How to Prevent Heat Stroke: Guidelines from Children’s Hospital of Philadelphia

CHOP

When summer heat grows intense, parents need to be mindful of their children’s health. But pediatricians at Children’s Hospital of Philadelphia (CHOP) say there’s no reason to stay indoors all day.

“Kids need outdoor time all year round,” says David Pollack, MD, a CHOP pediatrician. “The activity, the sunlight, the fresh air, and the exposure to nature are all important for their health. And older kids benefit from detaching from computers and electronic devices. On the hottest summer days, parents simply need to observe some common-sense guidelines and pay close attention to how their kids are feeling.”


Recognize the signs of heat exhaustion or heat stroke
Watch for these signs of overheating and heat-related illness:

  • Symptoms of heat exhaustion include pallor (an unhealthy pale appearance), weakness, headache, nausea, muscle cramps or fainting. If you notice any of these signs, even subtle ones, cool your child off and have them drink extra fluid right away.
  • Symptoms of heat stroke include high fever, flushed skin, confusion or loss of consciousness. This condition warrants a call to 911.

    While heat exhaustion and heat stroke can be scary, your child is unlikely to experience them if you follow simple precautions. Dr. Pollack offers these guidelines to stay safe and comfortable on hot days and prevent overheating.

Avoiding heat-related illness in babies and young children
Babies and young children are at greater risk of overheating because they sweat less, which limits their ability to cool down in the heat.

  • Take special care not to overdress babies when the weather is hot.
  • Give them extra fluid to drink — more breast milk or formula, or plenty of additional water if they are weaned. Breastfeeding mothers should also drink extra water on hot days.

Avoiding heat-related illness in children of all ages
When your children are old enough to understand and communicate how they’re feeling, remind them to pay attention to their bodies in the heat, and to tell an adult if they don’t feel well or need to take a break.

  • Keep them hydrated. Remind your kids to drink water regularly, all day long. Bring water with you when you go out so it’s always available. Monitor urine output. If your kids aren’t peeing, they are likely not drinking enough.
  • Dress them in light clothes. Children, like adults, need light clothes in hot weather — light in weight and color. Dark colors absorb heat from sunlight, while light colors reflect it. Choose clothes made from lightweight, breathable fabrics, the type of clothing you would be comfortable in when out in the heat.
  • Go outside when the sun is low and the air is at its coolest, in the morning and late afternoon or evening. The hours between noon and 4 p.m. are the most dangerous for heat exposure in very hot weather. Use that hottest part of the day for your indoor activities and for resting.
  • Allow extra time for rest. Heat is tiring, and especially tiring for children. Plan your day with breaks for everyone.
  • Help your kids cool off. Give them a cool bath or spray them with a water mist. Run their wrists and ankles under cold water. Wipe their heads with a wet towel. If you have a place to swim, bring them, taking care to stay out of the full sun between noon and 4 p.m.
  • Never leave a child unattended in the car. Cars heat up quickly to dangerous temperatures when parked in the sun, even when it isn’t hot outside. When you park, check the back seat to make sure everyone is out of the car before you leave it.
  • Keep your home cool. If you don’t have air conditioning, open windows for ventilation and run a fan.
  • Find air-conditioned public spaces. You might spend part of your day at the library or a mall. Many cities and communities have "cooling centers," which may be libraries or community centers with AC that residents can utilize if they don't have AC in their homes.


How to prevent heat illness in young athletes
There are a few additional precautions to keep in mind for young athletes exercising during summer months. To stay cool while playing sports in the summer and early fall, Naomi Brown, MD, FAAP, CAQSM, a pediatric sports medicine specialist at CHOP, offers the following tips:

  • Get acclimated to the heat. If your child has been spending a lot of time in air conditioning, have them do light exercise outside for 10-15 minutes at a time, to start getting them used to the hot weather. It can take 10-14 days for young bodies to get used to exercising for extended periods of time in the heat. 
  • Train in the morning or evening. If possible, have your child do outdoor training in the early morning or later in the evening. They should avoid exercising during the hottest part of the day, specifically between 10 a.m. and 4 p.m.
  • Stay hydrated. In addition to water, young athletes can benefit from electrolyte replacement if they are sweating more than usual. Make sure they’re staying hydrated with water and supplement with a sports drink like Gatorade.
  • Use the buddy system. Tell your child the symptoms of heat illness: dizziness, headache, vomiting, unusual behavior and disorientation. This way, they can tell a parent or coach if they’ll feeling ill or see one of their teammates struggling with the heat. This is especially true if your child has the sickle cell trait, as they are at increased risk of heat-related illness.
  • Wear sunscreen and light-colored clothes and be aware of the medications your athlete is taking. For example, antihistamines that include diphenhydramine decrease sweating and doxycycline increases sun sensitivity.

Parents and caregivers can follow these guidelines to help keep everyone in the family cool and healthy on those steamy summer days.

This article was contributed by Children’s Hospital of Philadelphia, King of Prussia, a partner of the YMCA of Greater Brandywine.