Heat Exhaustion And Heat Stroke In Kids: Signs And Treatment

Heat strokes in kids may occur when your child’s body temperature spikes up. As a result, they may start showing signs of hyperthermia (overheating).

Heat strokes, also called heat exhaustion or heat cramps, are mostly mild and may give rise to painful muscle spasms during intense activities in hot weather. However, it can be managed with sufficient fluids, electrolytes, and proper rest.

Heat exhaustion is a condition where the body temperature increases and requires cooling methods to return to normal. While, on the contrary, heatstroke is a serious heat-related ailment, where the body temperature crosses 104°F (40°C), requiring immediate medical attention (1).

This post explains the possible causes, risk factors, signs, complications, diagnoses, treatments, and preventive strategies for heat-related illnesses, such as heat exhaustion, heat cramps, and heatstroke in children.

Causes Of Heat Exhaustion And Heatstroke In Children

The normal body temperature is maintained by mechanisms of heat loss or heat gain, depending on the ambient temperature. The process of maintaining normal body temperature is called thermoregulation.

During summer, the body regulates its temperature through the secretion of sweat, which evaporates to lower the body temperature. Any failure in thermoregulation by heat loss during hot and humid conditions may result in increased body temperature, resulting in heat cramps, heat exhaustion, or heatstroke.

The following factors may reduce heat loss and often cause heat exhaustion or heat stroke in children (2).

• Strenuous activities in hot and humid weather conditions
• Exercise in children not conditioned to the exercises or the environment
• Dehydration
• A tight and thick layer of clothing
• Certain medications (eg: diuretics) or existing illness (eg: diabetes or spinalcord injuries)

Risks And Complications Of Heat Exhaustion And Heatstroke In Children

Alterations in thermoregulation of the body due to environmental or other factors are the major causes of heat exhaustion in most children. The following factors may increase the risk of developing heat-related illness (3).

• Infants and younger children under four years of age have a higher risk of an immature temperature regulation system.

• Certain medications, such as antihistamines, anti psychotics, diuretics, etc. may affect the body’s heat regulation.

• Overweight and obesity may cause retention of more heat.

• Sudden increase in the ambient temperature, like in the case of heatwaves, may cause heat exhaustion.

• High humidity could cause heat exhaustion in higher temperatures due to reduced evaporation of sweat.

Heatstroke is the major complication of heat exhaustion, and it can be life-threatening if the body temperature reaches 40°C (104°F) or more. Heatstroke is a medical emergency since it increases the risk of brain and organ damage.

Symptoms And Signs Of Heat Exhaustion And Heatstroke In Children

Heat cramps are a milder form of heat-related illness, and may result in (4):

• Painful muscle cramps
• Thirst
• Profuse sweating
• Fatigue

Heat cramps can be controlled by rest and drinking fluids with electrolytes. If left untreated, this may lead to heat exhaustion or heatstroke.

Heat exhaustion signs and symptoms may include (2):

• Moist and cool skin
• Fatigue
• Excessive sweating
• Headache
• Nausea
• Dizziness
• Weak pulse
• Low blood pressure
• Muscle cramps

These signs and symptoms may develop suddenly or gradually based on the body temperature. If you notice any symptoms of heat exhaustion in your child, reduce body temperature as soon as possible to avoid heatstroke.

Signs and symptoms of heatstroke in children may include (1):

• Body temperature of 40°C (104°F) or above
• Lack of sweating
• Confusion
• Rapid heartbeat
• Fast breathing
• Flushed skin
• Appearing weak
• Nausea
• Vomiting
• Diarrhea
• Loss of consciousness

If the child has any of the above symptoms, seek emergency medical care to avoid complications.

Diagnosis Of Heat Exhaustion And Heatstroke In Children

Measurement of body temperature is enough to determine heat exhaustion or heat stroke in children. Rectal temperature may be measured for confirmation.

The following tests may be ordered to confirm heatstroke in children (3).

• Blood tests to assess blood gases, sodium, and potassium levels

• Urine test to analyze the composition and concentration of the urine

• Muscle function tests may be done to check for rhabdomyolysis (muscle injury)

• Imaging tests such as X-ray, ultrasound, MRI or CT may be conducted to check the health of internal organs 

Treatment For Heat Exhaustion In Children

Drinking fluids with electrolytes and staying in places with cooler temperatures or under shade may reduce heat cramps in children. However, heat exhaustion and heatstroke may require more cooling methods to achieve normal body temperature.

The following home treatments may be enough to manage heat exhaustion in children (5).

• Remove tight or extra layers of clothing; loose cotton clothes are preferable

• Stay in cool places, such as in an air-conditioned room, or under a fan

• Lay down and keep legs elevated from the heart level

• Drink cool water or electrolytes

• Try a cool bath or shower if possible

• You may place a towel soaked in cold water on the skin

Do not give acetaminophen, aspirin, or any other fever medication to reduce body temperature if your child has heat-related illness since it may harm the child (1). 

When To See A Doctor

If your child is experiencing heat exhaustion, you may ask them to rest in a cooler place and drink cold water. If there are no other signs and symptoms of heatstroke, you may wait for an hour until they feel well. Contact the doctor if the body temperature is not returning to normal within this time.

If they are unconscious, confused, have a body temperature of 40°C (104°F) or more, or are unable to drink water, seek immediate medical care. 

Treatment For Heatstroke In Children

Heatstroke treatments may include (5):

• Cold water immersion, which may reduce body temperature; immersing in ice water is the preferred method.

• If cool water immersion is not possible, evaporation cooling techniques are used in the hospitals. This method involves misting cool water to the body while warm air is fanned around the child, so skin is cooled while the water evaporates.

• Packing in ice and special cooling blankets.

• Muscle relaxants, such as benzodiazepines, are given to prevent shivering since the body tends to shiver while cooling. Shivering may increase body temperature, and the cooling methods may not be effective. Muscle relaxants should be taken only if prescribed by the doctor.

The most important is to start the cooling process as soon as possible and to keep cooling the child down even during the transport to the hospital.

Children with heat exhaustion may return to the normal temperature range within half an hour, whereas heatstroke may require more time and medical treatment. Recovery time after heatstroke may vary based on the severity and other effects, such as internal organ damage. The complete recovery in extreme cases may take a few days to months (6).

Prevention Of Heat Exhaustion And Heatstroke In Children

The following tips may help prevent heat exhaustion and heat-related illnesses in children (5) (7).

• Wear loose and lightweight clothing in the summer months.

• Use sunscreens to prevent sunburn. Sunburn reduces the body’s ability to maintain a normal temperature. Wearing sunglasses and wide-brimmed hats may reduce sunburn during outdoor activities.

• Stay hydrated enough since body temperature is maintained by sweating in hot weather.

• Never leave a child in a parked car even if you parked in the shade.

• Schedule outdoor activities in the morning or evening hours when the temperature is low.

• Discuss with a pediatrician if your child has any regular medications that may increase body temperature.

• If your child is not used to hot weather, let them acclimate gradually before beginning exercise or outdoor activities.

If your child is taking any medication, is ill,  or has a history of heat-related illness, outdoor and strenuous activities should be avoided during warm and humid conditions. In unavoidable circumstances, discuss with your child’s doctor regarding the activity and precautions to prevent heat exhaustion or heat stroke.

Frequently Asked Questions

How long can heat stroke last?

The duration of a heat stroke cannot be specified as it is a serious condition requiring emergency care. However, if a child continues to feel unwell and does not cool down after 30 minutes of a heat exhaustion episode, a heat stroke may occur, and it needs to be treated medically (2).

Why does my child get overheated so easily?

Children may not realize that they are thirsty, resulting in dehydration. Additionally, children below nine years have a lesser ability to sweat, which may make them more susceptible to overheating (8).

How long does it take for a child to recover from heat exhaustion?

It should not take more than 30 minutes to recover (at least feel better) from heat exhaustion. Past this time indicates a medical emergency (2).

How do you know when a child is dehydrated?

Mild dehydration in children may cause symptoms such as dizziness, headache, nausea, dark yellow urine, less frequent visits to the toilet, dry lips, tongue, mouth, or throat. Severe dehydration can make children less active and have pale and sunken eyes, absence of tears when crying, cold hands or feet, faster breathing and heart rate, irritability, or confusion (9).

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Reviewer Author

Dr. Wayne HoughMBChB, MMed, FC Paeds

 

Dr. Wayne Hough is a pediatrician with around six years of experience in the field. He is currently based in the Northern Suburbs of Cape Town in South Africa. Dr. Hough got his medical degree from the University of Stellenbosch.

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Aastha SirohiBeauty & Lifestyle Writer

   

Aastha Sirohi is a beauty and lifestyle content writer with over three years of experience in writing for different genres. She has a master’s degree in English Literature from The English And Foreign Languages University and a bachelor’s degree in education from the University of Mysore.

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