Extreme heat, or a heat wave, occurs when temperatures are substantially hotter and more humid than average for an area and usually lasts for multiple days to weeks. Because of this humidity, heat waves may feel hotter than the actual temperature, and this subjective experience is measured by the heat index. Extreme heat can be dangerous as the body must work extra hard to maintain a normal temperature and stay comfortable, putting vulnerable individuals at risk for becoming sick. Extreme heat may accompany drought conditions.

Being prepared beforehand is the best way to help children and family members adjust after extreme heat. To improve their preparedness, families should:

• Be informed about how to access updated weather information. Families should know what official radio stations, websites, and/or social media will provide weather updates and alerts, including the heat index. Help families to understand the different extreme heat alerts:
  • Excessive Heat Outlook: Issued when the potential exists for an excessive heat event in the next 3-7 days. An excessive heat outlook provides information to those who need considerable lead-time to prepare for the event.
  • Excessive Heat Watch: Indicates conditions are favorable for an excessive heat event to meet or exceed local excessive heat warning criteria in the next 24 to 72 hours. Families should continue to monitor conditions. 
  • Excessive Heat Warning: Heat index values are forecasted to meet or exceed locally defined warning criteria for at least 2 days (daytime highs=105-110° F). Families should take precautions to avoid heat-related illnesses.
  • Heat Advisory: Heat index values are forecasted to meet locally defined advisory criteria for 1 to 2 days (daytime highs=100-105°F). Families should take precautions to avoid heat-related illnesses.
• Understand the risks of extreme heat. Families should be aware that infants, children under the age of 4, the elderly, those who are chronically sick, and those who are overweight are more at risk for heat-related problems. Families should recognize the symptoms of these heat-related illnesses:
  • Heat Stroke: Occurs when the body is unable to regulate its temperature. Symptoms include extremely high body temperature (above 103°F); red, hot, and dry skin (no sweating); rapid and strong pulse; throbbing headache; nausea; confusion; and changes in consciousness. Seek medical attention immediately and cool the body. Do NOT give fluids.
  • Heat Cramps: Involuntary spasms of large muscles that occur after physical activity in hot weather. Rest and drink a sports beverage.
  • Heat Exhaustion: Symptoms include cold, pale, and clammy skin; heavy sweating; cramping; weakness; headache; nausea or vomiting; dizziness; and exhaustion. Cool off the body and hydrate. Seek medical attention if symptoms worsen or last longer than an hour.
• Take protective steps to limit the consequences of extreme heat. Families should know that it takes time to adjust to hotter temperatures, so they should limit physical activity until they become accustomed to the heat. Encourage them to keep pets cool and hydrated too. 
• Make sure they can keep their residence cool. Air conditioning is the best protection against heat-related illnesses. Families can also weather-strip their doors and window sills to keep the cool air in, and use drapes, shades, or awnings to cover windows that receive heavy sun.
• Identify places that offer respite from the heat. Identify places in the community where families can go to cool down if they do not have access to air conditioning or if increased demand has caused power outages. Potential locations include restaurants, libraries, malls, and stores.
• Plan for children’s needs. Families should give children factual information about extreme heat in simple terms. Remind them that outdoor activities may be limited during the heat wave and to stay hydrated. The mobile app Help Kids Cope provides information on how to talk with children of different developmental levels. 

Knowing what to do during a period of extreme heat can help families stay safe. Families should:

• Monitor the local weather forecast for extreme heat alerts and current updates. 
• Provide extra protection to at-risk individuals. Children under the age of 4, the elderly, those who are chronically sick, and those who are overweight are more at risk for heat-related problems and need to be extra cautious during heat waves.
• Minimize the effects of heat when outside. Encourage family members to wear light-colored, light weight, loose-fitting clothing, including a hat and shoes. Have them regularly apply sun block with an SPF greater than 30. Families should drink plenty of fluids before and during activity, and avoid sugary liquids. It is best to take frequent breaks inside or in the shade, and schedule vigorous activities in the morning or evening. If a family member feels overheated, they should go indoors, rest, and hydrate immediately. 
• Minimize time spent outside. Family members should avoid extended exposure to the sun and spend more time in air-conditioned places during the warmest part of the day. Pets should follow the same plan; limit outdoor exercise and keep fresh, cool water available.
• Never leave a child or pet in a parked car.
• Follow official water regulations or restrictions if in a drought. 
• Explore alternatives to outdoor activities. Parents and caregivers should acknowledge children’s eagerness for outdoor activities, while also exploring indoor alternatives. Encourage families to make a list of things they enjoy doing together, such as going to the library or to the store, that can be done during the hottest hours. Have them consider indoor workouts such as yoga, pushups, or walking up and down the stairs, for children involved in sports who may be frustrated that their practice is canceled and want to maintain their conditioning. For additional ideas, view these handouts.
• Monitor children for any heat-related issues. Get medical attention if necessary.

After a period of extreme heat, most families will recover and be able to return to their normal routines rather quickly. Most children will demonstrate resilience after a heat wave. The greatest problems such as sleep issues and irritable mood tend improve quickly when the heat decreases. Those children who have experienced a loss of a loved one or pet will need additional grief support to help them adjust.