Car Seat Safety

Safety • Nov 12, 2019

Car Seat Safety and Car Accidents

Anyone else feel like they are constantly in the car?  Going to work, running errands, going to the library or park, and of course, hitting I-70 to visit family (road trip!)—I’m constantly in my vehicle! Wherever I go, my little one is often with me. Keeping him safe in the car is a top priority! Let’s review how to keep kids safe in the car, when to go to the ER after a car accident, and what should you do with your car seat after an accident.

Car Seat Safety Recommendations

In 2018, the American Academy of Pediatrics (AAP) released its most recent recommendations for car safety. These recommendations were made to reduce severe injury and death in children involved in car accidents.

  • Infants/Toddlers should be in rear-facing car seats until they outgrow the weight/height limits of your specific car seat. Many rear-facing infant/toddler car seats have a weight limit of 40 lbs, but be sure to check your specific model. Keeping small children rear-facing reduces head and neck injuries, which can be life-threatening!
  • Once forward-facing, keep your child in a five-point harness until they reach the weight limit, which is typically 65 lbs for most models.
  • Older children should be kept in a booster or front-facing car seat with seat belt adjusting guide until the seatbelt goes comfortably over their shoulder and across the lap (not touching the neck or sitting up on the abdomen). Seat belts usually start fitting children properly when they are around 4’9, about 8-12 years. A child who is too small for the seat belt risk significant injuries to the blood vessels in the neck and the organs in the abdomen due to pressure to these areas from the seat belt in the event of an accident.
  • Children under the age of 13 should always ride in the backseat of the car no matter their height or weight.
  • The safest place for a car seat or booster is in the middle back seat.
  • Remember to model car safety to your children by always wearing your seat belt when riding in a car!

We’ve Been in an Accident. Should I Go to the Emergency Room?

Car accidents vary in severity from minor bumps and “fender benders” to high-speed collisions with the complete destruction of vehicles and on-scene fatalities. The decision to seek a medical evaluation for your child after an accident depends on how your child was restrained, the severity of the accident and your comfort level as a parent.

When to Go to the ER

  • If your child has obvious injuries such as bleeding, limping, bruising or marks (particularly on the neck or abdomen), or, if they can talk, are reporting pain
  • If your child had a loss of consciousness or is vomiting after a car accident
  • If your child is crying and difficult to calm, as this could be a sign of injury in a child who cannot talk yet
  • If the cars involved were going fast (above 40 miles per hour), if airbags were deployed, if your child was not properly restrained in a car seat or seat belt, if someone died as a result of the accident, or if emergency workers had to open the car to get your child or other passengers out of the car—these are all indicators of a more significant accident
  • If you are advised by on-scene emergency workers to have your child evaluated by a doctor
  • If you are concerned that your child might be injured

Evaluation after a car accident in an emergency department will include a head-to-toe physical exam looking for injuries. Depending on the severity of the car accident and identified injuries on exam, your child may need to be placed in a neck brace, get x-rays, and/or have blood work drawn to further evaluate for injuries to the bones and internal organs.  If your child has several injuries or there is a concern for an injury to an internal organ, pediatric trauma surgeons may become involved in your child’s care. Very injured children are often identified by emergency workers at the site of the accident and are brought to a pediatric emergency room to be seen quickly by a trauma team, which typically includes pediatric emergency medicine doctors, pediatric trauma surgeons, nurses and occasionally, pediatric anesthesiologists.

Should I Replace My Car Seat After an Accident?

The National Highway Traffic Safety Administration developed guidelines to help families identify when the car seat should be replaced due to concern for damage from an accident which could make the car seat unsafe to use. A car seat can continue to be used after an accident if the following criteria are met:

  • There are no cracks or deformities to the car seat (be sure to look under padding to find any hidden breaks)
  • The car in which the car seat is installed could be driven away from the scene
  • The car door nearest to the car seat is undamaged
  • No one in the car was injured in the collision
  • Airbags did not deploy in the car

If you need to replace your car seat after an accident, check in with your insurance company as they may cover the cost of a replacement car seat under your policy. Many ERs also have programs to assist in getting a replacement car seat, particularly if you need one to get home. So, be sure to ask about this if your child is in the ER after a car accident.


Car accidents can happen at any time to anyone. Protecting yourself and your children by buckling up and following the AAP guidelines for proper car seat safety may save a life and prevent severe injuries in your littlest loved ones.