Back to School Check-ups

Even though school has just started up, it’s still not too late to think about the importance of a back-to-school check-up.

All healthy babies and children should have an annual doctor’s exam and one before starting first grade. After that, back-to-school check-ups should be repeated every two years.

Although August is the ideal month to schedule your child for this check on physical growth and development, psychosocial development and general health, don’t hesitate to do so in September. The sooner any problems in these areas are detected, the sooner your child can be helped. It’s much easier to intervene before problems escalate.

Generally, a back-to-school visit to the doctor’s office includes a head-to-toe physical exam; screenings for vision, hearing and hernias; blood and urine tests; a tuberculosis test (every three to four years); a discussion of the child’s psychosocial development and family life; and a review of safety issues.

For teenagers, the doctor may address additional matters such as a scoliosis screening, smoking hazards and precautions if the youngster is sexually active.

The visit also includes a review and update of the child’s immunizations.

Before entering kindergarten, children must have evidence of vaccinations for polio; diphtheria, pertussis and tetanus (DPT). In addition, children who have not had chicken pox should have a varicella vaccine before entering school. And a tetanus booster is recommended by age 15 and every 10 years thereafter.

It’s just good medicine to schedule your child for a back-to-school check-up and most health insurance programs cover the costs, and many clinics and state agencies provide these services free to uninsured children.

Just think, getting a clean bill of health will be the easiest test your child will ever get an A+ on!

Recognizing Heat Illness in Children

Our bodies create a tremendous amount of internal heat. We normally cool ourselves by sweating and radiating heat through the skin. Under certain circumstances, such as unusually high temperatures, high humidity or vigorous exercise in hot weather, this natural cooling system may begin to fail, allowing internal heat to build up to dangerous levels. The result may be heat illness, which can be in the form of heat cramps, heat exhaustion or heatstroke.

Heat cramps
“Heat cramps are brief, severe cramps in the muscles of the leg, arm or abdomen that may occur during or after vigorous exercise in extreme heat. They are painful but not serious,” says Virtua Health pediatrician Anthony Napoli, MD. “Children are particularly susceptible to heat cramps when they have not been drinking enough fluids. Most heat cramps do not require special treatment. A cool place, rest and fluids should ease the child’s discomfort. Massaging cramped muscles may also help.”

Heat exhaustion
Heat exhaustion is a more severe heat illness that can occur when a person in a hot climate or environment has not been drinking enough fluids. Symptoms can include dehydration (intense thirst), fatigue, weakness and clammy skin. There also may be headache, nausea and/or vomiting, hyperventilation (rapid breathing), or irritability. If a child shows signs of heat exhaustion, resting in a cool area and drinking fluids are the keys to recovery.

What to do:
Bring the child indoors or into the shade. Loosen or remove clothing. Encourage food and drink. Give child a bath in cool (not cold) water. Call the doctor for further advice. If the child is too exhausted or ill to eat or drink, intravenous fluids may be necessary. “If left untreated, heat exhaustion may escalate into heat stroke, which can be fatal,” warns Dr. Napoli.

Heatstroke
“Heatstroke, the most severe form of heat illness, is a life-threatening emergency. The body loses its ability to regulate its own temperature,” states Dr. Napoli. “Unless you seek prompt medical attention, body temperature can soar to 105 degrees Fahrenheit – or even higher – and lead to shock, which can be fatal.”

Factors that increase the risk for heatstroke include overdressing and extreme physical exertion in hot weather with inadequate fluid intake. Heatstroke can also result when a child is left in, or becomes accidentally trapped in, a car on a hot day. When the outside temperature is 93 degrees Fahrenheit, the temperature inside a car can reach 125 degrees in just 20 minutes, quickly raising a child’s body temperature to dangerous levels.

What to do:
Call for emergency medical help if your child has been outside in the sun exercising for a long time and shows one or more of the following symptoms of heatstroke:

Headache Dizziness or weakness Disorientation, agitation or confusion Sluggishness or fatigue Seizure Hot, dry skin Temperature of 105 degrees Fahrenheit or higher Loss of consciousness “While waiting for help, get the child indoors or into the shade, undress him/her and sponge or douse him/her with cool water,” advises Dr. Napoli. Find more articles on heat illness and summer safety at www.virtua.org/kidshealth.