Heat-Related Illness

If you’ve ever spent a summer in Georgia, you know the sweltering heat. You may have described it as roasting, scorching or even blistering, and you’d probably agree that exercising in that kind of heat is a ridiculous notion. But many young athletes are gearing up for summer training right when school lets out and temperatures spike.

Heat-related illness is responsible for thousands of emergency department visits by young athletes every year. The temperature outside is not the only indicator of heat; humidity also plays a major role. Always be aware of the heat index, which is a measure of both temperature and humidity—it’s available through the local weather service online. For example, when the temperature is 90°F and the humidity is 80 percent, the heat index is 115°F, which places athletes at risk of suffering a heat-related injury.

Whether for free play or year-round organized sports, it’s incredibly important for kids to stay hydrated and for parents and caregivers to know the signs of heat-related illness. 

If your young athlete suffers from heat-related illness, where you take him for treatment matters. At Children's, our pediatric-trained team only works with children and teens. 

Heat index chart

Signs and Stages

Dehydration and heat cramps

Thirst, fatigue, dizziness, light-headedness, muscle cramps and loss of energy may be signs of dehydration. Athletes should take a break and drink water or a sports drink. Cramping muscles can be stretched and lightly massaged. Resume activity with caution only after all symptoms have cleared.

Heat exhaustion

Dizziness, a rapid pulse, headache, nausea, vomiting, chills and loss of coordination may be signs of heat exhaustion. An athlete may be sweating profusely, or his skin may be dry. Activity should be discontinued and the athlete should be rehydrated if he displays these symptoms. If he is unable to drink water or a sports drink, transport him to a medical facility for intravenous hydration. If you are unable to check his core body temperature, he should be taken to a medical facility for hydration and monitoring.

Heat stroke

Call 911 immediately. Confusion, irrational behavior, drowsiness, nausea, vomiting and a dangerously high temperature (104°F and above) may be signs of heat stroke. This is a life-threatening medical emergency that requires rapid cooling by immersion in an ice bath. Ice bags on the neck and groin may help if a bath is unavailable.

Tips to Stay Hydrated

Use these tips to keep your young athletes hydrated, especially during the summer months:

Thirst is a poor indicator of hydration status. When children and adolescents begin to feel thirsty, they may already be dehydrated.

  • Prehydrate 30 minutes before an activity. Kids and teens should drink until they are no longer thirsty, plus another 8 ounces.
  • Hydrate during an activity:
    • Drink 5 ounces every 20 minutes of activity for kids and teens weighing less than 90 pounds.
    • Drink 8 ounces every 20 minutes of activity for kids and teens weighing more than 90 pounds.
    • Encourage kids and teens to drink water during an activity instead of pouring it on their heads or faces.

Water is best for hydration if the activity lasts less than one hour. For activities lasting more than an hour, a fluid with carbohydrates (sugar) and electrolytes is best. Gatorade and Powerade were designed specifically for rehydration during exercise and contain the right amount of carbohydrates (about 6 to 8 percent). You may dilute a sports drink—one part sports drink to one part water—for a better taste. Drinks such as fruit juice and soda contain too much sugar for effective hydration and can cause cramping. Avoid carbonated and caffeinated beverages because carbonation can cause bloating and caffeine can speed up metabolism, generating more heat.

Call 404-785-KIDS (5437) or visit choa.org/sportsmed for more information.

By David Marshall, MD, Pediatric Sports Medicine Primary Care Physician, Children’s Healthcare of Atlanta | Medical Director, Sports Medicine Program

Dr. Marshall's expertise lies in the diagnosis and management of nonsurgical musculoskeletal injuries in young athletes.

At Children’s Healthcare of Atlanta, our Sports Medicine Program is one of the few in the country dedicated exclusively to the care of young athletes. We provide comprehensive assessment, treatment and expert advice for young athletes with injuries and conditions that affect sports performance. Our team consists of sports medicine primary care physicians, orthopaedic surgeons, physical therapists and certified athletic trainers.

This is general information and not specific medical advice. Always consult with a doctor or healthcare provider if you have questions or concerns about the health of a child.