As summer approaches and temperatures rise, so does the incidence of heat-related illnesses in school settings. According to the American Academy of Pediatrics (AAP), when the National Weather Service heat index is at or above 90°F, children are susceptible to various heat-related illnesses and conditions, including heat cramps, heat syncope, heat exhaustion, and, most dangerously, heat stroke. Schools must be prepared to keep their students safe and healthy while outdoors in warm weather, whether in school-sponsored athletic practices or competitions, at recess, or during educational field trips.
Children and adolescents are more vulnerable to high temps due to several reasons:
- Physiologically, kids are less capable of adapting to changes in environmental heat than adults.
- Children sweat less than adults and produce more body heat during physical activity, putting them at greater risk for adverse outcomes.
- Children often don't recognize when they are becoming overheated or dehydrated and may neglect to rest and drink fluids while playing or exercising, making them more susceptible to suffering heat-related symptoms or illness.
Heat Cramps
Heat cramps can often be an initial sign of heat-related illness, manifesting as muscle spasms and mild to severe pain, usually in the legs and abdomen. They are a direct result of the body temperature rising and low salt levels in muscles after excessive sweating. Interventions include moving the student to a cooler place, providing sips of water or a sports drink to replace fluids and electrolytes, ice application, and gently stretching or massaging the affected muscles.
Heat Syncope
According to the CDC, heat syncope is "a fainting (syncope) episode or dizziness that usually occurs when standing for too long or suddenly standing up after sitting or lying." Symptoms include dizziness, fainting, a pale complexion, weakness, and tunnel vision. Typical fainting or dizziness first aid is recommended: help the student lie down in a cool environment, elevate their legs to improve blood flow to the brain, monitor vital signs, and ensure they hydrate adequately.
Heat Exhaustion
More severe than heat cramps or syncope, heat exhaustion can significantly impair the body's ability to regulate temperature, leading to heavy sweating, weakness, dizziness, nausea, and headache. If not treated promptly, it can escalate to heat stroke, a life-threatening emergency. Key interventions include rest - moving the student to a cool area, removing any excess clothing, applying cool, wet compresses - and rehydration - encouraging the student to sip cool water or a sports beverage.
Heat Stroke
The most severe form of heat illness, heat stroke, is a medical emergency in which the body absorbs or produces more heat than it can release, causing a rise in core body temperature to greater than 104°F. Symptoms include hot, dry skin or profuse sweating, nausea, confusion, seizures, rapid heart rate, and, in severe cases, a loss of consciousness. Heat stroke is life-threatening and requires immediate intervention by calling emergency services, moving the student to a cool environment, providing fluids if the student can drink, and applying cool, wet cloths or ice packs to reduce body temperature until EMS arrives.
Education and awareness are essential in preventing heat-related illnesses. School nurses are vital in advising on the appropriate attire, emphasizing the importance of regular hydration, and advocating for adequate rest periods during outdoor activities or athletics. Educating both students and staff about the signs and symptoms of heat-related illnesses empowers everyone in the school community to act swiftly in beating the heat and preventing these potentially life-threatening conditions.
