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Archive for the ‘Summer Safety’ Category

picnic

Summer is the time for picnics and social gatherings. This brings about an increased chance of food poisoning which is vomiting and/or diarrhea that comes about from eating contaminated food.  The most common form of food poisoning is from infectious organisms, such as bacteria and viruses.  When eating outside the home, these organisms can contaminate food at any point during its production,  processing, or serving. More commonly, contamination can also occur in the home. This happens because of food that is improperly handled, incorrectly cooked, or inadequately stored. The most common food culprits are chicken products, fish,  and shellfish. Another common source of food poisoning is from food that has been cooked and left unrefrigerated for too long, especially at buffets and outdoor picnics.

Steps to prevent food poisoning:

  1. Wash hands, utensils and food prep surfaces frequently and thoroughly with soap and water.
  2. Keep raw foods separate from ready to eat foods.
  3. Cook foods to a safe temperature.
  4. Refrigerate or freeze perishable foods promptly.
  5. “When in doubt-throw it out.”

Signs and symptoms of food poisoning may start within hours or up to one to two days after eating the contaminated food. The most common symptoms of food poisoning are nausea, vomiting, stomach cramps and diarrhea. The vomiting and diarrhea are the body’s way of eliminating the contaminated food.

There is no easy method to differentiate between food poisoning and common stomach flu other than if more than one person comes down with vomiting and/or diarrhea after eating a common meal, then food poisoning is the probable culprit.  Fortunately, the symptoms of either food poisoning, or of stomach flu, are usually mild and often resolve without treatment.

The best treatment for food poisoning is to let it run its course.  In most cases, once the body rids itself of the contaminated food, the symptoms improve. For this reason, anti diarrhea medicine is not recommended because it may slow down the healing process.  If diarrhea must be controlled because of travel plans or work responsibilities, then an over the counter medication, such as Immodium, may be helpful.

The main goal of treatment is to replace lost body fluids to prevent dehydration. This can be done by drinking lots of liquids, such as electrolyte drinks for adults or Pedialyte for children. A proven method to help prevent dehydration in spite of frequent vomiting is to take frequent small sips of clear liquids until vomiting stops

 

When to seek medical attention:

  1. Inability to keep any liquids down for more than 6-8 hours.
  2. No urine production for 6-8 hours.
  3. Vomiting or diarrhea lasting more than 2-3 days.
  4. Blood in vomit or diarrhea.
  5. Severe abdominal pain.

Have a safe and enjoyable summer. Bon appetit!

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Sunscreen

I’d like to make my annual plea for the liberal use of sunscreen to protect all of us — young and old — from the damaging effects of the sun.  Please understand that the “healthy” bronze tan color that many people seek is actually how the skin demonstrates that it has been damaged by the sun.

The sun produces two types of invisible light. One is ultraviolet A (UVA), which is the ray that produces a tan but causes skin damage and aging, (think wrinkles and “old age” skin spots). The other is ultraviolet B (UVB), which causes the uncomfortable sunburn.

Both types can cause skin cancer, especially the deadly melanoma. This year in the U.S. there will be approximately 76,000 new cases of melanoma with some 9,000 deaths. These statistics can be reduced significantly by protecting our skin from the sun.

The damaging rays from the sun are most intense between the hours of 10 AM and 4 PM.

These are my suggestions:

  • Always start the summer season with a new fresh tube of sunscreen; price has nothing to do with performance.
  • Use a sunscreen with an SFP rating of at least 30. Higher than 50 is probably not necessary.
  • A sunscreen should be labeled “broad spectrum” protecting against both UVA and UVB and be water/sweat resistant.
  • Use at least 1 ounce (2 tablespoons) for your entire body, and apply liberally to the face, ears, and neck.
  • Don’t overlook applying to feet, back of neck, and bald spots.
  •  Apply at least 20 minutes before sun exposure and every 2 hours thereafter and more frequently if swimming or sweating profusely.
  • Avoid using sunscreen sprays on children as they can inhale the chemical ingredients. Use the lotion form only.
  • Whenever possible, wear light colored tight knit clothing and brimmed hats while in the sun.
  • Avoid tanning salons where damage — similar to the effects of the sun — can be done to the skin.

A sunscreen that has always been a favorite of mine, and one just recently highly recommended by Consumer Reports Magazine, is a brand called “NO-AD.” This product comes with an SPF of either 30 or 45, and is one of the cheapest sun screen products on the shelves.

Enjoy your outdoor summer activities, but do yourselves and especially your children a favor, and protect your/their skin from both damage and cancer by properly using a good sunscreen product.

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Kids

I’d like to talk about several common activities involving our children, how to ensure safety and to avoid unnecessary injury.

Playground injuries, mostly from falls, account for over 200,000 emergency room visits per year. The highest risk group is five to nine years of age. Young children need close adult supervision.

Make sure that underneath the equipment there is an adequate shock-absorbing material, such as chipped wood or any type of rubber product. Also, one needs to inspect the equipment to ensure that it is in good repair.

Bicycling (300,000 emergency visits a year) and skateboarding (30,000 visits) are the leading cause of head injury accidents in children. Proper safety for these activities includes adult supervision of younger children, routine bicycle maintenance, and mandatory use of head-protective helmets. These helmets must be proper to the activity and they must fit appropriately, but most importantly they must be worn!

Swimming accidents leading to drowning, and are the second leading cause of injury death among children 14 years and younger. All pools must be adequately fenced in and have properly functioning gates. Injury can be avoided by not running around the pool, not jumping onto floating objects, and proper use of a diving board. Again, adult supervision is paramount in preventing swim-related activities.

In 1971, trampoline injuries led to the NCAA eliminating the trampoline from sports competitions. I’m sure it’s also why we don’t see this event in the Olympics.

Trampoline injuries cause 80,000 emergency visits per year, for children age five and younger. If you own a trampoline, do not allow a smaller child to be on a trampoline with a larger child, as the smaller one is 14 times more likely to be injured.

In fact, one should follow the manufacturer’s recommendations and not allow more than one person on a trampoline at a time. Safety netting around the trampoline is essential to protect a child but is not foolproof to prevent injuries.

As with all the above activities, adult supervision is mandatory.

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Summer-S

Over the course of my emergency/urgent care career I’ve dealt with many different injuries and illnesses seen commonly during the summer months. I’d like to share some of my thoughts on making this a very safe summer for everyone.

Sunscreen – Almost everyone who spends time out in the sun must wear sunscreen to block the harmful, damaging effects of the sun’s ultraviolet rays on our sensitive skin. Use a sunscreen that offers protection against both UVA and UVB rays and has an SPF rating of at least 30. Apply it liberally and often (at least every two hours). Parents, protect your kids’ precious skin.

Insects – Beware of the many summer bugs lurking out there. For mosquito protection, use a repellant that contains DEET, which when used as directed is safe for adults and children over 2 months of age. Regarding the stinging insects such as yellow jackets, wasps and honey bees, avoid them if they are in your vicinity. If you do get stung by a honey bee (which is the only one of the stinging insects that leaves a stinger behind in your skin), remove it as quickly as possible by any means possible. It is now okay to just pull it out with your fingers and not waste time finding something with which to scrape it off. Immediately apply ice to the sting. When out in a woody or grassy area always check your entire body for ticks when you get home. If you find one, remove it as soon as possible by getting a pair of tweezers, grabbing the tick close to the skin and pulling it straight out.

Poison oak – The best protection is to recognize it and avoid it. If you come into contact with poison oak with your skin, clothing (including shoes and shoelaces), or garden tools, wash off immediately with soap and water. Poison oak oil must be washed off of your skin within a few minutes in order to avoid the dreaded rash. Remember, all parts of the poison oak plant contain the nasty oil, including the leaves, branches and roots.

Heat – Heat exhaustion is manifested by extreme sweating, fatigue and cramps. Heat stroke (a life-threatening condition) is manifested by lack of sweating, red hot skin, and a very high body temperature. Both conditions can usually be prevented by drinking plenty of liquids and avoiding direct sunlight as much as possible, especially between the hours of 11 a.m. and 4 p.m.

Water safety – 4,000 Americans drown every year, mostly men by a factor of four times more than women. Alcohol is frequently involved. Make sure the kids are supervised in the water every single minute. Watch out for rapid currents, rip tides, rocks, and always be aware of your surroundings. Boat injuries claim another 700 American lives a year. Drive your boat sensibly, have enough life preservers on board and do not drink alcohol and drive.

Bicycling – Wear a helmet! No matter how obvious this bit of advice is, I still see people riding without a helmet and I really cringe when I see children without this life-saving protection. Head injuries are often very serious, if not deadly, and are inexcusable for lack of a helmet. Be aware of your surroundings and be in control of your bike at all times. Don’t take foolish chances.

Eating – Summer picnics can be a common source of food poisoning manifested by vomiting and/or diarrhea. Food left out too long is the usual culprit. Handling uncooked chicken or eating undercooked chicken is also a common source of this illness.

Driving – We all drive more during the summer. The cheapest form of life insurance while you are in a car is the good old seat belt. Wear it! Make sure your children are in proper age-appropriate car seats. Handheld cell phone use while driving your car can be deadly and is now illegal. Don’t break the law.

Have a very enjoyable safe summer.

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Bicycle Safety

I did it again. I had another fall.  No, not from a ladder this time, (I think I learned my lesson), but from my bicycle. Thankful to be alive. Saved again from my own carelessness. How many times is it going to take to figure this out?

Anyhow, not long ago I was out for my routine bike ride going up in the Mount Hermon Conference grounds. The pavement was unusually wet due to a light rain during the night. As I got close to the top, I suddenly realized that I had misjudged my timing and had to get back home, so I quickly turned around and headed back in just a little more of a hurry. I came to a sharp curve in the road and as I made the turn I saw a car in the opposite lane. Although there may have been no problem with this, my reaction was to hit the brakes which locked up on the wet pavement and down I went. I ended up on my back partially on top of my bicycle. And yes, I was wearing my helmet.

I was able to pedal back home feeling just a little achy and decided not to tell my wife about what had just happened, since I don’t think she’s ever gotten over my ladder accident several years ago when, once again, I almost killed myself. When I arrived home and got off my bike I realized that my right hip was hurting and I was limping a little. I couldn’t hide that from my wife so I fessed up. She actually took it in stride. However, within a few hours my hip hurt so, that I couldn’t walk on it.

An x ray of my hip thankfully showed no evidence of a fracture but it took several weeks on crutches to recover.

The reason I’m telling this story is to remind my fellow weekend warriors and risk takers that accidents happen in a split second and are usually caused by a momentary act of carelessness such as my ladder and bike accidents. Hopefully even at my age I’m beginning to learn to take it just a little more cautiously and carefully with my activities. Coincidentally, both of my accidents occurred in unusually wet environments which should have made me even more careful.

I find that, for myself and the thousands of patients whom I have treated over the years for a wide variety of injuries, doing any activity in even just a little more of a hurry than usual or trying to take even a little short cut, or not being fully aware of our surroundings, are the common denominators for causing injuries. Almost every patient I treat for an injury, including myself, uses the word “stupid” when describing how their injury occurred.

Do yourselves a favor and exercise just a little more caution and patience in all your activities. Take it from someone who’s learning it the hard way.

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Athlete drink

I’m often asked by patients how much water they need to drink each day. The Institute of Medicine has calculated that men need about 13 cups or three quarts of liquids and women need about nine cups or two quarts of liquids daily. We also ingest approximately 2 ½ cups, or 20 percent of our daily intake of liquids from food, especially fruits and vegetables. In addition, beverages that we commonly drink such as coffee, juice, milk and soda are composed mostly of water.

Water makes up 60 percent of our body weight. Every cell and system of our body depends on water. Lack of water causes dehydration, a condition that occurs when the body receives an inadequate amount of fluids, which in turn slows down and eventually shuts down vital bodily functions.

Our bodies constantly lose water from perspiring, breathing, urinating and having bowel movements.

Various factors determine just how much more water we may need to drink, such as:

– Environment — Hot weather, especially with high humidity, increases perspiration. Even in frigid weather, water is lost from our bodies when breathing during activities such as skiing or hiking.

– Exercise —Also increases perspiration. The more prolonged and intense the exercising, the greater the fluid loss is.

– Illness — Intense or prolonged vomiting and/or diarrhea can lead to life-threatening dehydration. This is an unfortunate cause of death in many developing countries.

– Pregnancy and breast feeding — Increases women’s fluids needs.

After hours of prolonged exercise with heavy sweating we lose electrolytes, especially salt. This is when drinking a sports drink is recommended because it will not only replace the lost water but also the depleted electrolytes. Electrolytes lost through sweat from mild to moderate exercise, can be replaced from the food we eat.

Some liquids can act as a diuretic, which means they cause you to urinate more liquid than you’ve taken in. Caffeine is often implicated, but is really a weak diuretic. Alcoholic beverages on the other hand, especially at higher quantities, can be very potent diuretics causing dehydration which is a major cause of a hangover.

A rough guide as to whether or not you are consuming enough water is to check your urine color. If it appears light yellow, like lemonade, you’re probably well-hydrated but if it is very dark yellow, like apple juice, you need to drink more water.

To keep your body healthy:

– Drink a glass of water or other low or non-calorie beverage with each meal and between each meal.

– Drink water before, during and after exercise.

Bottoms up!

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Hot Tub Safety Tips

Hot tubs, also known as spas, Jacuzzis and soaking tubs, have long been enjoyed by people seeking relaxation, stress reduction and a way to soothe aching muscles.

In my research for this column, I could find no scientific studies relating to the safe use of hot tubs. Most literature I reviewed states that if you have health questions relating to safe use of your hot tub, you should consult your physician.

Well, folks, because of the lack of medical research data, this physician — and most of my colleagues with whom I have spoken — can’t give any scientifically proven guidelines for the safe use of hot tubs. What advice we can give falls along the lines of experience and common sense.

With that being said, here are my guidelines for the safe use of hot tubs:

Shower with soap and water before and after use of a hot tub.

Do not heat your tub hotter than 104 degrees Fahrenheit, and use an accurate thermometer to determine the temperature. Even if you’re in good health, do not soak longer than 20 minutes at a time.

A temperature of 100 degrees for 10 to 15 minutes is safer for those with heart disease or chronic medical problems and during pregnancy. It would be best not to use a hot tub during the first three months of pregnancy.

Children should be at least 5 years old and soak no longer than 10 to 15 minutes — and always under adult supervision — in a tub no hotter than 100 degrees.

Avoid hot tub use if under the influence of alcohol or drugs such as tranquilizers, antidepressants or sleeping pills.

Slowly exit the tub after soaking. Sit on the edge for a few minutes before standing upright. This should prevent the possibility of passing out because of the tub lowering your blood pressure.

Keep the tub clean and well maintained.

One way to prevent overheating is to not submerge your entire body in the hot tub water. Keeping your arms and shoulders out of the water is a good way to avoid getting too hot.

If someone with heart disease has been cleared by a doctor as well enough to exercise, they are probably at no risk when using a hot tub according to the above guidelines. Contrary to popular opinion, there is no evidence for increased risk of a heart attack while relaxing in a hot tub.

Hot tub folliculitis is a common pimple-like rash that will afflict some people after the use of a tub with a low chlorine level. It can be avoided by properly maintaining the tub and by showering after tub use. Unless severe, this rash will usually heal itself without the need to seek treatment from a doctor.

Enjoy your hot tub — that’s what it’s for.

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