Heat-Related Illnesses

By Dr. Ayesha Ahmad Anwar

Our Texas weather is continuing to heat up this summer, with steady temperatures in the triple digits. It’s important to know how to protect ourselves, and especially our children and young athletes, from heat-related illnesses. Heat-related illness occur after exposure to abnormal or prolonged amounts of heat and humidity, without relief or adequate fluid intake.

Children adjust more slowly than adults do to changes in environmental heat. They also produce more heat with activity than adults, and sweat less.

Children often do not think to rest when having fun, and may not drink enough fluids when playing, exercising, or participating in sports. Moreover, children do not often recognize the signs and symptoms of heat-related illness. Athletes, in particular, may feel greater pressure from peers and coaches to continue to exercise despite feeling symptoms of dehydration. Many children who have spent the summer indoors, in the comfort of air-conditioning, are also not acclimatized to being outside in hot, humid weather. It takes up to 14 days for a person to become accustomed to hot summer days, especially if they’re exercising or playing outdoors. Human bodies try to keep a constant body temperature around 98.6°F by balancing heat gain with heat loss. Exercising muscles create 10 to 20 times more heat than resting muscles. Sweating is the main way the body gets rid of excess heat. As humidity rises, sweating becomes less effective at cooling the body. Body temperature will rise if the body is unable to get rid of excessive heat, resulting in heat illness.

There are three main types of heat-related illnesses:

Heat cramps: Heat cramps are the mildest form of heat injury and consist of painful muscle cramps and spasms that occur during or after intense exercise and sweating in high heat. A person can also develop flushed, moist skin. First aid and treatment involves stopping exercise, moving to a cool place to rest, gently and slowly stretching cramped muscles, removing excess clothing and placing cool cloths on the skin, especially over the neck, underarm, and groin, fanning the skin to increase evaporation, and giving cool sports drinks containing salt and sugar. Future cramping may be reduced by improved conditioning, getting more used to exercising in hot temperatures, and drinking more salt-containing fluids.

Heat exhaustion: Heat exhaustion is more severe than heat cramps and results from a loss of water and salt in the body. It occurs in conditions of extreme heat and excessive sweating without adequate fluid and salt replacement. Heat exhaustion occurs when the body is unable to cool itself properly and, if left untreated, can progress to heat stroke. Symptoms include pale skin, temperature can be temporarily be elevated between 100-102°F, profuse sweating, nausea, dizziness, fainting, or weakness. First aid and treatment is similar to above and involves stopping exercise, moving to a shaded or air-conditioned area to rest, removing excess clothing and placing cool cloths on the skin, especially over the neck, underarm, and groin. Fan the skin to increase evaporation and give cool sports drinks containing salt and sugar. If there is no improvement, or the child is unable to take fluids, call your child’s physician or take your child to an emergency department immediately, because IV (intravenous) fluids may be needed.

Heat stroke: Heat stroke, the most severe form of heat illness, occurs when the body’s heat-regulating system is overwhelmed by excessive heat. It is a life-threatening emergency and requires immediate medical attention. Symptoms include hot, flushed skin, high temperature over 105°F, the absence of sweating, confusion or coma, and shock. First aid and treatment involves stopping any activity and moving to a shaded or air-conditioned area to rest. Begin cooling immediately by placing ice bags over the armpits and groin areas and do not wait for help to arrive. Call 911 or your local emergency medical service. Heat stroke is a life-threatening medical emergency and needs to be treated by a physician immediately. Remove excess clothing and drench skin with cool water, fan the skin to increase evaporation, offer cool fluids if alert and able to drink, and keep the feet elevated to counteract shock.

Some general guidelines to help protect your child from heat-related illnesses include the following:

  • Drink plenty of fluids before, during, and after vigorous or outdoor activities (including sunbathing), especially on hot days. Drinks of choice include water and sports drinks.
  • Avoid alcohol and fluids with caffeine such as tea, coffee, and soda, as these can lead to dehydration. Encourage athletes to drink 4 to 8 ounces every 15 to 20 minutes during any activity period.
  • Make sure your child dresses in light colored, lightweight, tightly-woven, loose-fitting clothing on hot days. Athletes should avoid the use of excessive clothing and equipment.
  • Schedule vigorous activity and sports for cooler times of the day, typically early morning or in the late afternoon/evening. Consider canceling or delaying an activity under extreme conditions. Practice for sports should be no more than one time a day, to allow athletes time to rest and recuperate.
  • Take rest periods in shady or cool areas. Schedule breaks every 10 to 15 minutes during any activity that lasts longer than 1 hour.
  • Makes sure your child is protected from the sun, by wearing a hat and sunglasses. Use a sunscreen that is at least SPF (sun protection factor) 15.
  • Increase time spent outdoors gradually to get your child’s body used to the heat. Allow athletes to gradually adjust to exercising in hot, humid weather by increasing activities slowly over the first 2 weeks of practice.
  • Teach children to take frequent drink breaks and “wet down” or mist themselves with a spray bottle to avoid becoming overheated.
  • Try to spend as much time indoors as possible on very hot and humid days.
  • Teach your child or adolescent to warm-up and cool-down before and after exercising.
  • Weigh athletes before and after each activity. Athletes should replace all of their weight lost during any exercise period prior to the next exercise period. Encourage athletes to eat a balanced diet that provides the necessary vitamins and minerals.
  • Identify athletes at high risk, such as athletes who are obese, are poorly conditioned, are not acclimated, have a current illness, are taking certain medicines, or have a history of previous heat-related problems.
  • Plan for emergencies—measure body temperature, call 911, and cool immediately.

Dr. Ayesha Ahmad Anwar is a pediatrician in Grand Prairie.