Signs of Heat Stroke in Kids
If you’ve been watching the news, you will know that there are heat-wave alerts around the country. In my area, our heat index is in the 90s.
Unfortunately, it is VERY easy to unknowingly become over-heated (especially for kids). Their bodies don’t regulate temperature as efficiently as ours, and they may not always realize / let us know if something feels wrong.
Which means that you, as the parent, need to know what to watch for. Lets dive in!
What is heat illness?
Heat illness is a spectrum that ranges from mild overheating (like heat cramps or heat exhaustion) to severe, life-threatening heat stroke.
(For a nerdy deep dive: When our bodies are exposed to too much heat and humidity, they cannot cool themselves down efficiently. This is especially true when the temperature is >90-95 F (32-35 C) and the humidity is >75%, so in these conditions we need to be extra vigilant about heat injury)
The bottom line: Signs of heat stroke
Be on the lookout for:
Flushed skin or feeling hot to the touch
Heavy sweating (early stages) or dry, hot skin (late stage = danger)
Fatigue, weakness, or dizziness
Nausea or vomiting
Rapid breathing or heart rate
Confusion or irritability
Headache
Fainting or extreme sleepiness
If your child has a temperature over 104°F or shows signs of confusion, difficulty staying awake, is vomiting, this may be heat stroke, which is a medical emergency.
Preventing heat stroke
Stay inside if the heat index is above 100F. If it is above 90F, minimize outdoor time as much as possible (eg sports).
Avoid outdoor activity during peak sun hours (11am–4pm)
Stay hydrated throughout the day (not just when thirsty). Click here for dehydration red flags.
Take frequent breaks in the shade or indoors every 20–30 minutes
Wear lightweight, breathable clothing
Never leave children in a parked car, even briefly
Layer methods of sun protection (sunscreen, hat, etc). Click here for product recommendations. Remember: sun protection is not the same as heat protection!
Is heat injury serious?
It can be if it is not caught quickly enough, but (I assume) you are reading this because you want to know what to watch for… and how to fix it. Heat illness can happen in 4 stages:
Stage 1: Over-heating
Usually mild, but — especially in younger kids who cannot communicate as well — watch for these non-verbal signs that they’re too hot:
Flushing
Sweating excessively
Thirst
Heat rash (see here for pictures and tips)
Decreased peeing or other signs of dehydration
Dizziness
Note: core body temperature may not be elevated
What to do:
Get out of the heat: go into natural shade, or an air conditioned room/car
REST. Physical activity can increase heat production and stress on the body.
Consider touching base with your pediatrician, esp for younger infants
Push electrolyte-containing fluids (see here for which are best and how much to give)
The Pediatrician Mom Tip: DO NOT give fever-reducing medications. Remember: the body is not over-heating because of a change in its own “set-point” so the fever-reducer will not work. Especially when dehydrated, fever-reducers can also harm kidneys.
Stage 2: Heat Cramps
Similar symptoms as above, PLUS:
Muscle pain (especially large muscles = arms, legs, belly)
Increased fussiness in a young child who may not be able to tell you they are in pain
Some people don’t think of heat cramps as a different category, but I think it is a useful way to think about it as a red flag that things are moving past just being over-heated.
What to do:
Same as above, PLUS:
Gentle massage of affected muscles
Talk to your pediatrician and consider seeking medical care. Sometimes IV fluids are needed.
Stage 3: Heat Exhaustion
At this point, the body has over-heated enough that it can no longer easily cool itself down — so the risk is much higher of serious outcomes.
Same as above, PLUS:
Body temperature may be elevated, but likely is still going to be below 104F ( 40C)
Rapid shallow breathing
Rapid heart beat, sometimes the pulse can feel weak
Nausea or vomiting
Heavy sweat
Thirst
Other signs of dehydration
The skin many be hot or cold and clammy.
Dizziness, headache, a sensation of light-headedness when standing
Sometimes mild confusion, but returning to normal quickly with cooling
What to do:
Seek medical care ASAP. In the meantime:
Get out of the heat: go into natural shade, or an air conditioned room/car
REST (remember: physical activity can increase heat production)
Remove excess clothing
Cool down quickly: cool bath/shower, spray, fan, cool packs to neck, groin, armpits
Push cool electrolyte-containing fluids
May need IV fluids, bloodwork, imaging, etc
The Pediatrician Mom Tip: Do NOT give fever-reducing medications.
Stage 4: Heat Stroke
This is potentially fatal, and is a result of the body no longer being able to control internal temperature. The body temperature rises rapidly and these patients need emergency treatment.
Symptoms may include all of the above, PLUS some or all of:
Elevated core body temperature (above 104F / 40C)
Altered mental status (confusion, hallucinations, delirium, sometimes fainting/loss of consciousness)
Rapid shallow breathing
Rapid heart rate, weak pulse
Nausea and vomiting
Skin may be flushed or may be pale, cool and clammy
Seizures
What to do:
Seek medical care ASAP. In the meantime:
Follow the same measures as above under heat exhaustion.
Do not give fever-reducing medication.
These patients often need to be admitted to the ICU.
