Ray Rays Pledge #heatstroke awareness 2015
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An in-depth discussion of child hot car deaths (aka vehicular hyperthermia, vehicular heatstroke) and preventive measures from a parent survivor of a heatstroke victim, the late Sophia Rayne "Ray Ray" Cavaliero.
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Ray Rays Pledge #heatstroke awareness 2015
- 1. It Takes a Village: Prevention of Child Vehicular Heatstroke Kristie C. Reeves-Cavaliero, Pharm.D. President and Co-Founder, Ray Ray’s Pledge™
- 2. ©Ray Ray’s Pledge™ 2015 Forgotten in the Backseat: More Common than You Think http://youtu.be/kYGAIagq-Wg
- 3. ©Ray Ray’s Pledge™ 2015 636+ The number of child hot car deaths reported in the media since 1998 http://ggweather.com/heat; Accessed 3/30/15.
- 4. ©Ray Ray’s Pledge™ 2015 TEXAS Leads the Nation! http://ggweather.com/heat; Accessed 3/30/15.
- 5. ©Ray Ray’s Pledge™ 2015 Forgotten Daycare Drop-off The #1 source of child hot car deaths Data on file. Ray Ray’s Pledge, 2015.
- 6. ©Ray Ray’s Pledge™ 2015 Heat-Related Illness A spectrum of symptoms due to excessive heat exposure Key initial physical sign to distinguish mild illness vs. heatstroke: Core temperature: ≥104˚F: heatstroke,,,,, Becker J. Am Fam Physician 2011; 83(11):1325-30.
- 7. ©Ray Ray’s Pledge™ 2015 Thermoregulation The body’s methods to maintain a healthy temperature Conduction Direct transfer of heat from a warmer surface to a cooler surface Evaporation Perspiration Radiation Absorption or reflection of heat without direct contact Eg: reflection of heat with light-colored clothing Convection Exchange of heat with surrounding air Becker J. Am Fam Physician 2011; 83(11):1325-30.
- 8. ©Ray Ray’s Pledge™ 2015 Heatstroke Also known as “hyperthermia” Body temperature exceeds 104˚F + Body’s thermoregulatory mechanism is overwhelmed and can no longer cool itself + Symptoms: Central nervous system effects: disorientation, sluggishness, hallucinations, seizure, loss of consciousness Other: hot/dry skin that is flushed but not sweaty, rapid heart rate, other heart rhythm disturbances Body temperature >107˚F: organs shut down, cellular damage Fatal if not rapidly reversed Becker J. Am Fam Physician 2011; 83(11):1325-30. http://ggweather.com/heat, Accessed 12/1/11.
- 9. ©Ray Ray’s Pledge™ 2015 Heatstroke in Children Children are more prone to overheating than adults: Immature thermoregulatory system: less efficient than adults A child’s body overheats 3-5 times faster than an adult body Adults more likely to modify behavior based on environment (eg: remove excess clothing, get out of a hot car) Tsuzuki-Hayakawa K and Tochihara Y. Eur J Appl Physiol 1995;72:12–17. http://ggweather.com/heat, Accessed 12/1/11.
- 10. ©Ray Ray’s Pledge™ 2015 Child Vehicular Heatstroke: An Unintended Consequence of Moving Children to the Backseat www.KidsandCars.org/heatstroke.html. Accessed 3/15/14.
- 11. ©Ray Ray’s Pledge™ 2015 Child Deaths Due to Vehicular Heatstroke: Why Are We Talking About It? http://kidsandcars.org/heatstroke.html, Accessed 12/1/11. NiTS Data. http://www-nrd.nhtsa.dot.gov/Pubs/811655.pdf. Accessed 3/15/14. Vehicular Heatstroke: 3rd leading cause of death! #1 cause of non-crash, non-traffic child car fatalities!
- 12. ©Ray Ray’s Pledge™ 2015 Child Vehicular Heatstroke: Understanding the Cause Data from 494 child hot car deaths (1998 – 2010) http://ggweather.com/heat, Accessed 12/1/11. Graph Courtesy of Jan Null, CCM. •More than 1 in 5 heatstroke DEATHS •Kids were supposed to go to DAYCARE that morning •FORGOTTEN in the backseat instead •Whereabouts went unquestioned
- 13. ©Ray Ray’s Pledge™ 2015 Understanding the Cause Child Vehicular Heatstroke Fatalities 2014 (n = 30) *DNS: destination not specified Data on file. Ray Ray’s Pledge, 2015. • Children being forgotten in backseat (60%) continues to be predominant factor • Forgotten daycare drop-off continues to be most common intended destination 23% 13% 27% 37%
- 14. ©Ray Ray’s Pledge™ 2015 Children Left in Vehicles: How Hot? How Fast? Rate of temperature rise in first 20 minutes: 6.25˚F/ 5 minutes Overall rate of temperature rise through 60 minute study: 3.1˚/ 5 minutes 80% of temperature rise in first 30 minutes Temperature rise begins within five minutes of shutting off ignition Temperature begins to plateau at 60 minutes McClaren C et al. Pediatrics 2005; 116:e109-11. http://ggweather.com/heat, Accessed 12/1/11.
- 15. ©Ray Ray’s Pledge™ 2015 “How Can ANYONE Forget that a Child is in the Backseat??” “If you’re capable of FORGETTING your CELLPHONE, you are potentially capable of FORGETTING your CHILD” David Diamond, Ph.D., USF Weingarten G. Fatal Distraction. IN: Washington Post 2009. http://www.pulitzer.org/works/2010-Feature-Writing.
- 16. ©Ray Ray’s Pledge™ 2015 Common Factors Associated with Parents Who Forgot their Children Stress Emotion Lack of sleep Change of routine Weingarten G. Fatal Distraction. IN: Washington Post 2009. http://www.pulitzer.org/works/2010-Feature-Writing.
- 17. ©Ray Ray’s Pledge™ 2015 Prevention Efforts: It Takes a Village!
- 18. ©Ray Ray’s Pledge™ 2015 Three Easy Prevention Steps www.RayRaysPledge.com; Accessed 3/15/14.
- 19. ©Ray Ray’s Pledge™ 2015 Ray Ray’s Pledge™ www.RayRaysPledge.com; Accessed 3/15/14.
- 20. ©Ray Ray’s Pledge™ 2015 For Heatstroke Information Please Visit Us: Sophia Rayne “Ray Ray” Cavaliero 5.15.10 – 5.25.11 www.RayRaysPledge.com www.facebook.com/rayraycavaliero Twitter: @rayrayspledge Instagram: rayrayspledge Email: info@rayrayspledge.com
- 21. ©Ray Ray’s Pledge™ 2015 Follow the Social Media Conversation on Child Vehicular Heatstroke! Common tags: #heatstroke, #childhotcardeath, #wheresbaby Upcoming social media events: April 22: #Run4RoRa in memory of Aurora Hollingsworth, Richland Hills TX May 22: National Heat Awareness Day July (TBD): National Heatstroke Prevention Day
Editor's Notes
- Heat exhaustion: Common symptoms of heat exhaustion include headache, weakness, dizziness, goose flesh, nausea, vomiting, diarrhea, irritability, and loss of coordination. The skin may appear pale or ashen, with associated tachycardia or hypotension. Normal mentation is maintained. Patients with heat exhaustion should remove excess clothing and be moved to a shaded, cool environment. They should be placed in a supine position, preferably with their legs elevated. Oral fluids are preferred over intravenous fluids for rehydration in those who are conscious, able to swallow, and not losing fluids secondary to vomiting or diarrhea. 9 Vital signs should be monitored, with transport to an emergency facility if symptoms do not improve after 20 to 30 minutes.3,6,9 Heat cramps: Heat cramps, or exercise-associated muscle cramps, can occur in any setting, but are more common when exercising in hot and humid environments. Dehydration, depletion of electrolytes, and sodium losses from sweat all accelerate in this type of environment, especially in those who sweat profusely.18 Treatment includes rest, prolonged stretching of affected muscle groups, and oral sodium ingestion. Intravenous normal saline may be used for more rapid relief, especially for severe, diffuse cramping or when oral repletion is not possible
- Thermoregulation by the body during times of heat stress is coordinated by central nervous system centers in the hypothalamus of the brain and the spinal cord; as well as peripheral centers in the skin and other organs Conduction: degree of conduction dependent upon temperature gradient, conductive properties of the object touching the body, and what percentage of surface area is in contact Evaporation: dependent upon sweat production (or ability to produce sweat) and vapor pressure gradient---as humidity increases, evaporation becomes progressively less effective at cooling the body Radiation: think about reflective properties of light colored clothing or upholstry vs. heat absorbing properties with darker clothing/upholstry Convection: convective heat exchange increases with increasing air speed and larger temperature gradient between air and skin
- Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002;346(25): 1978-1988.
- Children are particularly prone to heat-related illness because of their greater surface area to body mass ratio compared with adults. This permits more heattransfer from the environment to the body. They also have a diminished ability to dissipate heat because of slower sweat rates, a higher temperature threshold for the initiation of sweating, and production of a more diluted sweat. Furthermore, they are slower to acclimatize to the heat and have less of a thirst response. REF: Bytomski JR, Squire DL. Heat illness in children. Curr Sports Med Rep. 2003;2(6):320-324.
- TX data: 60% forgotten (28% of those were supposed to go to daycare that morning; in past 5 years, 63% forgotten/37% supposed to go to daycare); 12% intentional; remainder gained access; 1 case unknown
- -from the graph we see that, even on a 78 degree day (ie, not that hot outside), the temperature inside a vehicle within 30 minutes of shutting off the ignition can reach 110 degrees, more than hot enough to kill a small child.
- -prefrontal cortex: thinks and analyzes -hippocampus: makes and holds onto immediate memories -basal ganglia: nearly identical to the brains of lizards—inattentive, nonanalytical; controls voluntary but barely conscious actions; controls familiar/routine motor skills----kind of takes over as an auxiliary “autopilot” ***ie, when our prefrontal cortex and hippocampus are busily planning our day ahead on the way to work, the ignorant but efficient basal ganglia is driving the car---this explains why sometimes you drive from point a to point b without any memory of the route you took, the turns you made, or even the landmarks/ scenery you saw**** **either sudden or chronic stress can weaken the body’s more advanced components/ higher functioning centers, making them more susceptible to being overrun/ “bullied” by the more primitive “lizard brain” center
- "The quality of prior parental care seems to be irrelevant,“ David Diamond, Ph.D., usf