How to recognize heat stroke/ tips for keeping cool
Temperatures are soaring.
If you look at a map, you will see that most of the country is dealing with temperatures over 90 degrees, many over 100. Truth be told, most of you don’t need to look at any maps to know that you are sweltering. A lot of places are used to hot summers, but many are experiencing unprecedented heat waves that are lasting longer than usual. Records are being broken right and left.
The important number is actually the heat index. This is calculated based on the temperature and the humidity. Humidity makes things worse. If you are in a place with high humidity the sweat doesn’t evaporate as quickly and this keeps the body from releasing heat as fast as it may need to. If you want to calculate the heat index of where you are, you can use this link.
https://www.wpc.ncep.noaa.gov/
Don’t hate me - I have my sweater on here in San Francisco. I can’t live anywhere else. In extreme heat and humidity, I turn into an impossible creature.
For all of you who are not dealing with our local fog, here are some of the most important considerations when dealing with the heat. Even if it suddenly cools off, it makes sense to be prepared for the next wave.
Being overheated can have serious consequences.
Keep in mind that young infants don’t regulate their body temperature very well, so this puts them at greater risk. Scroll down for more info about this.
Symptoms of heat exhaustion might include:
Fevers 100-104
Clammy skin
Muscle cramps
Nausea
Dizziness
Lethargy
If not tended to, this can lead to heat stroke, which can be deadly!
Signs of Heatstroke include:
A temp at near or above 104 (fever reducing meds are not useful in this circumstance)
Flushed skin
Elevated heart rate
Weakness
Dizziness
Loss of consciousness
Medical intervention is essential!
Hydration is an essential part of preventing heat related complications.
It is important to replenish the fluids as well as the electrolytes that you lose when you are hot and sweaty. Pedialyte or similar electrolyte drinks may be better than plain water. Breast milk is perfect (of course). Even if your baby seems to be nursing well, if it is very warm out, keep an eye on the number of wet diapers! You may need to sneak in some extra fluid.
Nursing moms need to remember that they are losing fluid every time they feed their babies. It is essential to replace that as well as adding extra, so drink up! Perhaps start your day with one of the large water bottles that measures the amount. Fill it at the start of the day and it makes it much easier to track your intake.
Someone who is dehydrated will have:
Less urine, and the urine will be dark
Low energy
Dry mouth
No tears
Even if your little one is no longer in diapers, pay attention to how often your child is peeing and look at the color. Darker, infrequent urine might be your first clue that they need to be drinking more.
Ideas for staying hydrated:
Set a timer on your phone as a reminder that it is time for everyone to take a sip.
Maybe have an iced-tea party.
for kids, get a cool cup, a cool straw or fun ice-cubes to make it enticing
Pedialyte comes in popsicle form which can be a big hit.
Other good hot weather treats are watermelon and some mildly salty snacks.
It might surprise you, but milk is one of the best beverages for hydration
Frozen breast milk can make a wonderful ‘milk-sicle’
Ideas for staying cool at home:
Find the coolest room in the house. It is often downstairs..
Families may end up sleeping on the living room floor if it is less oppressive. Make it an adventure and call it camping.
Keep the shades down during the day.
Have a fan going if you are lucky enough to have one. Make sure the fan is placed in an area where curious kids can’t poke their fingers in there. Even better, get one of the fans that is toddler safe. For those of you without fans, put your order in now. Often in the midst of a heatwave there are none available. It is worth owning at least one so you are prepared for the next heatwave.
Baths are great. Unless the water is obviously dirty, don’t drain it and you can get in and out throughout the day.
Keep wet washcloths in the freezer and offer the frozen clothes throughout the day.
There are cool little cooling towels that can make a big difference. Once you wet them, they stay nice and chilly for hours.
If you have a yard or a place to put it, investing in one of the little plastic wading pools can give your kids hours of cooling fun.
Dress in minimal lightweight clothing.
Come up with some fun indoor activities that don’t require a lot of running around. Lots of kids love water play. Cover an area with a plastic sheet (a shower curtain is a great cheap option). Fill a plastic bin with water and then there are unlimited options ( including cleaning the bin with a big sponge!)
If this week requires a little bit more screen time than you like, don’t stress it. Try to be clear that there are some ‘hot weather’ rules that can be a little more relaxed.
If you don’t have air conditioning, see if you can find local places where you can hang out for a cooling break. Malls and libraries are often good options.
If you do go outside...
Beware of hot metal. Make sure you test the temperature of any slides or metal equipment before you let your child play on them. I once had a patient get a burn on their finger from pressing a metal doorbell, so I am not kidding around. Metal can get very hot.
Shade is best, but if you are in the sun, make sure your kids have a big floppy hat, sunglasses and sunscreen.
Don’t forget about your pets! Make sure they have plenty of water (add some ice cubes.) If possible when walking them, keep to grass. Extremely hot pavement can actually burn their paws.
Also…never ever leave kids and pets in the car. This is especially critical when the weather is hot. I am aware that folks with Teslas do have a pet comfort setting, but no child should ever be left in a car regardless of the temperature.
Keep in mind that in many hot areas of the world, the cultures have embraced the concept of the siesta. They take a collective break during the hottest part of the day. That sounds like a plan that most parents would be soundly in favor of…. Now we just have to get the kids on board.
Other heat-related considerations:
Fungal diaper rash
With increased heat and sweating, fungal rashes can become a problem. Yeast loves damp dark warm places, so a sweaty diaper area (or underwear area for potty-trained kids…or adults) is the perfect breeding ground for fungal rashes. These rashes in diapers can look like discrete red dots, occasionally coalescing into lumpy bumpy raised patches. Unfortunately, this can mimic the red papules of hand-foot-and-mouth. Dr. Ted has seen kids with diaper rashes sent home from daycare to get assessed for hand-foot-and-mouth. If you suspect that you might be dealing with a fungal rash, air out the diaper area and add over-the-counter Lotrimin three times a day. It’s extremely safe and well tolerated at all ages. There is NOT an infant formulation. You can also add some apple cider vinegar to the bathwater, which is antimicrobial and balances the pH (white vinegar is probably fine, but skip the balsamic).
Swimming considerations
The excessive heat warming fresh waters has created some unfortunate growth of naturally occurring bacteria, such as pseudomonas. Pseudomonas can present in a couple of ways. It can live in poorly controlled hot tub waters, creating a red spotty rash called hot tub folliculitis, but more importantly it can cause an excruciatingly painful swimmer’s ear. Luckily, pseudomonas can’t grow outside of wet environments, so drying the ears fully after swimming will not allow the bacteria a place to grow. We do not recommend Q-tips as they can traumatize the eardrum. Try using Debrox drops after swimming to dry out the ear, and any bacteria inside won’t be able to grow.
Blue green algae
If you’re going to any rivers or lakes, check your local resources to make sure there aren't any dangerous blooms. Here is the website for California, but it is easy enough to google wherever you are located.
Dogs can be impacted by this as well as your kids, so check before you swim!
Dr Ted’s Tidbits: Time to nerd out with science!
“Heat regulation in newborns is fascinating. We rely on sweating to get rid of heat. Water from our skin absorbs heat and carries it away with evaporation (see Nurse Judy’s bit of this, above), but newborns don’t make a lot of use of those valuable sweat glands for at least the first couple of weeks. Newborns also have an immature part of the brain that regulates body temperature called the hypothalamus. Without input from the hypothalamus, babies rely on outside forces to control their core temperature. In particular, babies are bad at cooling themselves off. So you’re in a place with a heat index over 90, it’s important to be proactive about keeping your baby from overheating.
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