not have the perceptual judgment or motor skills needed to safely cross a street until they are 14 years old. The study used virtual reality to simulate a busy street. Then, children, ages 6 to 14, were asked to cross multiple times.

The results show the children, up to their early teenage years, had a difficult time deciding when to cross the street. The study also evaluated how often the children were involved in an accident during the simulation.

Accident rates from the study:

· 6 year olds – 8%

· 8 year olds – 6%

· 12 year olds – 2%

So what do parents need to know?

Do not allow children under the age of 10 to cross the street by themselves. Even better, wait until they are a teenager and able to confidently know when to safely cross.

Cook Children’s recommends teaching these behaviors before allowing a child of any age to cross the street alone:

• Look left, right and left again before crossing the street. Cross when the street is clear, and keep looking both ways while crossing. Walk, don’t run.
• Understand and obey traffic signals and signs.
• Walk facing traffic, on sidewalks or paths, so that you can see oncoming cars. If there are no sidewalks, walk as far to the left as possible.

“When I visit children who have suffered pedestrian injuries, the most common thing they tell me is that they thought the driver saw them,” explained Evans. “It’s important to teach your children that just because they see a driver, it doesn’t mean the driver sees them. They need to make eye contact with the driver and wait for the driver to stop and signal to them before attempting to cross the street.”

"If it can accelerate your body, it can injure you," said Corwin Warmink, M.D., medical director of the Emergency Department at Cook Children's. "Vehicular accidents, including boats, ATVs, cars, scooters and bikes are all too common on holiday weekends during the summer."

Another danger Dr. Warmink is concerned about this weekend: broken bones. No one wants to spend Labor Day weekend in the hospital. But Dr. Warmink says many families do, thanks to trampolines and monkey bars.

One of the scariest threats we see all too often is drowning. And yes, it can happen to you. In August alone, 14 children were admitted to Cook Children's Medical Center for drowning-related injuries. Two of those children died.

"We've seen many cases where children took their life preservers off and jumped back into the water," said Magdalena Santillan, Trauma Injury Prevention specialist at Cook Children’s. "Often, parents are getting ready to leave the pool and don't realize their kids have jumped back in."

One of the best ways to protect your child around the pool or lake is to become a Water Watcher. This means adults take turns supervising the water with undistracted attention. You can find more information about the program here, including 5 seldom used tips that could save a child's life.

And Labor Day may mark the unofficial end of summer, but that does not mean an end to the heat. According to Dr. Warmink, heat-related illness also tops the list of Labor Day dangers. "Heat exhaustion, heat stroke, hot cars and sunburns are among the common injuries we see over the Labor Day weekend," said Dr. Warmink. "Parents should make sure their kids drink plenty of water and wear sunscreen, and of course, never leave a child alone in a car."

With your help, we can cut the number of Emergency Department admissions this holiday weekend and ensure a safe celebration for everyone.

Three kids have been ejected total, with one child surviving. It probably doesn’t come as a surprise the cause of the tragedies – the children weren’t restrained properly or not at all in their car seat.

Since April 2015, Cook Children’s Trauma team has treated 13 children who were ejected from a car.

Sharon Evans, Trauma/Injury Prevention outreach coordinator at Cook Children’s, says it’s so frustrating because she has seen wrecks where one child who was properly restrained live and the other child not buckled in dies.

“Honestly, it’s just so infuriating,” Evans said. “These accidents are totally preventable. It’s because the adults in the car aren’t doing something that could save their child’s life. I don’t think people think it can happen to them. But it can happen to anyone. It just breaks my heart because these are deaths that shouldn’t occur if people would just place their kid in the proper car seat and buckle them up with a seat belt.”

Statistics show this is especially a problem for Hispanics in the community. Ninety percent of the ejections that have occurred since April 2015 were Hispanic.

“I think a lot of it has to do with our culture,” said Magdalena Santillan, Trauma Injury Prevention specialist at Cook Children’s. “These are people who love their kids and they want to hold their baby. A lot don’t want to hear their baby cry and so it’s easier to hold their baby in the car. They are showing love, but the consequences are too high. This can be a deadly mistake.”

According to the Centers for Disease Control and Prevention, car crashes are a leading cause of death among children ages 3 to 14. From 2002 to 2011, about 9,000 children under the age of 12 died in car accidents, the agency’s statistics show. Correctly using a child safety seat can reduce the risk of death by as much as 71 percent.

“We know that car seats are working,” Evans said. “Research shows that a properly installed rear-facing car seat is five times safer and can dramatically reduce the risk of head, neck and spinal cord injury if your child is involved in a crash.”

Call 682-885-2634 to set up a FREE car seat checkup to ensure your seat is properly installed.

8 isn't enough ... life with 9 children

Nine children, ages 3 to 19 years old, make Mother’s Day a pretty special time for Kristy Goodnight. After all, that’s a lot of hugs and kisses to go around ... But when you consider each child has his or her own special needs, life can be amazingly hectic and difficult. And what’s the biggest challenge for the mom of nine? Click to read more.

Dr. Mom: How motherhood changed me as a pediatrician

After completing 24 years of schooling and medical training, you’d think that once I graduated from pediatric residency, I’d know a thing or two about the health of children. And I did. I knew a lot ... Then, I was blessed to have a beautiful son...who decided that I needed to be re-taught a few things about children.

And by a few things, I mean everything. Click to read more.

How being a mom shaped her practice

I am a better pediatrician because I have experienced life as a mom. I know the tears and tiredness of a new mom and so when she cries at the new baby check I can tell her it's normal and she believes me. Click to read more. Click to read more.

Because of the icy road conditions lately, you’ve probably kept your family indoors recently to make sure they were safe. But if you aren’t careful this winter, you risk new dangers inside your home.

Carbon monoxide is known as the ‘silent killer’ because it’s an odorless, colorless, tasteless gas. The Texas Department of State Health Services says, “Several household sources, such as gasoline-powered tools and generators, produce carbon monoxide. Anything that burns can produce carbon monoxide. The fumes are extremely hazardous and can cause sudden illness or death."

Carbon monoxide is especially dangerous to infants, women who are pregnant and their unborn children, the elderly and people with heart or breathing problems.

The Centers for Disease Control and Prevention (the CDC) recommends taking the following steps to prevent carbon monoxide exposure:

· Do have your heating system, water heater and any other gas, oil, or coal burning appliances serviced by a qualified technician every year.

· Do install a battery-operated or battery back-up CO detector in your home and check or replace the battery when you change the time on your clocks each spring and fall. If the detector sounds leave your home immediately and call 911.

· Do seek prompt medical attention if you suspect CO poisoning and are feeling dizzy, light-headed, or nauseous.

· Don’t use a generator, charcoal grill, camp stove, or other gasoline or charcoal-burning device inside your home, basement, or garage or near a window.

· Don’t run a car or truck inside a garage attached to your house, even if you leave the door open.

· Don’t burn anything in a stove or fireplace that isn’t vented.

· Don’t heat your house with a gas oven.

Evans is concerned because at Cook Children’s:

• In 2013, there were three motor vehicle crash deaths (compared to 0 in 2012).
• There has been a 10 percent increase in injuries due to unrestrained kids and a 4 percent increase in ejections.

“This is the time of the summer when a lot of families will be traveling on the road,” Evans said. “I’m very concerned about the amount of unrestrained children we are seeing. I would ask all parents to make sure their children are buckled up correctly to prevent a tragedy to their family.”

Graco car seat recall, what you need to know

To see if your model may be covered, or for additional information, call Graco at 1-877-766-7470, or visit www.gracobucklerecall.com, or email consumerservices@gracobaby.com. Sharon Evans, Trauma/Injury Prevention outreach coordinator at Cook Children’s, stresses to parents to register car seats when purchasing them so they will be notified of recalls.

I left the medical center and started the trek home. Within a few minutes, I knew it was a bad idea. Not only was it pouring, but it clearly had been for a while. The streets were filled with water. Lots of water.

After I made the phone call to my coworkers telling them it was unsafe to drive and to stay at the office, I realized that I needed to hurry to higher ground. I continued to drive cautiously.

The next 15 minutes were terrifying. I saw cars floating and people swimming on the road in front of me. My first thought was I need to get to a street that isn’t flooded. I turned onto a side street and ended up at an intersection that I knew my car couldn’t get through. The big SUV in front of me was driving through it and the water was hitting the car door. So I decided to back up. The only problem was there were cars behind me now.

I was stuck. Nowhere to go. I watched the water go from inches deep to over 2 feet in a matter of seconds. I found myself panicking. I mean seriously, I would never be stuck in a flash flood, right? Well I was.

I didn’t know what to do. I work at a children’s hospital and preach about safety to friends and family all the time. Now here I was, in a situation that I didn’t have a clue how to handle.

Do I get out? Do I stay in the car? Do I swim to higher ground? The water was so rough. It was literally swirling around my car and getting higher and higher.

Fortunately, either by the grace of the man upstairs or pure luck, all the cars behind me started to back up so I was able to do the same and eventually made my way to higher ground.

This was my first and definitely the LAST time I ever want to be in this situation. But just in case it happens again, I wat to be prepared. So I contacted my buddy at the Fort Worth Fire Department, Battalion Chief Richard Harrison and he gave me some good tips:

1. Be aware that flash flooding can occur. If there is any possibility of a flash flood, move immediately to higher ground. Do not wait for instructions to move.
2. Do not drive into flooded areas.
3. If floodwaters rise around your car, when water is not moving or not more than a few inches deep, abandon the car and move to higher ground. You and the vehicle can be swept away quickly. Call 911 in case of an emergency.
4. If your vehicle is trapped in rapidly moving water, stay in the vehicle. If the water is rising inside the vehicle, seek refuge on the roof.
5. If your car is parked in an area that is flooding, don’t go after it.
6. Do not walk through moving water. Six inches of moving water can make you fall. If you have to walk in water, walk where the water is not moving. Use a stick to check the firmness of the ground in front of you.

Chief Harrison says these same rules apply when you are in the car with a child, but make sure you give yourself more time to react. This is true if you have to leave your vehicle, especially if you have a car seat. It will take time to get out. Because of this, you have to heighten your awareness with everything going on.

Also, reassure your children that everything will be Ok and try to stay calm. I know I sure could have used my mother the other day.