We have all heard about leaving children unattended in the car. Why is this so dangerous? Joe Perno, M.D., medical staff affairs officer at Johns Hopkins All Children’s Hospital, explains why you should never leave a child alone in a hot car.

Sadly, this is a common problem. About 40 children a year die from heatstroke. 

• 52 percent—child “forgotten" by caregiver
• 29 percent—child playing in unattended vehicle
• 18 percent—child intentionally left in vehicle by adult

This is an extremely dangerous situation due to the dramatic internal temperatures vehicles can reach in a short time. Temperatures inside a locked car can reach 170 F. They can reach deadly temperatures in 10 minutes. They can reach these temperatures even when the outside air temperature is only in the 60s. Opening the window 2 inches has no affect on the internal temperature. Children are extremely susceptible to these rises in temperature due to their body surface area with young children, less than 4 years old at greatest risk.

What can be done to prevent it?

Some of these incidents are parents leaving the child in the car while running errands. This is a practice that should never be done. However, many of these are parents who forget the child is in the car with them. A couple of tips: Keep your personal items (purse, cell phone, briefcase) in the backseat with the child. Keep the diaper bag or child belongings in the front seat as a visual reminder. Have the daycare call you if the child is not dropped off by a certain time each day. Safe Kids wants everyone to ACT.

• A: Avoid heatstroke-related injury and death by never leaving your child alone in a car, not even for a minute. And make sure to keep your car locked when you’re not in it so kids don’t get in on their own. 
• C: Create reminders by putting something in the back of your car next to your child such as a briefcase, a purse or a cell phone that is needed at your final destination. This is especially important if you’re not following your normal routine.
• T: Take action. If you see a child alone in a car, call 911. Emergency personnel want you to call. They are trained to respond to these situations. One call could save a life.

When this happens the child is suffering from heat stroke. What is heat stroke?

Heat stroke is the most severe of several heat emergencies that can affect children and adults. Heat stroke is a body temperature above 104 with changes in the patient’s awareness such as delirium, seizures, coma or death. It is very different than when an illness drives the body temperature above 104. We have talked here previously about fever going above 104 but not harming you; it is very different when the body temperature rise is secondary to external temperatures. Less severe heat emergencies are heat exhaustion, which is typically muscle cramps, nausea or vomiting, headache, lightheadedness. Heat stroke is a medical emergency that needs to be treated immediately whereas heat exhaustion, depending upon how severe, can be treated with aggressive fluid intake of sport drinks and a cool environment.

How can we prevent a trip to the ER for these heat emergencies?

Avoiding exercise during the hottest parts of the day is the best prevention. Wearing synthetic lightweight clothing designed to draw sweat to the surface to allow for evaporation. Hydration is also a key factor. You must pre-hydrate before exercise ideally with three 8-ounce cups of water or sport drink two hours before exercise then two cups 15 minutes before exercise and then one cup every 15 minutes during exercise. If you wait until you are thirsty, you are already dehydrated and in need of fluids