Security footage has captured a mother's distressed screams as her daughter darted out in front of a van and was left clinging to life.
Shanae Taiepa, 6, was hit on Tuesday afternoon on The Horsley Drive at Smithfield in Sydney's southwest and was taken to Westmead's Children's Hospital with critical head injuries.
The little girl's family were parked outside a doctor's surgery when she broke free from her mother's hand and ran between cars.
"Wait for us," her mother can be heard yelling, before she starts screaming as Shanae is hit.
The doctor the family was visiting ran out to perform CPR on the six-year-old until paramedics arrived.
Shanae underwent surgery on Wednesday and remains in an induced coma in a serious condition.
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"We're dealing with young children, they're impulsive, you must keep an eye on them. Safety is everything," Acting Superintendent Craig Ireland said.
The 55-year-old male van driver was taken to Fairfield Hospital for mandatory testing and returned a negative blood alcohol reading.
Police do not believe he was speeding.
"There is footage from businesses in the area that show the accident unfolding and it appears the girl just stepped into the traffic and there wasn't a great deal the driver could do," Acting Superintendent Ireland said.
Officers have urged any witnesses to come forward.