Heat illness

What a scorcher we had early this week.  We’re really in the “dog days of summer” now.  And I write about this as most fall sports teams, including youth football, are beginning pre-season training.  So be aware of heat related sports injuries.

There are several factors that put especially younger children at greater risk for this problem:

  • Children’s body proportions are different–the younger the child the greater the head:body size ratio.  That means children expel more heat from their heads compared to adults.  Put a helmet on that kid’s head and he holds more body heat compared to an adult.
  • Children sweat less so have more difficulty dissipating internal heat.
  • Conditioning–young children tend not to prepare with off season training as much so are more prone to difficulties early on.
  • Experience–young athletes often may not understand their own limitations and may not have the insight or ability (or courage) to recognize their own distress and communicate this to coaches.
  • Obesity–obese adults may exercise but they tend not to be on teams as much so they have less peer pressure to keep up (and note that peer pressure is a much bigger issue for children and adolescents)
  • Medications, like anti-histamines, increase the risk of dehydration.

There are 4 levels of heat injury

  1. Dehydration–symptoms are dry mouth, thirst, fatigue, headache, cramps.  Treat with rest, fluids, move to cool place.  Child may resume play when symptoms resolve
  2. Heat cramps–intense abdominal or limb pains and knotted muscles.  Treat as above with high sodium fluids (like gatorade) and stretching.  Again, may return when symptoms resolve.
  3. Heat exhaustion–pale skin, profuse sweating, dizziness, fainting, severe nausea and cramps.  The child should stop playing, all extra clothing and equipment removed, cooled and treated aggressively with fluids.  If symptoms do not quickly improve seek prompt medical attention.  No return to sports until the next day at the earliest and a modified schedule at that, especially if it’s a hot day (dehydration tends to recur).
  4. Heat stroke–high fever, dry skin, altered consciousness (confused, agitated, combative, even seizures) plus the above cramps, nausea, headache, etc.  Frankly, if this occurs, somebody screwed up pretty badly.  Heat stroke is a medical emergency and the child should be transported to the nearest ER, preferably by ambulance.

Principles of treatment involve prevention mostly.  Lots of fluids during practice, adequate rest periods, proper equipment for weather conditions (no helmets or pads during hot, humid days), good supervision and communication with young athletes during practice/games.  Having a certified athletic trainer on site is best.

Lastly, be sure that your child has had a recent physical so we can review current health status, any changes or new risks, and anticipate ongoing issues.

Please post questions or comments and thanks for following.


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