Preventing Heat-Related Illness

Playing outside in all types of weather and temperatures is healthy and promotes the benefits derived from exercise. However, a young child’s body cannot adapt to changes in temperature like older children and adults can.

Children’s bodies absorb more heat on a hot day (and lose heat more rapidly on a cold day). They do not perspire as easily as adults, so they are less able to cool off by sweating.

Heat illness occurs when the body is unable to cool off. Factors that commonly lead to heat illness in young children include wearing too many clothes, playing vigorously in extremely hot weather, and not drinking enough fluids. High humidity also can be a major factor even without extremely high air temperatures.

There are three main forms of heat illness: dehydration, heat cramps and exhaustion, and heat stroke.

Dehydration

Young children are prone to dehydration in warm weather, especially when overexposed to the sun. By the time a child feels thirsty, he or she may already be mildly dehydrated.

Dry or sticky lips and mouth, fatigue, dizziness, and lightheadedness may also indicate dehydration. A child who does not urinate for six hours or longer, or whose skin does not immediately flatten when softly pinched and released may also indicate dehydration.

If caught early, dehydration can be treated by giving fluids and removing the child from the heat. Serious dehydration should be treated as a medical emergency; and hospitalization, along with intravenous fluids, may be necessary. Dehydration can quickly become serious, especially for infants or very young children.

To prevent dehydration in young children, encourage them to drink plenty of water, especially when playing outside on warm or sunny days. If possible, schedule outdoor physical activities for the cooler parts of the day.

Heat Cramps and Heat Exhaustion

Heat cramps are an early warning sign that the body is having difficulty adjusting to the heat. They are brief, severe cramps that usually affect the leg, arm, or abdomen, and may occur during or after playing or exercising in extreme heat.

Children are most likely to get heat cramps when they have not been drinking enough fluids. To treat, move the child to a cool place, allow him to rest, and give fluids (water) to drink. Lightly massaging the cramped muscles also may help.

Body fluids are lost through heavy sweating during exercise or other strenuous activity. This can lead to a more severe heat illness--heat exhaustion.

The child with heat exhaustion may appear weak and tired, have clammy skin from sweating, and complain of a headache. The child may also have nausea and/or vomiting, diarrhea, temperature more than 102° F, and complain of cramps.

If heat exhaustion is suspected, immediately move the child to a cool area, loosen or remove clothing, and sponge the child’s body with cool water. Give the child fluid (preferably water) to drink, and allow the child to rest. Contact a healthcare provider and call the child’s parent.

Heat Stroke

Cooling the body is essential because if left untreated, the child’s body temperature may continue to rise, resulting in heat stroke. Call for emergency medical services (EMS) if:

• The child’s body temperature rises quickly. The skin may be hot and is usually dry.
• You observe any symptoms of heat stroke such as headaches, dizziness or weakness; disorientation, agitation, or confusion; sluggishness or fatigue; or seizure.
• The child shows symptoms of shock, such as a weak, rapid pulse, shallow breathing, unresponsiveness, or unconsciousness.
• The child does not feel better in a few minutes.

Heat stroke is a life-threatening medical emergency. Body temperature can quickly rise to 108° F or higher, and the child can go into shock or coma.

While waiting for EMS, cool the child’s body fast! Take the child to a cool place, remove clothing, and sponge or pour lots of cool water over the child’s head and body. Avoid getting water in the child’s mouth or nose. You may also place cloth-wrapped ice packs in the child’s armpits and groin.

Preventing Heat Illness

The main way to prevent heat illness in children or adults is by using common sense. Here are a few simple steps that you can take to keep everyone healthy during the hot weather:

• Drink plenty of fluids, especially water. The body does not use thirst to indicate you are becoming overheated, so a constant fluid intake prior to and during exercise is necessary.
• Teach children to take frequent drink breaks and “wet down” or mist themselves with a spray bottle to avoid becoming overheated.
• Dress children appropriately in light weight clothing. Wide-brimmed hats provide wearable shade.
• Keep children inside or in the shade during midday or when the weather is hot.
• Be aware of any medical conditions, or medications, which may cause a child to be more heat sensitive.
• Pay attention to weather conditions, including the humidity.

Parents and caregivers need to understand the heat index which correlates temperature and humidity with the body’s ability to cool itself. This means that while the actual air temperature may be 90° F, it may feel like 105° F to the body! Children with chronic health problems, or those who take certain medicines, may be more susceptible to heat-related illnesses.

Never leave a child (or pet) in a vehicle during warm weather. Even with the windows down, the inside temperature of a vehicle can quickly reach 120° F.

Even if children are swimming in a pool or beach, you still have to be aware that high humidity and heat are a potential threat. Young children can safely play outdoors in warm weather provided that necessary precautions are taken.

Understanding weather conditions, using shaded areas along with proper clothing and sunscreen, and ensuring that children drink plenty of water are important steps to prevent heat-related illness. When the weather conditions put children at risk, take the children outside in the early morning hours and reserve the hottest hours of the day for inside activities.

Elaine Abrams, RN
Certified Health Educator and Community Health Coordinator, Nursing & Home Care, Wilton, CT and 2008 Recipient of the CT Nightingale Award for Excellence in Nursing

Internet Resources

American Red Cross, www.redcross.org/services/hss/tips/heat.html

Centers for Disease Control & Prevention, www.bt.cdc.gov/disasters/extremeheat/heattips.asp

Heat Index Calculator, www.drreddy.com/heat.html

Kid’s Health, www.kidshealth.org/parent/firstaid_safe/emergencies/heat.html

Medline, www.nlm.nih.gov/medlineplus/heatillness.html

Wisconsin Childcare Improvement Project, www.wccip.org/PIS_preventing_heat_exhaustion.html