Preventing Heat Illness

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Summer brings nice weather and freedom from being trapped indoors. Sunny skies and warmer temperatures encourage lots of exciting outdoor activities and adventures. However, some serious hidden threats may be lurking in the midst of all the fun. Staff and kids need to understand the perils of too much sun, too much heat, and poor hydration. They must learn to recognize the signs that the sun or heat have ceased being their friend and started being their enemy.

Excessive heat and sun pose many dangers: sunburn, dehydration, heat cramps, heat exhaustion, and heat stroke. All are at the very least unpleasant – heat stroke and sometimes heat exhaustion are life-threatening. Although heat illnesses may be somewhat related there is no linear progression from one to another. Direct exposure to the sun is not necessary for any of the heat illnesses except sunburn – too much heat for too long a time is enough, though direct exposure to the sun may exacerbate the problem.

The Enemies

Sunburn

Sunburn is a well-known and frequent challenge for anyone who supervises children in an outdoor environment, especially at the beginning of the season or for infrequent field trips. The following basics should be followed:

  • All children should have signed permission slips authorizing administering sunscreen if any programs will be outside.
  • Use a sunscreen with an SPF 15 or greater and which protects against UVA and UVB rays.
  • Apply sunscreen thoroughly – cover all areas that may be exposed to the sun.
  • Apply sunscreen 15-30 minutes before going outside and again every two hours; waterproof sunscreen should be used for water activities.
  • A child who shows signs of sunburn should be moved into the shade immediately; applying aloe vera will cool the skin. Additionally, the child should increase fluid intake to prevent dehydration.

Heat Cramps

Heat Cramps are painful cramps of the large muscle groups (e.g., abdomen, calves, and hamstring) that result from electrolyte depletion, dehydration, hyperventilation, and over exertion (especially in under-conditioned people).

Symptoms typically improve with rest, water, and a cool environment.

Dehydration

Dehydration commonly occurs during activities involving exertion and is increased by a rise in temperature or exposure to the sun's rays.

Warning signs for dehydration include headache, dry lips, weakness, nausea, and muscle cramping. Hydrating fluids should be pushed frequently when kids are active, especially when outdoors. Have indoor contingencies if the heat or its effects are too great. Every child should drink at every program transition, and should be taught that being thirsty means that you are already dehydrated. If someone becomes mentally altered or loses consciousness, call 911 immediately for emergency treatment.

While generally just uncomfortable, if not corrected, it can be debilitating or fatal. The human body perspires to cool itself, but that fluid must be replaced or the body cannot continue to function properly. Below is a quick guide for fluid intake before, during and after strenuous or outdoor activity.

Fluid Facts

When Consumed Adults Children
Before Activity 17-20 oz 4-8 oz
During Activity 7-10 oz every 10 min 5-9 oz every 20 min
After Activity 24 oz within 2 hrs 24 oz within 2 hrs

A soda does not count in these fluid calculations as these drinks do more harm than good.

Fluid Facts source: American Medical Athletic Association

Heat Exhaustion

Heat Exhaustion is largely a result of excessive heat and dehydration. Some of the symptoms of heat exhaustion include nausea, paleness, profuse sweating, dizziness, vomiting, fainting, and a moderately elevated body temperature caused by the heat. Children or staff who are suspected to be heat exhausted should be initially treated by moving to a cooler environment (indoors with AC, cool shade), loosening any tight clothing, cooling the skin by wetting and fanning, and by re-hydrating the patient. Those with severe heat exhaustion may need intravenous fluids, especially if vomiting or unconsciousness limits their fluid intake – these conditions present a potentially life-threatening condition which should be treated in a hospital setting.

Heat Stroke

Heat Stroke – Heat stroke is a failure of the cooling systems in the body and is the most severe form of heat illness.

HEAT STROKE IS A LIFE THREATENING EMERGENCY CALL 911 IMMEDIATELY.

People suffering from heat stroke normally are not perspiring – their skin is usually hot, dry, and red or flushed. However, athletes who are struck with heat stroke after vigorous exercise in hot weather may still be sweating considerably. In either case their internal temperature will be extremely high; they may be having seizures, demonstrate altered mental status or unconsciousness, and may be vomiting.

Rapid cooling with ice packs, removal of heavy or restrictive clothing, and treatment for shock should be started immediately. EMS should be called to transport the victim to a hospital. An observation stay is likely due to the potential for organ failure from the highly elevated temperatures.


Preventing Heat Illness

Drinking plenty of fluids (i.e., water or electrolyte-replacing beverages, never soda) and frequent rest and cool-down periods are the best prevention for heat illnesses. Hydration obviously helps to prevent dehydration which is the primary cause of both heat cramps and heat exhaustion. The elevated internal body temperatures that cause heat stroke are also impacted by dehydration. Allowing enough cooling-down periods during extreme heat is important in combating all forms of heat illness, especially heat stroke. Elevated humidity complicates the problem by making the perspiring process less effective – cooling periods and rest breaks should be more frequent and of longer duration.

Staying out of extreme heat is a wise choice if it is an option. Most resident camp and many day camp facilities don’t have options regarding where they program activities – they have what they have and that is basically outdoor space. It almost certainly does not include air conditioned play space. That should not be a problem, however, since there are literally hundreds of programming choices that can reduce the potential for heat illnesses. The options include wet activities, non-strenuous activities during the hot part of the day, and most importantly, drinking lots of water. Outdoor play can be safe play even in hot weather.

Please call us at 800-463-8546 to discuss this or any other risk management safety tip, or visit our web site at www.redwoodsgroup.com to learn more about camp risk management issues.

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