Children's heat stroke has entered the high season, and doctors have summarized the prevention recommendations of "clothing, food, housing and transportation"

Reviewer: Zheng Chengzhong, chief physician of the Department of Pediatrics of the Special Medical Center of the Strategic Support Force of the Chinese People's Liberation Army

Global Times health client reporter Wu Tong

Summer vacation is just around the corner, and many parents take their children out for activities and travel, but as the weather gets hotter, the chances of heat stroke increase. Heat stroke may seem like a small matter, but severe heat stroke is also fatal and should be taken precautions against. Especially children, due to the high metabolic rate and high body temperature, and the incomplete development of body functions such as regulating body temperature and heat dissipation, are easily affected by high temperature weather and belong to the group with high incidence of heat stroke.

In view of the fact that children's heat stroke cannot be diagnosed and treated in full accordance with adult methods, the consensus expert group led by the Disaster Pediatrics Group of the Pediatrics Branch of the Chinese Medical Association and Professor Zheng Chengzhong and Professor Shi Yuan of the Pediatrics Professional Committee of the Chinese People's Liberation Army conducted a scoring and discussion on the current relevant evidence on children's heat stroke according to the evidence evaluation standards of the Oxford Center for Evidence-Based Medicine, summarized the age characteristics of children's heat stroke and the key points of prevention and treatment, and formed the "Expert Consensus on Prevention and Treatment Programs for Children's Heat Stroke" to prevent and treat children's heat stroke in daily life. and hospital treatment strategies provide detailed advice.

The consensus pointed out that children's heat stroke can be divided into infant heat stroke and child heat stroke according to different ages. The common causes of heat stroke in infants and young children are excessive warmth, head and face covering (stuffy syndrome, heat covering syndrome), etc., Chinese parents have the habit of dressing, packing, covering the baby, which can easily lead to infant dehydration, high fever, sweating, lack of oxygen, coma, convulsions, shock, and even respiratory failure and circulatory failure. When parents find that infants and young children have hyperthermia, flushed face, irritability, lethargy or coma, etc., they should loosen the package and cool down in time.

Heat stroke in children is similar to heat stroke in adults, with dizziness and headache, limb weakness, palpitations, sweating, vomiting, lack of attention, and uncoordinated movements. If not taken in time, it may develop into severe heat stroke, muscle spasms, and even heat stroke, resulting in high body fever, cognitive impairment, convulsions, lethargy or coma. Children's heat stroke mostly occurs when exposed to high temperature and humidity for too long, such as military training, summer camps, summer sports, etc.

Although children are at high risk of heat stroke, they can be effectively prevented. The consensus mentioned that heat stroke in infants and preschool children is usually caused by deviation or negligence in family care concepts, so parents should fully strengthen the awareness of prevention, do not put their children in high temperature and humidity for too long, such as covering too many blankets and clothing, or leaving children alone in closed motor vehicles; For school-age children and adolescents, shock or fainting is often detected due to playfulness or lack of awareness of the prevention of heat stroke and its initial symptoms. Parents and schools should strengthen active prevention of heat stroke and awareness education on early warning symptoms of heat stroke. For example, tell your child that when the weather is hot, do not do physical activities outdoors at noon, and go out after 3 pm; In summer, when dizziness, fatigue, diarrhea, vomiting and other conditions occur in outdoor activities, be sure to rest and tell parents or teachers in time; Do not enter the air-conditioned room or directly blow the air conditioner immediately after sweating, wait for the sweat on the body to fall, the body temperature to drop, and the heartbeat to calm down before entering.

The consensus emphasizes that conventional measures to prevent heat, such as ensuring adequate drinking water and good rest, are important measures to prevent heat stroke in children. When exercising in a hot environment, children weighing 40 kg should be guaranteed to drink 150 ml of water or electrolyte drinks every 20 minutes, but never drink drinks that are too high in sugar or alcohol to avoid aggravating water loss. At the same time, cold frozen drinks should be avoided to avoid stomach cramps. Children who are active in a high temperature environment should adjust the ratio of activity time to rest time to ensure good rest. If you wear movable equipment, remove it in time when resting; Wear light, breathable, light-colored clothing during the activity, and change it after sweating. Parents of infants and young children should choose a light blanket, do not wrap too tightly, or cover the mouth and nose of the infant. When in a confined space, pay attention to the sweating and mental status of infants and young children in time.

It is also agreed that children can prevent heat stroke through hot training training. Hot training is a kind of heat resistance training commonly used by athletes, which improves the body's heat resistance and prevents heat stroke by gradually adapting to high temperatures. Experts recommend that when children carry out military training or field summer camps and other activities in high temperature climates, the corresponding hot training training is carried out in advance, and the training cycle is 10~14 days.

In addition, some children are prone to heat stroke due to their own diseases or the use of special drugs, which increase the heat generated by the body, or affect the body's heat dissipation capacity, water-electrolyte balance and the function of the thermoregulatory center. Therefore, when conducting outdoor activities under high temperature conditions, parents or activity organizers should pay attention to understanding whether the child has a history of disease or drug use, focus on such children, and strengthen observation and monitoring.

When children suffer from heat stroke, parents should first quickly move the child away from the high temperature environment, move to a cool place such as a ventilated and cool place, and loosen or take off tight clothing. Infants and young children should immediately unwrap the quilt to cool down, and change the sweat-soaked quilt in time. Replenish water in time to avoid excessive fluid loss from the body and aggravating heat stroke symptoms. After that, physically cool down as soon as possible, first use warm water, then use cold water to bathe the child's whole body, and place cold water bags on the forehead, bilateral neck, armpits, groin and other parts during the bath, and use a fan to increase convection heat dissipation. For older, better-established and conscious children, the child's torso and limbs can also be immersed in a cold tub by soaking and cooling. During the cooling process, the limbs can be continuously massaged to ensure smooth circulation, and the cooling force should not be too strong. If the symptoms are severe, they should be immediately sent to a medical institution with conditions for intensive care of children. ▲

Responsible editor: Wang Xiaoqing

Editor-in-chief: Li Di