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As we head into the warmer months we should remember that every year there are reports of a toddler left in his car seat for 15 min who comes in uresponsive with hyperthermia.
Heat related illnesses are a continuum from heat cramps to heatstroke. The hallmark of heatstroke is hyperthermia with mental status changes and when identified rapid cooling must be initiated. Mortality for heatstroke is reported as high as 80%.
Children are more susceptible to heat stroke because of a greater surface area to body mass ratio, higher metabolic rates, less developed sweating mechanisms, and inability to always remove themselves from the hot environment.
The quickest and easiest way to cool a conscious patient is by evaporation. Changing water from a liquid to a vapor is an endothermic process. Removal of all clothes, followed by misting or wiping with tepid water of the entire skin is very effective. Having a fan pointed at the child can enhance this method.
References
Lin, J. Losey, R. Prendergast, H. An Evidence-Based Approach to hyperthermia and other heat-related emergencies. Pediatric Emergency Medicine Practice. April 2009. Vol 6, No 4