Heatstroke, bug bites, swim safety are key summer issues

(Colby Ware, Special to the…)
May 27, 2010

With Memorial Day approaching and school soon reaching an end, it's a good time to brush up on summer health and safety. Dr. William Zirkin of the Greater Baltimore Medical Center's emergency department talks about common summer problems and how to avoid them.

Question: What are the warning signs of heatstroke or other heat-related illness? What are the best ways to avoid it?

Answer: Heat-related illnesses, including heatstroke, which is the most severe condition caused by overheating, are caused by the body's inability to cool itself. Young children, the elderly, people with certain chronic medical conditions (diabetes, alcoholism, etc.), and people on certain medications (diuretics, etc.) are most at risk for developing severe heat-related illnesses.

Early symptoms include heart palpitations, excessive sweating, muscle cramps, headache, shortness of breath, nausea and dizziness. As heatstroke develops, sweating may cease despite high temperatures, the body temperature rises and mental status changes occur.

The best way to avoid heat-related illness is to stay out of the hot sun, particularly on humid days. If you must be in the sun, keeping well-hydrated and using common sense are the keys to avoiding heatstroke. Hydration, typically with about 16 ounces or more per hour of sports drinks or water (not caffeinated beverages or alcohol), helps the body continue to cool itself. If possible, periodically coming inside to cool off is helpful, as is wearing light, loose clothing.

If one must exercise in this weather, it is best to do so in the early morning or later in the day as the sun is going down.

Q: What's the best type of insect repellent for my child and how often do I need to apply it?

A: Insect bites can cause serious diseases such as Lyme disease, so using a good insect repellent is important.

A good insect repellent should protect your child from insects (including mosquitoes) as well as ticks. The longer-acting repellents contain either DEET or Picaridin, and the higher the percentage of these chemicals, the longer the protection.

There are also some repellents with natural ingredients that are DEET- and Picaridin- free. These tend to provide shorter protection times.

The general guidelines are to avoid reapplying insect repellents more than once per day unless your child is getting bitten again.

Q: I hear a lot about the increase of child drowning accidents in the summer. What's the best age to teach my child how to swim?

A: There is no real consensus on this. The American Academy of Pediatrics says that children are not developmentally ready to learn to swim until age 4. However, there are many classes taught for children as young as 6 months that give a basic appreciation of the water and help children to learn basic swimming skills.

Certainly, children who are not proficient swimmers should never be left unattended or unwatched at a pool or other body of water.

Q: What are some things that parents overlook when it comes to pools and child safety?

A: Children can drown in very shallow water. Child safety devices such as inflatable floaties for the arms and flotation devices for the trunk are helpful but do not completely prevent drowning. Children still need to be watched at all times, and at least until age 5 should always be within an arm's reach at most. Obviously, people with pools at home need to safeguard against children entering the pool area when unattended.

Q: How long can food remain outdoors before it begins to spoil? What precautions should I take to keep food safe while on a picnic?

A: The answer to how long food can remain outdoors before it begins to spoil depends on the food. Certain foods, such as eggs, potatoes, vegetables and meats, are prone to spoiling quickly after they are taken out of the refrigerator. The general rule of thumb is that food that is out of the refrigerator for more than two hours is at risk of spoiling. This time goes down in hot temperatures.

The best way to keep food safe while on a picnic is to observe common sense:

•Keep spoil-prone food in the shade and in coolers with ice until ready to serve.

Only take out as much food as will be eaten quickly — leave the rest in the cooler.

Fruits should be eaten within 1-2 hours (other than fruits completely covered with a skin) after being taken out of a cooler or refrigerator.

Make sure beef and poultry are completely cooked before serving, and once cooked, they should be eaten or discarded within 2 hours. Other hot foods, either purchased or cooked on site, should also be eaten or discarded within 2 hours.

Keep covers on condiments, though generally these take a lot longer to spoil.

Q: What are the most common — and most preventable — reasons that parents bring their children to the emergency room during the summer?

A: We see a lot of preventable injuries, particularly from bikes, skateboards, rollerblades, etc. Severe head injuries and extremity injuries are very common. While some injuries from these fun activities are almost inevitable, some of the more serious injuries can be prevented with safer riding (avoiding riding down steps or in traffic) as well as always using proper-fitting equipment such as bike helmets and guards for wrists, knees and elbows.

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