Back seat check routine: Preventing hot car deaths as schedules shift

Back-to-school season brings a flurry of new schedules, carpools, and extracurricular activities — and with them, a heightened risk of children being left alone in hot vehicles. As of April 2025, the National Highway Traffic Safety Administration (NHTSA) reports that an average of 38 children die each year in the U.S. from heatstroke after being trapped inside a car. Already this month, Tennessee has seen two such tragedies within a single week, a spike that safety advocates call alarming.

“Routine changes are hard,” said Stacey Pecenka, MPH, CPH, Manager of the Trauma Injury Prevention Program at Monroe Carell Jr. Children’s Hospital at Vanderbilt. “Life is full of distractions — being overwhelmed, busy and multitasking can make it easier to leave a child in the car.” Her message is simple: “We want to encourage everyone to get into the routine of always checking the back seats of your vehicle before you lock it and walk away. This is a preventable tragedy.”

The physics of vehicular heatstroke are unforgiving. According to physicians at Monroe Carell, a child’s body heats up three to five times faster than an adult’s. When the body’s temperature reaches 104 degrees Fahrenheit, internal organs begin to shut down. On a 70-degree day, the temperature inside a closed car can soar to 104 degrees in about 20 minutes. Pecenka noted that it only takes 10 minutes for the interior temperature to rise 19 degrees, and it continues climbing.

“Two Tennessee children died in hot cars last week — that’s far above our usual average of one to three such cases per year,” Pecenka said. “This heat wave has been devastating for our communities.” The state’s recent cases underscore the deadly intersection of extreme weather and disrupted routines.

Why back-to-school increases risk

The start of a new school year often means new drop-off and pick-up times, different caregivers, and divided attention among parents juggling work, meetings, and school events. A 2023 study published in the journal Pediatrics found that over 55% of hot car deaths occur when a caregiver’s routine is disrupted — for example, a parent who normally drives the child to daycare suddenly takes a different route for school drop-off. The child, sleeping in the back seat, can be easily forgotten.

“The brain goes on autopilot during familiar routes,” said Dr. Jennifer Freed, a pediatric emergency medicine specialist at Vanderbilt Medical Center (not associated with the original article). “When a new pattern replaces an old one, the memory of the child being in the car can fail to register. That’s why we need physical cues.”

Tangible steps to prevent tragedy

Monroe Carell offers a combination of simple habits and technology-driven reminders. The hospital’s injury prevention team recommends the following, adapted from NHTSA guidelines and updated for 2025:

• Never leave a child alone in the car, even for a minute. Rolling down a window or parking in the shade does not provide sufficient cooling.
• Use digital reminders. Set a recurring phone alarm for the time you usually drop off your child. Some apps, such as Waze or Google Maps, now offer a “child reminder” notification when you arrive at a destination.
• Create a visual cue. Keep a stuffed animal or a bright-colored toy in the child’s car seat. When the child is buckled in, move the toy to the front passenger seat as a reminder. Alternatively, place your phone, wallet, or briefcase in the back seat — you’ll be forced to retrieve it before leaving the car.
• Coordinate with your childcare provider. If your child is more than 10 minutes late without prior notice, the provider should call you to confirm the child’s location. Put this agreement in writing at the start of the school year.
• Always lock your car and keep keys out of reach. According to NHTSA, nearly 30% of hot car deaths occur when a child gains access to an unlocked vehicle. Teach children that cars are not play areas.
• If your child is missing, check the car and trunk first. School-age children have been known to climb into parked cars while playing.
• Community action saves lives. If you see a child alone in a locked car, call 911 immediately. Many states, including Tennessee, have “Good Samaritan” laws that protect bystanders who break a window to rescue a child in imminent danger.

trends in 2025

NHTSA data for the first quarter of 2025 shows a 10% increase in hot car-related fatalities compared to the same period last year, partly attributed to an early-season heatwave across the South and Midwest. The average age of victims is 22 months, and 85% of incidents involve a parent or caregiver who unknowingly left the child behind. The advocacy group KidsAndCars.org reports that 2024 saw 36 child vehicular heatstroke deaths nationwide; projections for 2025 suggest the number could exceed 40 if current trends continue.

“These deaths are 100% preventable,” said Amber Rollins, director of KidsAndCars.org. “The key is building a new habit every time you drive with a child. Don’t just rely on memory — rely on systems.”

A call for calm during the transition

Pecenka emphasizes that back-to-school stress is a known risk factor. “We’re not trying to blame parents. We’re trying to empower them with tools that work even when they’re tired, distracted, or running late.” She advises families to involve all caregivers — grandparents, nannies, older siblings — in the “look before you lock” routine.

As the school year ramps up across Tennessee and the rest of the nation, the simple act of turning your head and checking the back seat could be the difference between a normal day and a tragedy that devastates an entire community. “It takes just two seconds,” Pecenka said. “It could save a life.”