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Health Issues

Heat Related Illnesses

Heat Cramps

Muscle pains or spasms, usually in the abdomen, arms or legs, may arise during strenuous activity. Heat cramps mostly affects youngsters who perspire freely, depleting their bodies of fluid.

What to do:

  • Usher the teen to a cool place, indoors or outdoors.
  • Give him water or a sports beverage to drink.
  • Gently massage the affected muscle to bring relief.
  • Insist that he wait several hours after the cramping subsides before he resumes any physical activity; further exertion may lead to heat exhaustion or heat stroke.
  • If cramping continues after one hour, seek medical attention.

Heat Exhaustion

This is the body’s response to an excessive loss of water and salt contained in sweat. Warning signs include: profuse perspiration; cold, pale, clammy skin; muscle cramps; fatigue; weakness; headache; nausea or vomiting; dizziness; fainting; rapid, shallow breathing; rapid, weak pulse.

What to do:

  • Use a thermometer to take body temperature (preferably rectal). If the body temperature is elevated to 103.1 degrees For higher, proceed to recommendations for heatstroke listed below.
  • Same steps as for heat cramps.
  • In addition, prepare a cool bath, shower or sponge bath.
  • If symptoms worsen or continue after one hour, seek medical attention, for untreated heat exhaustion can progress to heatstroke. Severe symptoms warrant an immediate trip to the hospital emergency department.


This is a potentially deadly condition in which the body’s thermostat malfunctions. It is not unusual for body temperature to soar to 105 degrees F or higher within ten to fifteen minutes. Compounding the danger, the person is unable to perspire adequately, so body heat is retained rather than released. Symptoms include: oral temperature of 103.1 degrees F or higher; red, hot, dry skin; rapid, strong pulse; throbbing headache; nausea; dizziness; confusion; unconsciousness.

What to do:

  • Have someone call for emergency medical assistance while you begin to cool the young victim.
  • Move her inside or to a shady area outdoors.
  • Remove as much clothing as possible.
  • Get cool water on her skin, either by immersing her in a bathtub or shower; giving a sponge bath; or spraying her with a garden hose. In low humidity, you can also wrap the teen in a cool, wet sheet.
  • Aim a fan or air-conditioner at her.
  • Take her body temperature every five minutes and continue your cooling efforts until the thermometer reads 102 degrees F or less.
  • Important: Do not give the youngster anything to drink. In her state, she could inadvertently inhale the liquid into her lungs, bringing about aspiration pneumonia.
  • If emergency medical personnel are delayed, call the hospital emergency department for further instructions.
  • Heatstroke victims sometimes begin to twitch uncontrollably. In the event of a seizure, make sure that the young person doesn’t injure himself on furniture. Never try to insert a spoon or other hard object in his mouth to prevent him from swallowing his tongue; simply turning his head to the side will suffice. The same advice applies if the teenager is vomiting, to keep his airway open.

Before letting your teenager play in an athletic program, find out if the school or league has a medical-emergency plan in place. The National Athletic Trainers’ Association suggests asking these questions:

  • Who will provide emergency first aid?
  • Who will summon emergency medical services (EMS), and how?
  • How will parents be notified in the event of an emergency?
  • Is the coaching staff trained to administer first aid and cardiopulmonary resuscitation (CPR)?
  • Are emergency medical devices readily available at all times?
  • Is there a qualified health-care provider available to school athletes on a daily basis?
  • Does the school or league consult with a physician experienced in sports medicine?

Teenagers should see their pediatrician for an annual medical screening at least six weeks prior to the start of the athletic season. More than two-thirds of the fifty states require yearly physicals to screen youngsters for any health condition(s) that could preclude their taking part in athletics. Studies show that it winds up serving that purpose for about four in five teens.

The sports evaluation should preferably be performed on an individual basis at the pediatrician’s office. The exam is designed to look at medical issues and injury risk factors relevant to sports participation. Height and weight are measured. Then the doctor examines the eyes, ears, nose, oral cavity, lungs, cardiovascular system, abdomen, genitals and skin. Strength, flexibility and joint stability are also assessed.

A thorough medical history alone picks up 75 percent of all medical problems that could affect adolescent athletes. Particular attention is paid to any familial patterns of heart disease, the leading cause of sudden cardiac death in young athletes. Fortunately, sudden cardiac death (SCD) is extremely rare in teenagers. “In the United States,” says pediatric cardiologist Dr. Luckstead, “perhaps fifteen kids a year might fit into that category. The difficulty is in picking it up.” Most victims of SCD exhibited no signs of illness prior to the fatal collapse.

“What we try to do is to look for red flags that will tip us off,” he explains. “For instance: Does the teenager pass out sometimes when he runs or get dizzy sometimes while exercising? Did he have a relative who died suddenly of heart failure at a relatively young age? If we suspect that the teenager may have a risk factor, we usually order an electrocardiogram at the time of the examination. And if we’re extremely suspicious, we get a more costly test called an echocardiogram.” By measuring the thickness of the heart wall, as seen on the ECHO, doctors can predict which patients are in danger of suffering fatal cardiac arrest.

Only about 3.3 percent of boys and girls who undergo the PPE have medical problems that could restrict their athletic involvement, but many more have conditions or effects from prior injuries that could, without attention, lead to further injury. Following additional evaluation, all but approximately 0.3 percent of kids will be cleared to play. If a teen is found to have a disqualifying condition, a second opinion is in order, given how disappointing it can be for a child to learn that she is medically ineligible to pursue a favorite activity. It is also worthwhile to examine other options for safe physical activity. For example, if a spine disorder makes football unsafe, the athlete may still be eligible to participate in a noncontact sport such as swimming, tennis or track.

Last Updated
Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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