"Caregivers and clinicians should be aware of the risk for serious illness or fatal overdose from administration of cough and cold medications to children ages [less than] 2 years. Caregivers should only administer cough and cold medications to children in this age group when following the exact advice of a clinician. Clinicians should be certain that caregivers understand 10 the importance of administering cough and cold medications only as directed and 20 the risk for overdose if they administer additional medications that might contain the same ingredient. Caregivers should always inform their health-care providers of all medications they are administering to a child."

The common cold is a mild, self-limiting condition that will resolve in about seven days whether it is treated or not. Cold are caused by a virus and antibiotics do not work against viruses; antibiotics should therefore not be used to treat colds. Prescription and over-the-counter cough and cold medications should not be used in children younger than 2 years of age."

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With proper preparation, life-threatening heat illness is avoidable. Both heat exposure and dehydration will diminish an athlete's ability to train and complete; however, even if an athlete is well hydrated, hot weather alone can cause heat illness. When the rate of heat production by the body exceeds the rate of heat dissipation the thermoregulatory system may become overloaded and cause heat cramps, heat exhaustion, or heat stroke.

Heat cramps typically begin as muscle twitching and can progress to localized contractions of the muscles of the legs, arms, or abdomen. Treatment includes cessation of the activity, moving to a cool, shaded area, drinking cold water, and using gentle massage and stretching of the cramped area. Before returning to running the cramp and the pain should be completely gone.

Heat exhaustion is a form of shock due to the inability of the body to meet demands of blood flow to skeletal muscle (exercise) and skin (heat dissipation). Signs and symptoms are weakness, fatigue, profuse sweating, dizziness, fainting, headache, nausea, diarrhea, loss of mental clarity, increased body temperature, increased heart rate, decreased blood pressure, muscle cramps, and loss of coordination. Treatment includes cessation of running; moving to cool, shaded area; monitoring temperature, pulse, and blood pressure; body cooling with cold water or ice; slow rehydration with cold water or sports drink per the person's tolerance. If symptoms worsen, call 911. Do not return to activity the same day. Recovery is usually complete within 12 - 48 hours.

Heat stroke is a medical emergency requiring rapid diagnosis and treatment. Signs and symptoms fall into three groups: decline of mental acuity (confusion, forgets details, cannot follow progress of game/race); bizarre behavior (combativeness, loss of temper, blank stare); physical decline (unsteadiness, loss of coordination, nausea/vomiting/diarrhea, unconsciousness, seizure, body temperature >104° F, rapid/shallow breathing, rapid/weak pulse, and decreased blood pressure). 911 must be called IMMEDIATELY. The person must be placed in a cold (ice) bath as quickly as possible (and removed once temperature drops below 102° F). Have the person sip cold water or sports drink until EMS arrives. A health care profession should determine a return to activity date. Heat stroke can cause permanent heat intolerance.

Increased susceptibility to heat illness can be caused by: previous heat difficulties, poor conditioning and acclimatization, obesity, sun burn, heart disease, skin disease, fever, inappropriate clothing, certain medications (beta-blockers, cyclic antidepressants, diuretics, antihistamines, antibiotics), cystic fibrosis, mental retardation, use of ephedra or other stimulant supplement, pushing too hard.

Hyponatremia means too little sodium in the blood. It is caused by overhydration. More common in both slower runners and women, hyponatremia can be deadly. Symptoms include weakness, nausea, pounding headache, dizziness, vomiting, delirium, bloating, and swollen fingers and ankles. Fluid intake must be optimized, not maximized. No fluid should be given until urination has begun and salty foods are encouraged.

Dehydration - loss of body fluid - reduces the body's capacity for heat loss. If you are thirsty, you are about 2% dehydrated. This can cause loss of energy and impaired performance. A 5% loss can cause gastrointestinal problems (nausea, vomiting) and muscle cramps. At 7% coordination loss and hallucinations may occur and a 10% loss may result in circulatory collapse and death.

High sweat rates can cause large losses that worsen dehydration. In 1984 Alberto Salazar lost 8.1% of his body weight during his 2 hour 14 minute Olympic race. He lost 1 pound of body weight every 12 minutes.

Here are some guidelines to optimize your performance and prevent hyperthermia and dehydration: