Boy, Is It Hot Out There!

When I was in high school, summers meant lots of exercise in the heat.  I would go for runs with sweat literally pouring off my arms.  Then came summer soccer practice- push ups and calisthenics, sprints and indian runs with grass clippings stuck to my arms and legs, coaches and captains yelling like army drill sergeants.  A lot of kids quit the team during the first weeks of practice.  Then I was glad for all the running I had done; it was a little comfort that I was maybe suffering less than the kids around me. It is the time of year now when we all start hearing about the heat on the news.  The biggest and saddest stories are the ones about someone leaving their small child strapped in their car seat in the car.  They always say, "I was only going in the store for a few minutes."  Unfortunately, a few minutes is all it takes to cause injury or death in an infant or toddler because of heat.   How long could you stand it in a parked car, engine and A/C off, in the sun?  Five minutes?  Ten minutes?  Now compare people to baking cakes in the oven.  It takes about 40 minutes to bake a cake.  It takes 20 minutes to bake a cupcake.  So imagine you are the cake and your toddler is the cupcake.  Now how long do you think they will last in that parked car?  Again, even a few minutes is too much. Fortunately, those infant and toddler tragedies are rare.  In the Emergency Department we see more cases of teenagers with heat injury.  These are usually kids on the practice field for school sports.  The mildest injury is heat cramps, where the only symptom is painful muscle cramps.  The next degree is heat exhaustion, where the teen has dizziness and weakness and headache from heat exposure and dehydration.  The most severe form of heat injury is heat stroke.  Teens with heat stroke become confused or unconscious, stop sweating, and are at risk for death. Heat injury is preventable.  The first strategy is adaptation.  Athletes should slowly build to the harder work-outs, like I used to with my runs.  Start with work-outs of lighter intensity and shorter duration.  Football players should spend the first weeks of practice in shorts and t-shirts only.  Then progressively add intensity, duration, and equipment.  The second strategy is plenty of hydration.  Athletes should drink before, during, and after work-outs, all three!  There should be no limits to access water or sports drinks.  Coaches who restrict fluids are only hurting their kids, and hurting their performance, and should be fired.  Thirdly, school team work-outs should be scheduled for the early morning and late evening- start practice at 7am instead of 9am, or 6pm instead of 4pm.  There should be at least two hours between sessions.  Finally, coaches should have an action plan to deal with heat injury.  Like surveillance for concussions, coaches should be watching their players for signs of cramping, sleepiness, headaches, weakness.  Summer should be a fun time for kids outdoors.  But it's hot out there, so treat your kids right in the heat.