TAME THE HEAT: DANGERS OF HEAT STROKE IN CHILDREN

Summer is here, and Delhi will get hot and dusty.  Alongside mangoes, this season brings with it the risk of heat-related illness. Sweating heavily without replacing enough fluids can lead to dehydration or heat cramps. If the body cannot shed enough heat for any reason, there is a risk of heat exhaustion and, in extreme cases, heat stroke - a medical emergency.

WHY ARE CHILDREN MORE VULNERABLE TO HEAT STROKE?

Children are particularly vulnerable to heat-related illnesses, because their bodies have a greater surface area-to-body mass (which causes a greater heat gain). They tend to produce more metabolic heat per mass and their sweating capacity is considerably lower in children than in adults.

ARE THERE OTHER KINDS OF HEAT RELATED INJURIES OTHER THAN HEAT STROKE?

Heat injuries can be viewed as a continuum of illnesses relating to the body's inability to cope with an increase in heat load. They can be heat cramps, heat exhaustion and the feared heat stroke.

Checkout - Impact of Heat Waves on Children’s Health

WHAT ARE THE MILDER VERSIONS OF HEAT RELATED ILLNESSES?

1. Heat Cramps are acute, painful and involuntary muscle contractions that occur during or after intense exercise sessions in the heat. Heat cramps are associated with fluid deficiencies (that can lead to dehydration), electrolyte imbalances and neuromuscular fatigue. They can be earliest indications of heat injuries and may occur independently or with other symptoms of heat exhaustion.
2. Heat exhaustion: Heat exhaustion is caused by loss of water and salt, often as a result of exercise in hot weather. If it is not treated, it may progress to heat stroke. Symptoms of heat exhaustion include (but are not limited to)   normal or elevated body temperature, although not as high as 40°C (104°F),   profuse sweating, pale skin, fast, shallow breathing, fast, weak pulse, headache, nausea, vomiting, dizziness, weakness, or fainting, heat cramps and   exhaustion .If his symptoms are severe, or if your child seems confused or disoriented or is behaving oddly, it is imperative to take him to a doctor right away.

WHAT IS HEAT STROKE?

It is an acute, life-threatening emergency, which results from an overload or impairment of heat-dissipating mechanisms. It is defined as a core temperature ≥40 to 41°C (104 to 105.8°F) accompanied by central nervous system dysfunction in patients with environmental heat exposure.

WHO IS AT RISK?

At risk are the elderly, infants, the obese, people with hyperthyroidism, and those taking certain drugs.

WHAT ARE THE MAIN SIGNS OF HEAT STROKE?

The main signs that indicate heat stroke are increase in core body temperature, usually above 40° C (104° F) ,  central nervous system dysfunction, which may take the form of altered consciousness, seizures, confusion, emotional instability( including irritability, aggressiveness, apathy) or irrational behaviour .It can progress to  seizures and even coma.

Other possible signs of heat stroke include(but are not limited to)   nausea, vomiting,  diarrhoea ,headache,  dizziness or weakness ,  hot and wet or dry skin ,  increased heart rate alongside  fast breathing .

WHY ARE WE AFRAID OF HEAT STROKE?

If child is not treated promptly, it can result in multi-organ failure. This process may include muscle breakdown, renal impairment, difficulty in breathing and requirement of ventilation (ARDS). It can also cause impairment in clotting (DIC), injury to organs as heart, intestines, liver, pancreas among others. In such a case, your child will need admission to PICU, and will need rapid cooling, dialysis among other treatments.

SO, WHAT CAN WE DO?

• Children should wear clothing that is light-coloured and lightweight to facilitate body cooling.
• Plan their physical activities and rest breaks in accordance with the intensity of activity and environmental conditions, if possible limit outdoor activities.
• Try activities such that they stay out of direct sunlight and crowded areas.
• Make sure they drink non-alcoholic, non-diuretic fluids. Water is a good option, but children may drink more of a flavoured beverage such as juice .
• Cool the body with water.
• NEVER leave children or pets alone in a car, even for a few minutes. Cars can heat up to dangerous temperatures very quickly. Children who are left unattended in parked cars are at very high risk for heat stroke, and possibly death.

ANY SPECIAL PRECAUTIONS FOR CHILDREN PLAYING SPORTS?

Children who exercise in the heat are at higher risk than adults, because they produce more heat, sweat less, and may forget to drink enough.

• Make sure the coach or supervisor is knowledgeable about exercising in the heat and that there is a plan for dealing with heat-related illnesses if they arise.
• Reduce the intensity of exercise when it is very hot, humid, or sunny.
• Make sure children take frequent breaks.
• They should preferably wear lightweight, light-coloured clothing.
• Make sure children are well hydrated before exercising, and regularly when exercising. 
• IMPORTANTLY, seek medical care immediately if your child has symptoms of heat related illness.