700 Children's® – A Blog by Pediatric Experts

Exercise and Heat Illness - Signs, Symptoms and What Parents Need to Know

Jul 31, 2019
Athlete running on a football field

When the temperature rises outside, it is important to be aware of the dangers it can bring. Exertional heat illness is one of the top three causes of death in sports and prevention is one of the greatest tools to keep from having a serious injury associated with the heat. 

If participating in sports or activities outside, always be sure to have frequent breaks with plenty of water. It is important to always monitor the temperature and the heat index and know that heat can have a serious effect on even the most conditioned athletes if they are not acclimated to it.

Excessive Heat Warning— Emergent! Issued when the heat index is expected to be 105 degrees or higher for at least two days and the air temperature at night will not be below 75 degrees. If precautions are not taken, an excessive heat warning could result in serious illness and even death.

Excessive Heat Watches—Be Prepared! Heat watches are issued when conditions are favorable for an excessive heat event within 24 to 72 hours. A Watch is used when the risk of a heat wave has increased, but its occurrence and timing is still uncertain.

Heat Advisory—Take Action! A Heat Advisory is issued within 12 hours of the onset of extremely dangerous heat conditions. The general rule of thumb for this advisory is when the maximum heat index temperature is expected to be 100 degrees or higher for at least two days, and night time air temperatures will not drop below 75 degrees; however, these criteria vary across the country, especially for areas that are not used to dangerous heat conditions. Take precautions to avoid heat illness. If you don't take precautions, you may become seriously ill or even die.

How to Prevent Harm from the Heat

  • Drink plenty of fluid (not caffeinated, energy or alcoholic drinks).
  • Find a cool place, in the shade or in a well-ventilated shelter with fans or air-conditioning.
  • Cool down periodically in water (swimming pool, bath or shower).
  • Wear lightweight, light-colored, loose fitting clothing and head protection.
  • Limit physical activity and avoid exercising in the heat of the day.
  • Apply effective sunscreen (SPF 30+) if outside.
  • Monitor the color of your urine (dark yellow is bad, clear urine is good).

Proper Hydration is key. Thirst is not a good indicator of hydration, you will already be dehydrated once you are thirsty. Looking for clear urine is a good indicator of proper hydration. Hydration is a before, during and after process

Drink at least 20 ounces of water or sports beverage two hours BEFORE activity. Have frequent water breaks DURING activity, with six to eight ounces of water at each. Then make sure to replenish all the fluids lost from sweat AFTER the activity is over.

Signs of Heat Exhaustion

  • Confusion
  • Rapid, weak pulse
  • Dark-colored urine
  • Dizziness
  • Fainting
  • Fatigue
  • Headache
  • Muscle or abdominal cramps
  • Nausea, vomiting, or diarrhea

Signs of Heat Stroke 

  • Throbbing headache
  • Dizziness and light-headedness
  • Lack of sweating despite the heat
  • Red, hot, and dry skin
  • Muscle weakness or cramps
  • Nausea and vomiting
  • Rapid heartbeat, which may be either strong or weak
  • Rapid, shallow breathing
  • Loss of consciousness

What to Do Should You Develop Any of the Signs Above

  • Call an ambulance on 911 for life threatening signs.
  • Rest in a cool well ventilated area.
  • Drink plenty of fluid, water and sports drinks.
  • Apply cool wet cloths or ice packs to the neck, groin and armpits.

*If Available, the Best and Most Efficient Way to Cool the Body’s Core Temperature Is Cold Water Immersion up to the Neck*

If the heat index is high, there is a heat advisory/warning or both always consider other options from being outside if possible.  If being outside is unavoidable then make sure to drink plenty of water before activity and take frequent water breaks.

Watch our video on making your own homemade sports drinks or click here to find more information about Sports Medicine at Nationwide Children's Hospital.

Featured Expert

Nationwide Children's Hospital Medical Professional
Ryan Ingley AT, ATC
Sports Medicine

Ryan Ingley AT, ATC is an athletic trainer at Nationwide Children's Hospital Sports Medicine. He joined NCH in 2015, initially serving at Lakewood High School and more recently at Big Walnut High School. Outside the school setting, Ryan is involved with the Play Strong program, a medically supervised wellness program, and New U, a medical weight loss program.

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700 Children’s® features the most current pediatric health care information and research from our pediatric experts – physicians and specialists who have seen it all. Many of them are parents and bring a special understanding to what our patients and families experience. If you have a child – or care for a child – 700 Children’s was created especially for you.