Sea, sun, smiles… and (heat) stroke?

from Baby's and Beyond - Volume 9 l Issue 4

by Media Xpose

How teacher quality and personality can improve student learning

Sea, sun, smiles…

and (heat) stroke?

With warmer weather, many families are making their way to our beautiful beaches, hiking trails and nature reserves for some well-deserved family fun.

By Dr Markus Vorster, Emergency Medical General Practitioner: MBChB, UFS

Whether its sunbathing by the seashore, having a poolside braai, hiking up Table Mountain or enjoying a game of cricket in the backyard, always remember that excessive sun and heat exposure could be extremely dangerous to young children, adults, and pets alike.

Heat Related Illness (HRI) refers to a spectrum of disorders that result from exposure to excessive environmental heat and the body’s inability to effectively regulate its own core temperature. It is commonly referred to as heat stroke, but heat stroke represents only the most severe form of HRI. Children make up almost half of HRI cases in the emergency room (48% of all cases), with exercising adolescents, children left in unattended vehicles, and kids with severe sunburn being at a particularly high risk. Recent febrile or gastrointestinal illness (like vomiting or diarrhoea), as well as drinking caffeinated beverages also increases this risk.

The reason why young children are so susceptible to

HRI is because they have immature central thermoregulatory centres (the parts of the brain tasked with maintaining normal body temperature), take longer to acclimatise to warm weather and have a decreased ability to sweat. They also don’t have the ability to change their behaviour in response to increased heat like adults can (like drinking cold fluids).

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Three types of HRI

1

Heat stress refers to the sensation of discomfort caused by excessive heat exposure. The body’s core temperature remains normal (less than 37°C), but your child will appear listless or lethargic, thirsty, and warm to the touch.

2

Heat exhaustion is a moderate from of HRI where the core body temperature starts to increase (37°C-40°C) and can cause fatigue, dizziness, nausea, vomiting and headaches. Other signs of dehydration may be present, such as a fast heart rate, dry mouth, eyes looking sunken and a pushed in fontanelle (the soft spot on baby’s head). Stomach and leg cramps may also be present in older children.

3

Heat stroke, the worst form of HRI, is a life-threatening condition where the body temperature rises above 40°C and a person becomes confused of unconscious. If you suspect your child may be suffering from heat exhaustion or heat stroke, you should take them to an emergency unit immediately. Doctors will use active cooling techniques, such as monitored cold water submersion and intravenous fluid administration to bring down the core body temperature. It is important to note that medications used to treat fever, like paracetamol (Panado® or Calpol®) or ibuprofen (Inflamax®) are ineffective in bringing down an increased temperature due to HRI.

Heat stress can be managed at home by giving regular sips of cold fluids, dabbing the person with a cold cloth, and fanning them down regularly.

Dr Markus Vorster is the Principle Clinical Manager of Life Healthcare Kingsbury Hospital Emergency Unit in Claremont, Cape Town. He obtained his medical degree at the University of the Free State in 2017 and has a special interest in cardiopulmonary resuscitation and healthcare ethics.

Life Kingsbury Hospital 24-hour Emergency Unit: Wilderness Road, Claremont, Cape Town T +27 (0)21 670 4039

How to stay cool

Prevention is always better than cure. Here are some tips to ensure your little one stays cool during those hot summer days: • Always apply a high protection factor sunscreen (minimum SPF 50) when spending time outside and frequently reapply after swimming and every two hours thereafter. • Make sure there is enough shade for your child when outside playing on the beach. A pop-up beach tent works wonders. • Take a spray bottle with you to the beach or on a hike and frequently mist young kids. The evaporation helps to regulate body temperature. • For those uncomfortably hot summer nights, try putting your child’s bedding in a plastic bag and placing it in the refrigerator for use at bedtime. • Always keep babies under six months out of direct sunlight between the hours of 10:00 and 15:00. • Make sure your child is always wearing a head covering when outside, preferably a floppy, wide brim hat that protects the face, neck, and ears. • Dress kids in closely woven, loose-fitting and comfortable clothes. Do not be tempted to dress babies in multiple layers when it’s hot outside.

A single layer is sufficient for a newborn when the ambient temperature is above 25°C. • To prevent absentmindedly forgetting your little one on the back seat of an unattended car (an accident that happens far to regularly when a parent deviates from their daily routine to do a school or creche run), take off your shoe and place it next to them on the car seat when starting your journey. This will serve as a reminder when you arrive at your destination.

Being attentive and well informed about the risk of Heat Related Illness is the best way to ensure that your family’s day of fun in the sun does not turn into a night spent in the emergency unit. 