Whenever a patient comes into the emergency department with their child after being involved in a car accident, I always tell them that they need to get a new car seat. To encourage patients to get them replaced, I make sure to mention that most car insurance companies will cover the cost of these new car seats.

Recently, however, I found an interesting article by the National Highway Safety Traffic Safety Administration (NHTSA), which suggests that car seats don’t always need to be replaced after an accident. According to the website, car seats only need to be replaced if the car was involved in a moderate or severe crash, but not after minor crashes. Minor crashes were defined as follows:

  • “The vehicle was able to be driven away from the crash site;
  • The vehicle door nearest the safety seat was undamaged;
  • There were no injuries to any of the vehicle occupants;
  • The air bags (if present) did not deploy; AND
  • There is no visible damage to the safety seat”

If the car accident was minor enough to meet all of these criteria, the car seat is safe for further use. If just one of these criteria were not met, then a new car seat is in order.

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The NHTSA came up with the above criteria after analyzing studies by both the Insurance Corporation of British Columbia (ICBC) and the Insurance Institute for Highway Safety (IIHS). The studies included subjecting car seats to multiple minor car accidents, noting any damage to the car seat, and even going so far as to x-ray the car seats to guarantee that no internal damage occurred. All of the tests showed that each car seat performed just as well in each additional crash as it did the first.

The NHTSA went on to explain their concerns about people getting replacement car seats. They felt that children may be subjected to rides without any car seat whatsoever if there was an interval of time between the accident and the car seat purchase, or if a new car seat was never purchased for monetary reasons.

In an ideal world, children would not be subjected to car rides without car seats while they waited for a replacement seat. However, we know that these cases do happen, and even a minor car accident with an improperly restrained child can have serious consequences. Armed with the above information, I will no longer advise patients that they need to get a new car seat if the car accident was minor. Instead, I will loosely use the above guidelines and err on the side of caution when it comes to recommending a new seat. Hopefully by using these guidelines, it will cut down on the number of children that ride in cars without car seats and create a safer situation for children everywhere.

Jillian Knowles, MMS, PA-C, works as an emergency medicine physician assistant in the Philadelphia area.


  1. National Highway Traffic Safety Administration. Child restraint re-use after minor crashes. U.S. Department of Transportation. http://www.nhtsa.gov/people/injury/childps/ChildRestraints/reuse/restraintreuse.htm. Accessed September 10, 2015.