Sending Your Kids Back to School? Risks Every Parent Should Know.

By Karen Thompson MSN, APRN, Pediatric emergency medicine nurse practitioner affiliated with Children’s Memorial Hermann at  Memorial Hermann The Woodlands Medical Center

Now that school is back in session, local kids are resuming their studies and extra-curricular activities. While most parents  focused on ensuring their children had adequate school supplies and a new outfit for the first day of class, they most likely haven’t given any thought to their child suffering an illness or injury while at school. Though the carefree days of summer may be over, summertime’s heat and humidity will last at least another month or two for Southeast Texas residents.

With football drills and band practices that go on for hours in the unrelenting heat, students can be at risk for serious dehydration by simply participating in their favorite activities. Most heat-related illnesses  are especially prevalent in athletes. Houston’s high humidity and temperatures in the 90s or 100s increase the risk of heat-related illness. Here’s what you can do to protect your children.

Hydration is Key

The most common heat-related illness is simple dehydration. In extremely hot and humid areas areas like Houston,  people can sweat up to 1.5 liters of fluid per hour, so it’s important to consume a similar volume of fluid for every hour of activity.

Know the Warning Signs of Dehydration

Signs of dehydration in a child or adolescent could include a decrease in urination, dry mouth and flushed or pale skin.  Additionally, they may not be acting normally and instead are very sleepy, irritable or dizzy.

Recognizing the Signs of Rhabdomyolysis

A more serious complication of heat-related illness, especially when exposure to heat is combined with intense physical activity, is rhabdomyolysis.  This condition occurs when muscle fibers break down and the components of those fibers enter the bloodstream. Muscle breakdown leads to increased levels of certain electrolytes, myoglobin and creatinine kinase in the blood.

The most common symptom of rhabdomyolysis is having dark colored urine. It is often described as looking like tea. A person experiencing rhabdomyolysis may also experience muscle cramps, nausea and vomiting, as well as the common signs of dehydration. A serious complication of rhabdomyolysis is damage to the kidneys.

Any child or adult showing signs of dehydration or rhabdomyolysis should be evaluated in an Emergency Center.

What to Expect at the ER

Parents can expect that any child with symptoms of significant dehydration or rhabdomyolysis will have labs drawn to check for electrolyte abnormalities and other findings that can help their healthcare provider estimate the degree of dehydration or muscle injury. The child will most likely have a temporary intravenous (IV) catheter placed to rehydrate with IV fluids. In some cases, additional studies such as an electrocardiogram (EKG) may be used.

Many children and adolescents with dehydration or rhabdomyolysis can be treated in the ER and then discharged home to rest and rehydrate.

For more information and tips to keep your kids safe, visit

For the Memorial Hermann ER nearest you, visit

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