WebMD The Magazine - Feature
Hansa D. Bhargava, MD, FAAP
Ryan Stanton, MD, doesn't want to meet you this summer. The Lexington, Ky., emergency room physician knows that when the weather starts heating up, so do a host of health hazards that can quickly turn a festive day at the beach into a disaster. He tells WebMD the Magazine about what brings summer revelers into his emergency room most often -- and how you can enjoy the warm weather while escaping the same fate.
Every homeowner loves the sight of a pristine, neatly mowed yard. But in their haste to get that lawn in shape, some people forget to take precautions. "In the warmer months we see lots of mower injuries -- toes, hands, and fingers getting caught in blades, and things like rocks and sticks getting flung out of them," says Stanton. "People start tinkering with the mower and reach under it to unclog it, and forget there's a spinning blade there. Those are hideous injuries."
They're also hard to repair, because not only can whirling blades cause complex lacerations and fractures, but they can bury contaminants like grass and dirt in the wound. To be safe:
Stanton has lost track of how many boating accidents he's seen as an ER doctor. "People's biggest mistake by far is drinking and boating. People get out there and drink alcohol all day in the sun, and you end up with the same accidents you have with driving -- with the added risks of falling out of boats, getting hit by propellers, and drowning."
It's also easy to get lax about life jackets. "Kids need to have them on all the time," he says. "Even if having them under the seat fulfills the law, in an accident, chances are anyone who doesn't know how to swim won't be able to get to them in time."
When you are going to be out on a boat or at the beach with a child, basic lifesaving skills are a must, not a luxury. "The courses are easy, usually just one day or half a day," Stanton says. "There's no mouth-to-mouth [resuscitation] anymore if you are not trained -- just chest compressions."
You can find first aid, cardiopulmonary resuscitation (CPR), and other emergency lifesaving courses near you with the American Heart Association's ECC (Emergency Cardiovascular Care) Class Connector tool online at americanheart.org.
You've romped outdoors with the kids all day, and your water bottle ran dry long ago. Suddenly you feel dizzy and lightheaded, and your mouth tastes like cotton. You're dehydrated -- meaning you haven't taken in enough fluids to replace those you've been sweating out.
People can get dehydrated any time of year, but it's much more common in the summer months, when they are active outdoors in the warm sun. Heatstroke is the most severe form of dehydration. That's when your internal temperature rises to dangerously high levels. Your skin gets hot, but you stop sweating. Someone with heatstroke may pass out, have hallucinations, or suffer seizures.
Preventing dehydration and heatstroke couldn't be easier: Drink plenty of fluids, especially water, take regular breaks in the shade, and try to schedule your most vigorous outdoor activities for times when the heat isn't so strong, such as early morning or late afternoon.
For persons suffering more serious dehydration or heatstroke, get them indoors, have them lie down, and cool them off with ice packs and cool cloths. Someone who is seriously affected by the heat may need intravenous fluids in the ER.
With all the skin cancer warnings, you'd think Americans would be getting fewer sunburns, not more. But you'd be wrong. The percentage of adults nationwide who got at least one sunburn during the preceding year rose from 31.8% in 1999 to 33.7% in 2004, according to the CDC.
Your risk for melanoma doubles if you've had just five sunburns in your life. "A sunburn is a first-degree burn, right up there with thermal burns," says Stanton. "And we even see some second-degree thermal burns, often when people are out drinking or falling asleep in the sun and don't realize how long they've been out there."
In addition to practicing "safe sun" -- wearing sunscreen that protects against both UVB and UVA rays, long-sleeved shirts, and wide-brimmed hats, and staying out of blistering midday rays -- there are things you can do to treat a severe sunburn, Stanton says:
"You're going to have a pretty miserable 12 to 24 hours with the initial symptoms no matter what you do," Stanton warns.
Food poisoning puts about 300,000 people in the hospital every year, hitting its peak in the summer months. You don't want diarrhea to be the souvenir of your family's annual summer picnic.
"Anything that has mayonnaise, dairy, or eggs in it and any meat products can develop some pretty nasty bacteria after only a couple of hours unrefrigerated," says Stanton. "Every summer we'll have five or six people coming in from the same reunion or family picnic with food poisoning symptoms."
To prevent food poisoning, follow the U.S. Department of Agriculture's advice to:
Mild cases of food poisoning can be cared for at home, Stanton says. Avoid solid foods, and stick with small, frequent drinks of clear liquid to stay hydrated. Once the nausea and vomiting have eased, you can try bringing food back into your diet -- slowly and in small, bland portions (Grandma knew what she was talking about when she recommended tea and toast to settle an upset stomach). If symptoms persist for more than a couple days (or more than 24 hours in small kids), see a doctor.
You start to hear the booms, pops, and snaps in mid-June, long before Independence Day arrives. Many people love fireworks, but fireworks don't necessarily love them back. Nearly 9,000 individuals were injured by fireworks in 2009, according to the U.S. Fire Administration, and two were killed. "We see pretty significant hand and eye injuries from fireworks every summer," Stanton says. The safest way to watch fireworks is at a professionally sponsored display. At least six states ban all consumer fireworks, and several more allow them only with limitations. But if you can buy fireworks legally and want to set off a few at home, take these precautions:
To care for a fireworks burn, wrap it in a clean towel or T-shirt saturated with cool water and get to an emergency room to have the injury checked out.
You're out for a pleasant day of working in the yard and you dig up a hornet's nest -- literally. For most people, a bee or wasp sting is just painful, but for a few, it can be life-threatening. You may not know you're one of them until after you've been stung -- sometimes more than once. Three in 100 adults in the United States -- or nearly 7 million people -- have life-threatening allergies to insect stings, according to the Journal of Allergy and Clinical Immunology.
To stay free of bees (and other stinging insects, including mosquitoes) when outdoors, avoid heavy perfumes and scents (especially florals), wear light-colored clothing with no floral patterns (stinging insects are attracted to dark colors and flowers), and guard food and sugary drinks like sodas. Most people who get stung will just have pain, tenderness, itchiness, and swelling at the sting site. But see a doctor or go to the ER immediately when you have:
Stanton advises keeping an epinephrine auto-injector with you. The pen holds a prescription medication designed to treat severe allergic reactions by tightening the blood vessels and relaxing the airway muscles. One quick jab to the thigh helps slow down a life-threatening allergic response.
But don't assume that using the pen is enough. "In the vast majority of people, the reaction will outlast the pen, so once you've used it, you should still go to the ER for observation or further treatment," Stanton says. "The pen buys time."
To treat a milder reaction, take acetaminophen for the pain and an antihistamine for hives and swelling. (This works for mild reactions to mosquito bites as well.) "Icing the wound can help too," Stanton says.
SOURCES:Ryan Stanton, MD, UK Healthcare, Lexington, Ky.U.S. Fire Administration Focus on Fire Safety: "Fireworks."Morbidity and Mortality Weekly Report, June 1, 2007; vol 56: pp 524-528.The Skin Cancer Foundation: "Sunburn."American Academy of Allergy, Asthma and Immunology: "Allergy Statistics."Asthma and Allergy Foundation of America: "Insect Stings."National Ag Safety Database: "First Aid for Bee and Insect Stings."University of Maryland Medical Center: "First Aid: Dehydration and Heat Stroke."
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