Whether enjoying good weather in the UK or heading on a hot family holiday, it's vital to know the difference between heat stroke and heat exhaustion. This is because even mild heat exhaustion can escalate rapidly and if it turns to heat stroke, this is a medical emergency that requires immediate medical attention.
Children are naturally more vulnerable than adults to the heat, so whether it’s an unexpected heatwave in the UK, a holiday to a hot country, or simply warmer weather at home than they are used to, it’s important to know the difference between heat stroke and heat exhaustion, so that as a parent you can take measures to cool them down or seek urgent medical attention if necessary.
If you are unsure how to manage your child's symptoms after they’ve been outside in the heat, then it’s crucial to seek personalised advice from a doctor as soon as possible - either a GP or at A&E.
GPs Dr Arthi Sinha and Dr Babak Ashrafi shared with us their advice for parents on heat stroke and heat exhaustion, including how to tell the two related conditions apart, appropriate treatment and measures parents can take to aid their youngster’s recovery at home after they’ve seen a doctor.
It is important that parents follow key NHS advice and are guided by their GP. You should immediately seek help if your child has been in the heat and they show symptoms such as a high temperature, fast heartbeat, shortness of breath, seizure or fit, or loss of consciousness. This could be heat stroke and requires emergency medical care.
What is the difference between heat stroke and heat exhaustion
"Heat exhaustion and heat stroke are both conditions caused by the body becoming overheated, sweating and losing excessive amounts of water and salt," explains Dr Sinha. "Heat stroke is a medical emergency that requires immediate help, whereas heat exhaustion may not require this if managed appropriately and on time."
"Heat stroke and heat exhaustion usually happen during a heatwave in the UK or in a hot climate on holiday," says Dr Ashrafi. "Both heat stroke and heat exhaustion can develop quickly over a few minutes or gradually over several hours or days." It is important to remember that it is possible to develop heat exhaustion even when you are not in direct sunlight.
Dr Sinha explains that the symptoms of heat exhaustion include, "excessive sweating - maybe with a heat rash - as well as fatigue, dizziness, nausea and headaches," she explains. "They might also feel very thirsty with cramps in their arms and legs, and they may feel their heart racing too. Children, especially younger ones, may become irritable."
If someone has heat exhaustion then it is important they are cooled down as soon as possible, advises Dr Sinha. "This involves moving away from the source of heat, removing excess clothes, using cooling measures such as a fan or sponging - especially in the armpits or neck area - and taking on water and perhaps a rehydration or electrolyte drink," she suggests.
"If cooling does not work, they will start to get symptoms of heat stroke," warns Dr Sinha. "This involves a deterioration, with an ongoing high body temperature, racing heartbeat, confusion, fits, delirium or even loss of consciousness." She adds that they should be placed in the recovery position, and you should call 999.
As mentioned, if not treated, heat exhaustion can lead to heat stroke. "It occurs when the body is unable to regulate its internal temperature, which will rise above 40 degrees celsius," warns Dr Ashrafi. "Symptoms among children additionally include sweating, rapid heartbeat and breathing, loss of consciousness, seizures, disorientation and feeling flushed, as well as hot and dry skin." If these symptoms are present then your child might have heat stroke which is considered a serious medical emergency and you need to call 999.
How do I know if my child has heat exhaustion?
"Heat exhaustion symptoms among children include cool, clammy skin despite the warmer temperatures, headache, goosebumps, nausea and vomiting, dizziness and increased heavy sweating," warns Dr Ashrafi. "A child’s temperature can be higher than normal during heat exhaustion, but less than 40 degrees celsius."
Dr Sinha notes: "Children, especially those under the age of five, can sometimes have symptoms that are more atypical or harder to recognise when it comes to both heat stroke and heat exhaustion. They may just present as more irritable, reduce their eating or drinking or eventually become drowsy, sleepy or lethargic."
Children are more susceptible to heat exhaustion than adults because, "children are less able to regulate their body temperatures as efficiently as adults and can become unwell quickly, so even mild heat exhaustion is important to recognise as it can escalate rapidly," explains Dr Sinha.
What to do if your child has heat exhaustion
"Heat exhaustion usually does not need urgent medical attention if your child can cool down within 30 minutes," says Dr Ashrafi. Measures you can take include moving them away from the source of heat, removing excess clothes, using cooling measures such as a fan or sponging, giving them water and perhaps a rehydration or electrolyte drink.
The NHS says, "If someone has heat exhaustion, follow these 4 steps:"
- Move them to a cool place.
- Remove all unnecessary clothing like a jacket or socks.
- Get them to drink a sports or rehydration drink, or cool water.
- Cool their skin – spray or sponge them with cool water and fan them. Cold packs, wrapped in a cloth and put under the armpits or on the neck are good too.
If these steps to cool down are working, the NHS says, "They should start to cool down and feel better within 30 minutes."
However, Dr Sinha emphasises how important it is to react quickly to heat exhaustion symptoms in children to help avoid it turning into a more serious condition and advises seeking medical help if you see any concerning symptoms in your child: "If you think your child is suffering from heat exhaustion, you should take them to see a doctor as soon as possible," advises Dr Sinha.
"They can also become unwell quickly, so it’s important to act fast," warns Dr Sinha. "Seeking medical help early for kids is important as they can often have unusual symptoms that may be hard to recognise, and they can also become unwell quickly. Having worked as a GP in the NHS and private sector, I always tell parents to follow their gut instinct and to just get their child checked if they are not sure - they are usually right." She adds that you shouldn’t worry about revisiting your doctor several times if needed, since your child’s symptoms can change.
Once they’ve been seen by a healthcare professional, there are certain steps parents can take to aid their child’s recovery from heat at home. “Keep your them indoors and out of the sun," recommends Dr Ashrafi. "Encourage them to drink cool fluids, and apply a cool flannel or sponge to their skin."
How long does heat exhaustion last?
"Heat exhaustion can be reduced with gradual resolution within 30 minutes to an hour if it is spotted and the right measures taken," says Dr Sinha. "If this does not work, then it may progress to heatstroke."
Recovery time can vary greatly for a child recovering from heat exposure. "It can take one to two days - or even longer - to resolve depending on the severity," reveals Dr Sinha. "This is a very serious condition that needs to be treated in hospital."
What to do if you think your child might have heat stroke
Heat stroke is considered a serious medical emergency and if you think your child might have heat stroke you need to call 999.
As mentioned above, if your child has heat exhaustion but starts deteriorating - with an ongoing high body temperature, racing heartbeat, confusion, fits, delirium or even loss of consciousness - then they might have heat stroke and should be placed in the recovery position and you should call 999 immediately.
When to see a doctor
As Dr Sinha emphasies above, due to the potential severity of heat exhaustion, she would advise that you see a doctor straight away if you think your child has heat exhaustion. If you, your child or someone else have signs of heatstroke, call 999 now.
"If your child has symptoms that you are worried about - such as an ongoing high body temperature, racing heartbeat, confusion, fits, delirium or even loss of consciousness - then you should take them to see a doctor straight away, which can be your GP or in A&E depending on how unwell they are," says Dr Sinha. "It is always best to get checked to ensure nothing is wrong, rather than wait."
You should call 999 if your child has symptoms of heat stroke, such as a temperature above 40 degrees celsius, sweating, rapid heartbeat and breathing, loss of consciousness, seizures, disorientation and being flushed, as well as hot and dry skin. "Seek emergency medical care straight away," insists Dr Ashrafi.
How to reduce the risk of heat exhaustion and heat stroke
There are certain factors that can make children more vulnerable to heat. "They are not able to regulate their body temperatures as efficiently as adults," explains Dr Sinha. "In addition, they are less likely to be able to spot that they are getting overheated and take appropriate measures - such as stopping physical activity, taking rest, hydrating with fluids and ensuring clothing is appropriate."
Parents should be particularly cautious about their children during heatwaves in the UK, or while holidaying in a hot climate. "Heat stroke and heat exhaustion can both be prevented by taking precautionary measures," says Dr Ashrafi. "These include drinking plenty of liquids, staying out of the sun during peak high temperatures, wearing loose fitting clothing, applying sunscreen, and avoiding extreme physical exertion during higher temperatures."
Dr Sinha adds that you should keep your house cool in summer if possible: "Parents should ensure that the environment is the correct temperature – using fans or other cooling measures as appropriate. They should make sure their children are appropriately dressed for the weather and that they do not play outdoors during peak heat hours - between 11am and 3pm. During hot weather or heat waves, it is useful if they have a water bottle that they are in the habit of drinking from, to ensure that they have had enough fluids during the day."
Dr Sinha adds: "Certain children may also be more susceptible to heat exhaustion and heat stroke. These include obese children - since body temperature regulation is more difficult - as well as those not wearing the right clothes, such as certain types of school uniforms, and those with learning disabilities who may have less awareness and not be able to seek help as needed."
The NHS advises doing the following to help prevent heat exhaustion or heatstroke:
- drink more cold drinks, especially if you're active or exercising
- wear light-coloured, loose clothing
- avoid the sun between 11am and 3pm
- avoid excess alcohol
- avoid extreme exercise
- if you're inside on a very hot day, close curtains, close windows if it's hotter outside than in your home and turn off electrical equipment and lights that get hot
