Letters to the Editor

Silver Alert saves

The Silver Alert program is a lifesaver. What is it? It is a statewide plan to aid local law enforcement in the rescue or recovery of a missing elderly person who has become lost while driving a vehicle. In Florida, there are an estimated 523,463 individuals with probable dementia.

This year alone, 46 older Florida residents have been the subject of a Silver Alert. Since the program was established by Gov. Charlie Crist (October 2008), 307 Silver Alerts have been issued. To date, 43 cognitively impaired drivers have been safely returned home as a direct result of Florida’s Silver Alert program. This is a program that works.

Recently, a new dimension was added to Silver Alert that further strengthens Florida’s safety net for these vulnerable adults. Today, 10 of Florida’s state-designated memory disorder clinics (MDCs) across the state — including the Orlando Health Center for Aging Memory Disorder Clinic — are partnering with law enforcement agencies in their communities to provide follow-up and support for these cognitively impaired drivers and their families. In the end, this partnership is expected to reduce repeat Silver Alerts by connecting drivers and their loved ones with relevant community resources to help keep these cognitively impaired elders safe and secure.

Silver Alert is an important and effective program that just keeps getting better.

—Ira J. Goodman, M.D., neurologist, and

David Smuckler, M.D., geriatrician

Orlando Health Center for Aging Memory

Disorder Clinic

Staying hydrated in the summer heat

The warm summer months that make outdoor activities more enjoyable for our families are here. But outdoor activities come with the risks of dehydration. Under normal conditions, we lose body fluids through sweat and urination; in the summer months, this increases as our bodies cool by sweating and radiating heat through our skin. The fluid lost, along with the salts it contains, is usually replaced through our regular diet. However, high temperatures, high humidity and vigorous exercise may cause children to lose large amounts of water and salts through excessive sweating. When these are not replaced, children may become dehydrated and experience other heat-related illnesses.

If your child is sweating profusely on a hot day, watch for these signs of dehydration:

• Dry or sticky mouth

• Few or no tears when crying

• Eyes that look sunken into the head

• Lack of urine

• Dry, cool skin

• Lethargy or irritability

• Fatigue or dizziness

When our body’s natural cooling system fails, our internal temperature builds up, resulting in heat cramps, heat exhaustion or even heat stroke.

Heat cramps are brief, severe cramps in the muscles occurring during or after vigorous exercise in extreme heat due to the loss of salts and fluids while sweating. The low level of salt in the muscles causes cramping, which, although painful, is not serious.

Heat exhaustion is a more severe heat-related illness, occurring in hot environments when enough fluids are not consumed. Watch your child for fatigue, clammy skin, headache, nausea, rapid breathing (hyperventilation) and irritability. If these occur, you should bring your child indoors or into the shade, loosen or remove their clothing, encourage them to eat and drink, and give them a bath in cool (not cold) water. If untreated, heat exhaustion may escalate into heat stroke, which can be fatal.

The most severe form of heat illness, heat stroke, is a life-threatening medical emergency. The body loses the ability to regulate its temperature, which can soar to 106 degrees or higher, causing brain damage or even death if not treated quickly. Prompt emergency medical treatment is required to regulate the body temperature. Call for emergency medical help if your child shows any of these heatstroke symptoms:

• Flushed, hot, dry skin with no sweating

• Temperature of 105 degrees or higher

• Severe, throbbing headache

• Weakness, dizziness or confusion

• Sluggishness or fatigue

• Seizures

• Decreased responsiveness

• Loss of consciousness

The best way to prevent dehydration is to make sure children receive plenty of fluids while they are physically active, consuming more than they lose. It is also important that children hydrate often during hot weather. Children participating in sports or strenuous activities should drink fluids before the activity begins and hydrate again at regular intervals (every 20 to 30 minutes) during the course of the activity and after it ends. Ideally, sports practices and competitions should be scheduled for early morning or late afternoon to avoid the heat of the day.

Thirst is not a reliable sign of dehydration. By the time a child feels thirsty, they may already be dehydrated. Also, thirst can be quenched before the necessary body fluids have been replaced, so make sure children hydrate before thirst develops and continue even after thirst is quenched.

It is important for parents to recognize the early signs of dehydration and to respond quickly if they develop. The goal in treating dehydration is to replace lost fluids and restore the body’s levels to normal. A child who is mildly dehydrated from overexertion will probably be thirsty and should be allowed to drink as much as they want.

Plain water is the best fluid for the first hour or two. After this, the child might need drinks containing sugar and electrolytes (salts) or food. Also, the child should rest in a cool, shaded environment until the fluid has been replaced.

If you are treating your child for dehydration and feel there is no improvement or that the dehydration is worsening, call your doctor immediately or take your child to the nearest emergency department.

—Catherine Lamprecht, M.D.,

pediatric infectious disease physician at Nemours Children’s Clinic