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Pediatric Heat-Related Illness: Recommendations for Prevention and Management

August 2017

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Morbidity and mortality are directly related to the duration and intensity of hyperthermia. Early recognition and rapid reduction of core body temperature are critical to survival and prevention of multiorgan failure. This issue offers an overview of thermoregulation and evidence-based recommendations for the management and prevention of heat-related illness in pediatric patients.

  • Monitor core temperatures continuously with a rectal or esophageal probe. Stop cooling measures once core temperature has decreased to 38°C-39°C (100.4°F-102°F).
  • Ice-water immersion (conductive cooling) cools quickly, but may be difficult to set up and monitor in the ED.
  • Spraying warm water over the patient’s skin and sitting them in front of a fan (evaporative cooling) may be as effective at cooling as ice-water immersion.
  • Due to the lack of evidence for the use of cooled IV or iced lavage fluids, it is not routinely recommended for heat-related illness.
  • Most at risk for hypothermia are children who are obese, taking certain medications, or have chronic diseases.
  • Emergency clinicians should advocate for modification of athletic training programs and raising awareness of the danger of leaving children in vehicles, even for short periods in moderate temperatures. 

Key words: heat-related illness, hyperthermia, exertional heat illness, heat stress, heat cramps, heat exhaustion, heat stroke, heat exposure, thermoregulation, heat dissipation, evaporation, conduction, evaporative cooling, evaporative cooling measures, conductive cooling, conductive cooling measures, rectal temperature, esophageal temperature, core temperature, ice-water immersion, acclimatization, emergency department, pediatric, child

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Last Modified: 08/16/2017
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