Parents' and Coaches' Guide to Dehydration and Other Heat Illnesses in Children (page 2)

These guidelines were developed to help parents and coaches increase the safety and performance of children who play sports in hot weather. Children who play sports or are physically active in hot weather can be at risk for heat illnesses. The good news is heat illnesses can be prevented and successfully treated.

Children sweat less than adults. This makes it harder for children to cool off. Parents and coaches must make sure that children take it slow to be sure they can get used to the heat and humidity gradually.

There are other reasons why a child may become ill from a heat illness. Those who have a low level of fitness, who are sick, or who have suffered from dehydration or heat illness in the past should be closely watched. A medical professional such as a certified athletic trainer (ATC) should be on site to monitor the health and safety of all participants during games and practice, especially when it is very hot and humid.

Dehydration

Children get dehydrated if they do not replace body fluids lost by sweating. Being even a little dehydrated can make a child feel bad and play less effectively. Dehydration also puts children at risk for more dangerous heat illnesses.

Signs and Symptoms

• Dry mouth
• Thirst
• Being irritable or cranky
• Headache
• Seeming bored or disinterested
• Dizziness
• Cramps
• Excessive fatigue
• Child not able to run as fast or play as well as usual

Treatment

• Move child to a shaded or air-conditioned area.
• Give him or her fluids to drink.

"When can I play again?"

A child may be active again as soon as he or she is symptom-free. However, it’s important to continue to watch the child.

Heat Cramps

Heat cramps are a mild heat illness that can be easily treated. These intense muscle spasms usually develop after a child has been exercising for a while and has lost large amounts of fluid and salt from sweating. While heat cramps are more common in children who perform in the heat, they can also occur when it’s not hot (for example, during ice hockey or swimming).

Children who sweat a lot or have a high concentration of salt in their sweat may be more likely to get heat cramps. Heat cramps can largely be avoided by being adequately conditioned, getting used to the heat and humidity slowly, and being sure a child eats and drinks properly.

Signs and Symptoms

• Intense pain (not associated with pulling or straining a muscle)
• Persistent muscle contractions that continue during and after exercise

Treatment

• The child should be given a sports drink to help replace fluid and sodium losses.
• Light stretching, relaxation and massage of the cramped muscles may help.

"When can I play again?"

A child may be active again when the cramp has gone away and he or she feels and acts ready to participate. You can help decrease the risk of recurring heat cramps by checking whether the child needs to change eating and drinking habits, become more fit, or get better adjusted to the heat.

Tips for Parents

• Before your child starts playing a sport, he or she should have a physical examination that includes specific questions about any history of heat illness.
• Tell your child’s coach about any history of heat illness.
• Make sure your child is properly hydrated before he or she heads out the door to practice or a game. Give your children their own water bottles.
• Make sure your child’s coach has your emergency contact numbers.
• Check that your child’s league/team has an emergency action plan.

Tips for Coaches

• Be aware of temperature and humidity levels. Change practice length, intensity and equipment use as the levels rise.
• It should be easy for children to drink fluids during practice, and you should remind them to drink regularly. Fluid breaks should be scheduled for all practices and become more frequent as the heat and humidity levels rise.
• Every athletic organization should have an emergency action plan for obtaining emergency medical services if needed.
• Always have contact information for parents available.

Activity Guidelines

Fluid breaks should be scheduled for all practices and become more frequent as the heat and humidity levels rise. Add 5°F to the temperature between 10:00 a.m. and 4:00 p.m. from mid-May to mid-September on bright, sunny days.

• Children should receive a 5-10 minute rest and fluid break after every 25 to 30 minutes of activity.
• Children should receive a 5-10 minute rest and fluid break after every 20 to 25 minutes of activity. Children should be in shorts and t-shirts (with helmet and shoulder pads only, not full equipment, if worn for activity).
• Children should receive a 5-10 minute rest and fluid break after every 15 to 20 minutes of activity. Children should be in
  shorts and t-shirts only (with all protective equipment removed, if worn for activity).
• Cancel or postpone all outdoor practices/games. Practice may be held in an air-conditioned space.

This document was adapted from: Inter-Association task force on exertional heat illnesses consensus statement. June 2003. National Athletic Trainers’ Association. The full document can be obtained at www.nata.org/industryresources/heatillnessconsensusstatement.pdf.

To learn more about the National Association for Sport and Physical Education, click http://www.aahperd.org/NASPE/