Heat Cramps, Exhaustion and Stroke

Also known as: heat cramps, heat exhaustion, heat stroke, heat-related illnesses.

What are heat cramps, exhaustion and stroke?

Children have greater difficulty managing overexposure to heat for a variety of reasons and are therefore more vulnerable to heat-related injury. Heat cramps, exhaustion and stroke are three related conditions that represent progressively worsening symptoms that can occur during prolonged exposure to heat and humidity without adequate amounts of fluid intake. Heat cramps are the first and mildest form of heat related symptoms that can occur, followed by heat exhaustion and then heat stroke at the severe end of the spectrum.

What causes heat cramps, exhaustion and stroke?

Usually it’s some combination of exposure to prolonged high temperatures, high humidity, strenuous activity, lack of breaks during athletic competition, with an inadequate fluid intake that causes heat cramps, exhaustion and stroke. Some children, particularly those who have chronic health conditions, are overweight/obese, take certain medications and/or wear heavy or thick clothing while doing physical activity (football or marching band) are at greater risk.

What are the symptoms of heat cramps, exhaustion and stroke?

Heat cramps are painful muscle cramps or spasms usually affecting larger muscle groups that occur after heat exposure with mild/high fever, pale moist skin and nausea. Children/adolescents may be dehydrated and the muscles groups involved feel hard.

Heat exhaustion is more severe than heat cramps and is characterized by muscle cramps, a fever higher than 104* F, dizziness, weakness, excessive sweating, fatigue, anxiety, headache, nausea, vomiting, diarrhea, high heart rate and a warm dry skin.

Heat stroke presents with a high fever, rapid heart rate, headache, vomiting, confusion, agitation, lethargy, stupor or seizures, which may go to coma or even death.

What are heat cramps, exhaustion and stroke care options?

All children with heat related injury should stop activities, should move (or be moved) to a cool place, preferably under a fan, receive fluids (orally or by intravenous route) that contain salt, excess clothing removed and cool cloths placed on the skin.

For heat cramps, in addition to the above, the muscle groups involved should be slowly and gently stretched.

For heat exhaustion, and/or heat stroke if no improvement occurs with the above treatment, and fluids cannot be taken by mouth, the child/adolescent should be transferred immediately to an Emergency Department for intravenous fluid administration and further management.


Reviewed by: Jose R. Rosa-Olivares, M.D.

This page was last updated on: January 13, 2020 04:49 PM