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How to Prevent Heat-Related Illness in Pediatric Patients

— Educating families can go a long way

Ƶ MedicalToday
A photo of a little girl playing in an urban fountain in the summer.
Carlos is a primary care pediatric resident.

As a child growing up in South Carolina, summertime was equivalent with playing outside until dusk, running through lawn sprinklers, and all-day exploration adventures. Now, as a pediatrician in Washington, D.C., summertime means witnessing the impact of climate change on the health of us all. Hotter summers lead to higher chances for poor health outcomes like , , , and other .

In 2023, we had the summer temperatures of the last two centuries, and the number of was greater than previous years. Yet, 2024 has somehow broken more records, with the planet recording its last week -- and here in D.C. we were .

While climate change has an impact on everyone, we don't all share an equal burden of its consequences. Groups that disproportionately experience more of those are individuals with disabilities, the elderly, and children. I've seen the impact firsthand on my young patients. Luckily, pediatricians can help prevent such adverse outcomes -- known as "heat-related illness" -- in kids.

Children spend more time outside during the summer, and a higher percentage of kids than adults consume . This can worsen their body's response to the heat. Children who live in with less green space -- historically low-income communities and communities of color -- can have higher exposure to during high-heat days. Children who live in areas impacted by wildfires can be exposed to poor air quality from smoke in addition to carcinogenic toxins including benzene. These circumstances can lead to a variety of health complications, including asthma.

Special consideration should also be given to children with chronic illnesses, behavioral health concerns, those on medications that impact sun sensitivity, and young infants. We should also remind the parents of our patients that their children should never be left unattended in vehicles, even if windows are ajar.

Here is a list of other tips to provide to the parents of your pediatric patients on how to prevent heat-related illness:

  1. Hydrate and cool: Ensure kids are hydrated and have ways to stay cool or cool down (e.g. hats, access to shade or air conditioning). Use sun protection when outdoors.
  2. Be aware of the heat index: Check local weather channels or phone apps to determine the high temperatures for the day and the level of humidity to determine the heat index. On days of , it's more difficult for sweat to evaporate from the skin and cool the body temperature. Being aware of this can determine how you manage kids' outdoor time and playtime.
  3. Prepare: Have an emergency plan in case a child appears dehydrated or faint. On days of high heat, complete outdoor activities in the early morning or late evening. If necessary, make alternative plans for indoor activities (especially for student athletes). Have plenty of water and no-sugar electrolyte fluids for rehydration. If using outdoor pools and water parks for cooling, adhere to water safety.
  4. Be alert: If a child is showing signs of increased body temperature and heat-related illness (see details below) then act quickly to cool down the body (relocating to A/C or shade, or offering cool packs) and consider seeking medical attention if needed.

What Are the Signs of Heat-Related Illness?

Both healthcare professionals and parents need to be able to recognize the signs and symptoms of including heavy sweating, muscle cramps, weakness, light-headedness, headache, nausea, and vomiting. Worsening dehydration symptoms can present with cold, clammy skin, inability to sweat, darker urine, less urinating, and increased thirst. Parents should seek medical attention immediately when these symptoms are present.

The Role of Healthcare Professionals

Pediatricians and other healthcare professionals who interact with parents or kids can play a role by educating parents. You should consider the following:

  1. Counsel parents and patients on summer preparedness.
  2. Recognize the . Have items in your community center or clinics to respond to heat-related conditions. Become familiar with the to assess dangers of heat for vulnerable populations.
  3. Teach patients about preparedness, and practice preparedness by assessing patient access to air-conditioning or cooling centers (i.e. libraries, recreation centers, malls).
  4. Advocate for climate change policies that provide equitable access to climate mitigation. Join local school or athletic boards, professional societies, and community advocacy groups.

As healthcare professionals, we must be educated about the effects of climate change on health, especially for vulnerable groups like kids, and engage our patients and parents in the discussion.

is a primary care pediatric resident at the Medical University of South Carolina. She is a member of the Medical Society Consortium on Climate and Health.

The views of the author do not necessarily reflect those of the Medical Society Consortium on Climate and Health or its members.