Monroe Carell Jr. Children's Hospital at Vanderbilt

Volume 14 Issue 18 .                                                                                     Summer 2020

Safety Source

Thank you for being a Safety Source family! 
Child Passenger Safety Edition

This week we want to focus on child passenger safety, as it is National Child Passenger Safety week. There are interactive tools for your children to learn the importance of child passenger safety, as well as information for parents. We hope this will be a fun way to learn about important safety topics together as a family. Let us know if we can be a resource to you in anyway! As always, we try to include the best topics to keep your family happy, healthy, and safe! If you wish to see a particular topic or question addressed in our next issue, please let us know!

Newsletter Highlights


Video for Kids

Interactive video for kids to learn about booster seats 

Activities for kids to learn about child passenger safety

Lots of activities to learn about child passenger safety and how you can help your family stay safe. 

Interactive Quiz about Child Passenger Safety

Test your child's knowledge about child passenger safety through an interactive online quiz. 

More Information for Parents

Information for parents about child passenger safety. 

9 common car seat mistakes

Make sure that your precious cargo is being transported safely with these 9 tips for car seat use.

Would it surprise you to know that more than 82 percent of all car seats are installed incorrectly? As child passenger safety technicians, we see a lot of common mistakes and we get a wonderful opportunity to work with families to make sure their most precious cargo is being transported safely.

This week, we are sharing common car seat mistakes we see, along with some simple changes that can help prevent a serious injury.

1. Car seats that are too loose.

If a seat is correctly installed, when you pull at the belt path, the seat should move no more than one inch from side to side or back to front. A child-passenger-safety technician trained in car-seat installation can show you how to get a correct and secure installation.

2. Straps that are too loose.

The harness straps should fit snugly with no slack. If they are too loose, a child can be ejected from the seat. To test, using your thumb and forefinger, try to pinch the straps vertically at the collarbone. You should not be able to pinch any harness webbing. Also, avoid putting bulky clothing on children, such as a thick winter coat, before you put them in a car seat.

3. Incorrectly positioned harness straps.

They should be at or below shoulder level in a rear-facing seat or at or above shoulder level in a forward-facing seat. Be sure to check the straps often, as children grow quickly and the harness position can be easily overlooked.

4. Not using the top tether.

An Insurance Institute for Highway Safety study found that only half of car seats were attached by the top tether and most parents didn’t think it was necessary. Actually, the top tether is very important because it significantly reduces a child’s risk for head and other injuries in a crash. Check the vehicle and child restraint manuals for limits on tether and anchor use.

5. Turning forward too soon.

For the best protection, keep your baby in a rear-facing infant or convertible car seat for as long as possible, until they reach the highest weight or height the seat allows.

6. Placing toys, mirrors or other items in or around a car seat.

Avoid using any after-market products with your car seat. Rarely will they have been crash-tested with the seat and they may change how the seat works in a crash. These items also can become dangerous projectiles in a crash. Store all loose items in a console, pocket or the trunk. Some child-seat manufacturers make products specifically designed for the seats and come with the seat at the time of purchase.

7. Using an old or second-hand seat.

Used seats are unlikely to come with the manufacturer’s instructions (vital for correct installation), may be missing important parts, may have been involved in crashes (even unseen damage can affect the seat’s functioning), may fall short of current safety standards, or may have been recalled due to faulty design. In addition, car seats expire because their parts break down over time. To find a seat’s expiration date, look for a sticker on the seat with manufacturing date or expiration date. If you can’t find it, contact the car seat manufacturer.

8. Getting rid of the booster too early.

A seat belt that doesn’t fit properly can do more harm than good, penetrating internal organs, damaging the spinal cord or, if the shoulder strap is improperly fitted, seriously injuring the head. It is important to keep your child in the booster seat until the seat belt fits properly. Because seat belts are designed for people who are at least 4-feet, 9-inches tall, that may not be until your child is 12 years old or older.

Take a few extra minutes to check your car seats and make sure your little bundle of joy is safe! If further assistance is needed, and to ensure your seat is correctly installed, call to speak with a child passenger safety technician or to schedule an appointment.

9. Not registering your car seat.

Although child restraint systems undergo testing and evaluation, it is possible that a child restraint could be recalled. Registration cards on car seats are there for one reason: to provide the manufacturer with contact information to reach the owner if the car seat is found to have a safety defect or other safety alert. The government standard requires that the consumer be contacted for all recalled car seats on the market, even if you bought it six to 10 years ago. Make sure you complete that form and mail it in. You can also go online and register your seat with the manufacturer.

Take a few extra minutes to check your car seats and make sure your little bundle of joy is safe!

Also, many parents think that the handle on an infant seat has to be pushed back when the carrier is in the car. This is not always true. Many carriers are safe with the handle in other positions in the car. Check the manual that comes with your child’s seat to know which position is safest for the handle.

Visit the Kohl’s Seat Smart Program to learn more.

Let's Talk About Tether Straps

Have you ever seen a strap on the back of your child’s forward-facing car seat and wondered what it was for? It’s called a tether strap and it has a very important purpose. According to a Safe Kids study, 64 percent of caregivers were not using the tether strap to secure their child in the forward-facing position, mistaking it as an optional feature. There has been a lot of progress in many areas of car seat use, but use of the tether remains an area of needed improvement.

What is a tether strap?

A tether strap is a single seat-belt-like strap that connects the rear of a child safety seat to an anchor point on the vehicle behind the seat. They are typically clipped by a hook to the back of the safety seat behind the child’s head on convertible, combination or forward-facing only-seats. These straps reduce the forward motion of a child’s seat in a crash, in turn reducing the forward motion of a child in the forward-facing position. Without use of a tether strap, a child’s head may strike the seat in front of them, the vehicle console or other occupants in a crash.

How do you use it?

A tether strap is a separate piece of equipment, so it can be attached to the tether anchor in any compatible vehicle or safety seat. Use the tether with either the seat belt or the lower anchors but never both.

A tether anchor may look like a loop or ring, and may be located behind the vehicle’s seat, on the inside of the headliner or other locations. Clip the tether strap to the anchor, making sure it extends properly to the rear of the safety seat. Once attached, tighten it to remove any slack. Make sure the lower anchors or seat belt are also tightened.

In a NHTSA study, 17 percent of forward-facing seats were found to have been installed too loosely, moving two inches or more at the belt path. The best practice is for the seat to not move more than one inch when tested at the belt path.

Where is the tether anchor located?

Check your vehicle owner’s manual to determine where the tether anchors are located. Make sure you aren’t actually using a cargo hook. Cars manufactured in the 2002 model year and later will have at least three tether anchors in the rear seating area. If you have an older vehicle, you may have to have your vehicle retrofitted with a tether anchor. Contact your vehicle manufacturer for more information.

Remember: If using the lower anchors and tether in the forward-facing position, there is a 65-pound weight limit. If your child’s weight is higher than this, switch to the seat belt and tether combination. If you are ever unsure about the installation of your car seat, visit a Car Seat Fitting Station and have a certified Child Passenger Safety Technician check your seat. The peace of mind you’ll gain from learning about proper installation will be worth the trip.

Click for more information about Car Seats
Suicide Prevention with Children

Suicide is a growing public health concern. It is the second leading cause of death for people 10 to 34 years of age and the fourth leading cause among people 35 to 54 years of age.1 Each day in Tennessee, an average of three people dies by suicide. As of 2017, suicide is the second-leading cause of death for young people, ages 10-19 in Tennessee, with one person in this age group lost to suicide every week.4 It is important to understand that a suicide attempt is different than suicide ideation. A suicide ideation is defined by someone who is thinking about or considers suicide.

Parents, it is important to trust your instincts. If you believe that your child or a loved one could be struggling with mental health issues or suicide ideation, act on that. It would be better to offer help than to ignore your instincts. You should never ignore threats or statements given by your children as dramatic or a phase. Many times, these statements can be a cry for help and should be taken seriously.

Studies have shown that children who are experience three or more of the following risk factors are at a higher risk for considering suicide2:

  • Major loss (i.e., break up or death)
  • Substance use
  • Peer or social pressure
  • Access to weapons
  • Public humiliation
  • Severe chronic pain
  • Chronic medical condition
  • Impulsiveness/aggressiveness
  • Family history of suicide

It is important to know about the things that may trigger or add additional stress to your child. Here are a few more tips to help support your children during a difficult time:

  • Talk with your child about your own feelings. Explaining to your child that he or she is not alone and that everyone experiences struggles at some point in their life, can really make a big difference.
  • Seek professional help right away. Reach out to a mental health provider in your area.
  • Model healthy habits by taking care of your own mental health and showing your child various ways to approaching life’s problems.
  • Routinely hosting family check-ins could help with building communication. This includes letting them know that you will always be there for them even if they don’t feel like talking at that moment.
  • Remember to keep all guns at home stored safely and secure away from your children.

Supporting loved ones with who may be experiencing mental health issues can be tough. Remember to seek out professional help for additional resources and support. Please visit the Tennessee Suicide Prevention Network here for more information. Call the statewide crisis line 24 hours a day, 7 days a week, 365 days a year at 855-CRISIS-1 (1-855-274-7471) if you think your child is experiencing a mental health crisis.

  1. https://www.cdc.gov/violenceprevention/suicide/fastfact.html
  2. https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Ten-Things-Parents-Can-Do-to-Prevent-Suicide.aspx
  3. https://afsp.org/teens-and-suicide-what-parents-should-know
  4. https://www.tspn.org/
Join us for a Child Passenger Safety Facebook Live Event

On Wednesday, September 23, the Tennessee Highway Safety Office is partnering with Tennessee Highway Patrol and Monroe Carell Jr. Children’s Hospital at Vanderbilt for “Talking Traffic Safety,” a new THSO chat series hosted via Facebook Live to celebrate Child Passenger Safety Week. Join us LIVE on the Ollie Otter Facebook page for a virtual Q&A session and panel discussion of all things child passenger safety. The public is encouraged to participate by sending questions to the speakers during the event.

Read more
Are You interested in learning more about Child Passenger Safety?

We are now offering online webinars that offer important safety information about Child Passenger Safety. If you interested in learning more, or about us partnering with your organization, please contact us! 

Learn more about Online Webinars for Child Passenger Safety
How to make Race Car Snacks

Easy recipes for your child to learn how to cook while having fun in the kitchen! 

Click for Recipe
Meet the Injury Prevention Team


Purnima Unni

is the Pediatric Trauma Injury Prevention Program Manager for Monroe Carell Jr. Children’s Hospital at Vanderbilt. She has a Masters in Public Health and is a Certified Health Education specialist with over 20 years of experience in injury prevention. She is a wife and mother of two girls and her rescue puppy. She loves to cook, travel and watch murder mysteries.

Eppiphanie Richardson

is an Atlanta native who decided to take on Nashville as her newest adventure. She is also the Associate Program Manager for the Be in the Zone-Turn Off Your Phone Campaign which educates teens and parents on the dangers of distracted driving. She has a passion for healthcare and serving others. She feels privileged to be able to serve Monroe Carell Jr. Children’s Hospital at Vanderbilt. In her free time, she enjoys exploring Nashville, dancing, running, and spending time with her husband and son.

Mimi Sanders

is a Nashville native and received her Masters from Vanderbilt University. She is the Associate Program Manager for the Kohls Seat Smart Program, which focuses on educating caregivers, children, and community partners on the importance of car seat safety. She is so excited to join the team at Monroe Carell Jr. Children’s Hospital at Vanderbilt. In her free time, she enjoys volunteering with her local church’s special needs ministry, hanging out with family and friends, and doing yoga


Visit our Website
Resources from our generous partners
Tips about Child Passenger Safety
Click for Tips from Safe Kids
Tips from AllState about Returning to School
Click for Tips from AllState
Tips for Teens and Safe Driving
Click for Tips
Thank you to our generous partners and organizations
Safety Source Newsletter-Weekly Edition

2200 Children's Way, Nashville
TN 37232 United States

This newsletter is brought to you by the Pediatric Trauma Injury Prevention Program and Kohl’s Stay Seat Smart Program at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

Unsubscribe