For children between the ages of 3 and 14, accidental injury-related deaths happen most often when riding in a car. Children are more likely to be injured, suffer more severe injuries, or die in motor vehicle crashes when they are not properly restrained. According to the CDC, car seats reduce the risk of death by 71% for infants and 54% for toddlers less than 4 years old.

With proper measures made in advance, such as the proper use of child safety seats that are appropriate for a child's age, most accidental injuries and accidental injury-related deaths can be prevented. Children can get hurt when parents or caregivers don't properly restrain them when riding in a vehicle, or are unaware of the dangers associated with certain motor vehicle situations. High-risk situations may include the following:

• Lack of the use of child safety restraints or improper use of safety restraints in motor vehicles

• Improperly used or installed child safety seats

• Placing children in front of passenger seat air bags (either in an infant safety seat or sitting facing forward)

• Allowing children to ride in the cargo areas of pickup trucks

• Trunk entrapments

• Leaving children unattended in cars

Use of safety restraints in motor vehicles

Physically, children are smaller than average adults. Their smaller size means that the standard safety belts in motor vehicles do not properly fit to protect children's bodies.

One age group, from 4 to 8 years of age, is especially at risk for improperly using safety belts in motor vehicles. According to the American Academy of Pediatrics, children don't fit in adult shoulder and lap belts (without a booster seat) until they are 57 inches tall, and between the ages of 8 and 12.

However, children between the ages of 4 to 8 years who have outgrown their child safety seat often are placed too soon in adult shoulder and lap belts without a booster seat. A booster seat is necessary if the shoulder strap of the seat belt crosses your child's neck rather than her chest and the lap belt crosses her stomach rather than her hips or upper thighs.

Use of child safety seats

Many people think they have installed their child safety seat correctly and believe they are using it properly. However, the National Highway Traffic Safety Administration proves differently. As many as 73% of child safety seats are found to be improperly installed and/or used. A child can suffer injuries or death in a motor vehicle crash if the child safety seat is not properly installed or used.

Some of the most common mistakes in installing or using child safety seats include the following:

• Safety belt not holding the seat in tightly or not in locked mode

• Harness straps not snug or positioned correctly

• Harness retainer clip not at armpit level

• Locking clip not used correctly

• Car seat recalled and not repaired (includes booster seats)

• Infants placed rear-facing in front of an active air bag

• Children turned forward-facing before reaching 2 years of age and 20 pounds

Parents and caregivers should carefully read their vehicle owner's manual and the instructions that come with the child safety seat to make sure that the seat belt is properly installed and used. Some child safety seats are not compatible with certain vehicles. Try the child's safety seat in your vehicle before you purchase it. Also, place your child in the child safety seat before purchase to make sure of proper fit.

The danger of air bags

Air bags, when properly used with the vehicles' lap and shoulder belts system, can save adult lives. However, air bags can increase the danger to a child's safety.

When infants in rear-facing child safety seats and children who are unrestrained are placed in the front seat with an air bag, they may be too close to an inflating air bag in the event of a crash. An air bag will inflate at speeds up to 200 mph, which can hurt passengers who are too close to the air bag. In addition, because of the child's size, the air bag can strike him or her on the head or neck, resulting in serious or fatal injuries.

To make that your child is as safe as possible in a vehicle, never place him or her in front of an air bag. The safest place for small children riding in vehicles is the rear seat, away from the impact of head-on crashes. If your child must ride in the front seat, move the seat as far back as possible, away from the air bag. If the car has no back seat, infants will only be safe in their rear-facing child safety seats if the vehicle has no air bag, or if the air bag has been switched off (an option in some vehicles).

Riding in the cargo area of trucks

Pickup trucks, although popular vehicles, may not be as safe as other vehicles for small children. Limited cab space often leads to parents letting their children ride in the cargo area. However, riding in cargo areas increases the risk of dying when involved in a crash. Being thrown from the cargo area is the main cause of injury and death for cargo passengers. Covered cargo areas, too, can pose a danger to children because of carbon monoxide poisoning from exhaust fumes.

The National Highway Traffic Safety Administration (NHTSA) is campaigning for stricter passenger safety laws nationwide for passengers riding in pickup trucks. Currently, 8 states prohibit people of all ages from riding in cargo areas with some exceptions. Also, 31 other states have placed certain restrictions on riding in pickup truck open beds. To protect your children, the NHTSA recommends that children never be allowed to ride or play in cargo areas of any vehicles.

Trunk entrapment

A child's nature is to explore his or her surroundings. Unfortunately, this exploration can place a child in danger. Accidental trunk entrapment, when children lock themselves in a trunk, can be fatal due to hyperthermia (heat stroke) or suffocation.

To prevent accidental trunk entrapment, teach your children not to play in and around vehicles. Always lock the vehicle and keep the keys away from children. Carefully watch your young children when they are around vehicles. Keep rear fold-down seats closed inside the vehicle.

Leaving children unattended in cars

As tempting as it may be to run a quick errand, leaving children unattended inside a vehicle, "even for a minute," can be dangerous. When left unattended, children may be able to start the vehicle or put the vehicle in neutral. In addition, heat buildup or dangerously cold temperatures inside a vehicle can quickly become fatal to children.