Children sweat less than adults. This makes it harder for children to cool off. Parents and coaches must make sure that children take it slow to be sure they can get used to the heat and humidity gradually. There are other reasons why a child may become ill from a heat illness. Those who have a low level of fitness, who are sick, or who have suffered from dehydration or heat illness in the past should be closely watched.

Dehydration -

Children get dehydrated if they do not replace body fluids lost by sweating. Being even a little dehydrated can make a child feel bad and play less effectively. Dehydration also puts children at risk for more dangerous heat illnesses.

Signs and Symptoms

Dry mouth

Thirst

Being irritable or cranky

Headache

Seeming bored or disinterested

Dizziness

Cramps

Excessive fatigue

Child not able to run as fast or play as well as usual

Treatment

Move child to a shaded or air-conditioned area.

Give him or her fluids to drink.

"When can I play again?"

A child may be active again as soon as he or she is symptom-free. However, it’s important to continue to watch the child.

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Heat Cramps- Heat cramps are a mild heat illness that can be easily treated. These intense muscle spasms usually develop after a child has been exercising for a while and has lost large amounts of fluid and salt from sweating. While heat cramps are more common in children who perform in the heat, they can also occur when it’s not hot (for example, during ice hockey or swimming). Children who sweat a lot or have a high concentration of salt in their sweat may be more likely to get heat cramps. Heat cramps can largely be avoided by being adequately conditioned, getting used to the heat and humidity slowly, and being sure a child eats and drinks properly.

Signs and Symptoms

Intense pain (not associated with pulling or straining a muscle)

Persistent muscle contractions that continue during and after exercise

Treatment

The child should be given a sports drink to help replace fluid and sodium losses.

Light stretching, relaxation and massage of the cramped muscles may help.

"When can I play again?"

A child may be active again when the cramp has gone away and he or she feels and acts ready to participate. You can help decrease the risk of recurring heat cramps by checking whether the child needs to change eating and drinking habits, become more fit, or get better adjusted to the heat.

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Heat Exhaustion- Heat exhaustion is a moderate heat illness that occurs when a child continues to be physically active even after he or she starts suffering from ill effects of the heat, like dehydration. The child’s body struggles to keep up with the demands, leading to heat exhaustion.

Signs and Symptoms

Child finds it hard or impossible to keep playing

Loss of coordination, dizziness or fainting

Dehydration

Profuse sweating or pale skin

Headache, nausea, vomiting or diarrhea

Stomach/intestinal cramps or persistent muscle cramps

Treatment

Move child to a shaded or air-conditioned area.

Remove any extra clothing and equipment.

Cool the child with cold water, fans or cold towels (replace towels frequently). ◆ Have child lie comfortably with legs raised above heart level.

If the child is not nauseated or vomiting, have him or her drink chilled water or sports drink.

The child’s condition should improve rapidly, but if there is little or no improvement, take the child for emergency medical treatment.

"When can I play again?"

A child should not be allowed to return to play until all symptoms of heat exhaustion and dehydration are gone. Avoid intense practice in heat until at least the next day, and if heat exhaustion was severe, wait longer. If the child received emergency medical treatment, he or she should not be allowed to return until his or her doctor approves and gives specific return-to-play instructions. Parents and coaches should rule out any other conditions or illnesses that may predispose the child for continued problems with heat exhaustion. Correct these problems before the child returns to full participation in the heat, especially for sports with equipment.

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Exertional Heat Stroke- Heat stroke is a severe heat illness that occurs when a child’s body creates more heat than it can release, due to the strain of exercising in the heat. This results in a rapid increase in core body temperature, which can lead to permanent disability or even death if left untreated.

Signs and Symptoms

Increase in core body temperature, usually above 104°F/40°C (rectal temperature) when the child falls ill

Central nervous system dysfunction, such as altered consciousness, seizures, confusion, emotional instability, irrational behavior or decreased mental acuity

Other possible indicators include:

Nausea, vomiting or diarrhea

Headache, dizziness or weakness

Hot and wet or dry skin

Increased heart rate, decreased blood pressure or fast breathing

Dehydration

Combativeness

Treatment

Call emergency medical services for immediate transport to the nearest emergency medical facility.

Begin cooling the child while waiting for and during transport to the emergency facility.

Remove extra clothing or equipment. Begin aggressive whole-body cooling by immersing the child in a tub of cold water. If a tub is not available, use alternative cooling methods such as cold water, fans, ice or cold towels (replaced frequently), placed over as much of the body as possible.

"When can I play again?"

No child who has suffered heat stroke should be allowed to return until his or her doctor approves and gives specific return-to-play instructions. Parents should work with the child’s doctor to rule out or treat any other conditions or illnesses that may cause continued problems with heat stroke. The child should return to physical activity slowly, under the supervision of an ATC or other qualified health care professional, especially for sports with equipment.