Children are more prone to heat illness than adults because they have more body surface area per pound of weight. Young athletes, practicing hard in summer heat, are at particular risk. Learn to recognize the early warning signs of heat stress. Your knowledge could save a child's life.

Symptoms of Dehydration

• Thirst
• Fatigue
• Irritability
• Dry mouth
• Feeling hot

When children complain of thirst, feeling hot, or just seem irritable in the heat, they may have early dehydration. Get the child out of the sun into a cool, comfortable place. Have the child start drinking plenty of cool fluids such as water or sports drinks. (Sugary fruit juices or sodas with more than 8% carbohydrates are not absorbed as rapidly by the body.) The child should also take off any excess layers of clothing or bulky sports equipment. You can put cool, wet cloths on overheated skin.

If these symptoms are ignored, more serious heat illness such as heat exhaustion or heat stroke can occur.

Symptoms of Heat Illness Associated With Dehydration

• Heat cramps: Painful cramps of the abdominal muscles, arms, or legs.
• Heat syncope: Weakness, fatigue, or fainting after exercising in heat.
• Heat exhaustion: Profuse sweating, fatigue, headache, dizziness, loss of appetite, nausea, vomiting, chills, weakness, excessive thirst, muscle aches and cramps, vision problems, flushing, agitation or irritability, and sometimes unconsciousness.
• Heat stroke: High body temperature (often it's 104°F-105°F or higher) and rising, nausea and vomiting; seizures; disorientation or delirium; hot, dry skin; unconsciousness; coma; shortness of breath; decreased urination; or blood in urine or stool.

Note that there are other illnesses that can occur when exposed to the heat, such as prickly heat (heat rash) or heat edema (swelling of the arms and legs), but those are not associated with dehydration.

How to Treat Heat Illness Associated With Dehydration

There is a lot you can do for a person experiencing symptoms of a heat illness related to dehydration. First, call for help. Next, take the child to a cool, shady place and encourage him or her to drink plenty of liquids. If the child is experiencing a milder heat illness, rest and rehydration with water or a sports drink may be all that's needed. More severe heat illnesses require immediate medical attention.

Heat cramps. This is one of the mildest forms of heat illness. When a young athlete experiences heat cramps, pull him or her off the field into a cool area and gently stretch the affected muscle.  "Have them drink, drink, drink, and then drink more," says Albert C. Hergenroeder, professor of pediatrics at Baylor College of Medicine and chief of the sports medicine clinic at Texas Children's Hospital.

"High-sodium drinks will prevent children from getting heat cramps," says Jackie Berning, PhD, with the National Alliance for Youth Sports. "Gatorade has just enough sodium to prevent those cramps. But if you're a heavy sweater, and you're still getting cramps after drinking Gatorade, eat some salted pretzels or salted nuts. Those work fine." If the cramp goes away, the child can go back out to the game or practice but should be carefully monitored.

Heat syncope. Heat syncope is an episode of fainting or dizziness that occurs with prolonged standing or after suddenly rising from a standing or sitting position. In severe instances, the child may lose consciousness. People who exercise without a cool-down period, are dehydrated and aren't acclimatized to the hot conditions are more likely to experience this problem. Treatment consists of lying the person down and giving fluids if possible. If the person is unconscious or not able to drink, seek medical attention immediately.

 

Heat exhaustion. Heat exhaustion requires immediate attention. Symptoms include dizziness, nausea, vomiting, headaches, weakness, profuse sweating, excessive thirst, muscle aches and cramps, agitation or irritability, and sometimes unconsciousness. "This is a child who looks really wiped out and has symptoms of a clear problem to the casual observer, but her temperature is still less than 104," says Hergenroeder. Heat exhaustion requires immediate attention but is not usually life-threatening. However, in some cases, heat exhaustion can lead to heat stroke which requires emergency medical treatment.

Just as with heat cramps, a child with heat exhaustion should be brought to a cool place and given plenty of fluids. The child should not be allowed to play or practice again that day.

If the child is becoming unconscious or confused, has a seizure, difficulty breathing, vomiting or diarrhea, seek medical attention immediately.

 

Heat stroke. Heat stroke is a medical emergency. Heat stroke is characterized by a high body temperature (often it's 104°F-105°F or higher) and marked symptoms, including nausea and vomiting; seizures; disorientation or delirium; hot, dry skin (although in some cases a person with heat stroke has profuse sweating); unconsciousness; coma; shortness of breath; decreased urination; or blood in urine or stool. It can occur suddenly, without any symptoms of heat exhaustion. "A child with heat stroke is going to the emergency room immediately, packed in ice, with IV fluids," says Hergenroeder.

 

For a child with heat stroke, cool the body while awaiting the ambulance by removing clothing and placing ice bags on the neck, in the armpits, and the groin areas. Fan the person and spray with cool water. If she is awake and able to swallow, give fluids.

 

Reviewed by Charlotte E. Grayson, MD.

 

Published May 2004.

 

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SOURCES: Albert C. Hergenroeder, professor of pediatrics, Baylor College of Medicine; chief, the sports medicine clinic, Texas Children's Hospital. Jackie Berning, PhD, with the National Alliance for Youth Sports. Heat-Related Illness. American Family Physician, Sept. 1, 1998. WebMD Medical Reference from Healthwise: Heat-Related Illness.