Chapter 2 Index

A. Evaluation by system

B. Other categories of illnesses:

1. Metabolic and Endocrine

2. Collagen-Vascular Illnesses

3. Chromosomal Abnormalities

4. Generalized
--R/O Sepsis - Case Histories
--Approach to Neonatal Group B Strep Infection
--HIV: What the Primary Care Physician Needs to Know

Heat Stroke

Introduction: Children are particularly susceptible to the effects of heat.  There is a continuum of symptoms that ultimately lead to heat stroke.  It is important to recognize and treat the early signs of this potentially fatal condition.

Classification of Different Stages of Heat Stroke:

Stage One: Headaches, muscle cramps and fatigue

Stage Two: Heat Exhaustion - represents water loss along with electrolyte loss.  This stage is on a continuum with heat stroke, and is characterized by temperatures of 39 degrees or less, a lot of   sweating, and some CNS problems such as headache, disorientation, lethargy and even vomiting.

Stage Three: Heat Stroke: temperature is over 105 degrees, children are often unable to sweat, and they can have profound CNS symptoms such as coma, seizures.  This is a true emergency. Can have milder and more serious heat stroke.

General Ways to Prevent Heat Stroke:

1. Never leave a child - even for a few moments - in a parked car.  Unfortunately, there are many tragic results of doing this.
2. Dress children coolly; avoid the heat of the day (10AM - 3PM), give plenty of fluids.
3. If a child is involved in sports, s/he should get in good condition before doing heavy workouts with the team.  Also, there should be plenty of water available.  Children should be encouraged to drink before, during, and after exercise.
4. Educate parents and coaches to have their children recognize early symptoms of heat stroke.

Treatment: Varies With the Stage of Heat Stroke:

Stages One and Two: Move child to cool area, rehydrate gradually - orally in mild cases.  May need IV in cases where there is CNS confusion, decreased sweating or elevated body temp.

Stage Three: Heat stroke: Since the patient is severely hypovolemic, give IV treatment with 10-20 ml/kg over the first 15-20 minutes, clothing should be removed, patient put in a cool room, allows free radiation of heat; vigorous surface cooling especially of the head and scalp with ice bags, cold-water wetting and fanning.

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Department of Pediatrics  |  Medical College of Georgia
Please email comments, suggestions or questions to:
John T.  Benjamin M.D.,  jbenj@mcg.edu

February 27, 2004