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Preventing Heat Related Injuries
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By: Dr. Bhumi Upadhyay, Northeast
Pediatrics
With temperatures at record highs all
around the nation, safety in this scorching heat becomes an
important topic. With the recent deaths of two children in our
local area, parents and coaches need to be aware of the signs,
symptoms and prevention of heat related injuries. Everyone is
susceptible to heat injuries, but our children are at an increased
risk due to a few factors:
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Children have decreased sweating
capacity so are unable to dissipate heat as effectively as adults.
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Children produce more metabolic heat
then adults.
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Children have more surface area to
body mass, causing increased heat gain on hot days.
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Children are less likely to stop to
rest or drink if having fun.
Adults need to be aware of symptoms of
heat related injuries. The least severe are heat cramps. The child
will have brief, painful muscle cramps, flushed moist skin and
mild fever (less then 102 F). Treatment is to move child into a
cool place, remove excessive clothing, and place cool cloth and
fan skin. Encourage child to take some water or sports drink. The
cramps are caused by excessive fluid loss with a drop in the
sodium level so sports drinks are optimal.
The next level of heat injury is heat exhaustion. The body has
lost water and salt and now is unable to cool itself down. There
are muscle cramps, fever of >102 F, pale but moist skin, weakness,
nausea, vomiting, faint feeling, and even hyperventilating
(breathing fast). Same measures are taken as with heat cramps but
more vigilance in getting immediate medical attention if child is
too exhausted to drink.
Most severe and life threatening heat injury is heat stroke. The
body has completely lost its ability to regulate its own
temperature. The skin is warm and dry and the body temperature is
usually above 104 F. Other associated symptoms are severe
headache, nausea, vomiting, dizziness, confusion, hallucinations,
coma and even death. Treatment is to call 911 immediately and
proceed with the other measures while awaiting their arrival.
Immediately go indoors, undress child, sponge child with cool
water, followed by fanning. Do not give fluids unless child is
alert. Place ice bags under arms and in groin area and have child
lie down with feet slightly elevated.
The most important is PREVENTION. Here are some recommendations
from the American Academy of Pediatrics.
-At the beginning of any exercise/athletic program, the child
should be acclimatized which means there should be limited
intensity and duration, and gradual increase over 10-14 days.
-Child should be well hydrated prior to activity and continue to
have drink breaks every 20 minutes. Please do not rely on the
child to take the breaks. There should be mandatory scheduled
breaks by the parents and coaches. A good guideline is 5 ounces of
fluid every 30 minutes for an 80 pound child and 9 ounces every 30
minutes for a 130 pound adolescent. Water is a perfect drink.
Sports drinks are good in that they have a small amount of salts
that may increase the thirst and the flavoring increases desire
for child to drink. Avoid salt tablets to increase thirst because
it has too much sodium concentration. Also avoid caffeine drinks
which increase dehydration since it acts as a diuretic.
-Child should wear light colored loose clothing, limited to only
one layer. Sweat saturated shirt should be changed to a dry shirt.
-Teach child to come indoors when feeling overheated.
-Give child a spray bottle to mist self during activity.
-Child should wear hat and sunglasses if possible and have on sun
block.
-Heavy activity should be limited to before noon and after 6 pm.
-All outdoor physical activities should be cancelled if
temperature is above 84 F, especially with humidity >70%.
-Extra caution should be taken with children with higher risks,
such as cardiac conditions, diabetes, obesity, cystic fibrosis.
With school starting, parents and coaches need to be exceptionally
vigilant with prevention and diagnosing heat related injuries.
School and recreational sports are beginning, so let’s keep our
children safe!
Dr. Bhumi Upadhyay, a Board Certified Pediatrician and active
member of the American Academy of Pediatrics, graduated from the
University of Miami six year Honors Program in Medicine. She
completed her residency at The Childrens Hospital of Michigan and
has been practicing in the Tampa bay area for five years.
Northeast Pediatrics is a new solo pediatric practice, which
opened on November 1st 2005. Our mission is to provide personal
pediatric care to families of our community. We are accepting new
patients please call to get to know the doctor 526-PEDS.
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