By Dr. Jeannie Kenkare
Chief Medical Officer
Urgent Care of Connecticut
Activities abound during family outings to a beach, pool, lake or river. It’s so easy to get carried away with all of the activities that the safety and health risks associated with being on or near bodies of water are often overlooked. Here are some important safety and first aid tips to help maximize the enjoyment of these glorious summer days.
- Wear Shoes – Broken glass, rusty nails, boardwalk and dock splinters can break up the fun when bare feet meet them. Carry a small first aid kit containing alcohol wipes, antiseptic, band aids, a fine needle and tweezers. Puncture wound? Make sure you are up to date on your tetanus, and if not, get a tetanus booster – pronto.
+ Removing Splinters – Clean a fine needle & tweezers with alcohol. Use the needle to probe and gently push back skin to expose the splinter. Extract the splinter with tweezers. Apply antibiotic ointment.
- Avoid Jellyfish Stings – If there is a posting of jellyfish, swim another day.
+ Jellyfish Stings – Assist the victim to shore. If the victim is short of breath, call 911. Remove remaining tentacles from skin with a towel or other object to avoid getting stung. Pour seawater over the sting, as fresh water can activate the venom and make the pain more severe. Then, generously rinsing the affected area with vinegar for at least 30 seconds may deactivate the venomous stingers which may be embedded in the skin. There has been some disagreement over whether cold or heat is better for relieving pain. However, recent studies have suggested that soaking the affected area in tolerably hot fresh water for at least 20 minutes after the vinegar treatment may be more effective in pain relief, because the heat may decrease the potency of the venom. Check with a medical professional for appropriate pain medication.
- Swim in Supervised Areas and avoid Rip Currents – Swim only in safe areas at the beach and pay attention to the lifeguard. The undertow may be different around jetties and in off-limits areas. If you are ever caught in a rip current, remember to swim parallel to shore.
+ Suspected Drowning – Call 911. If victim is conscious, extend a long object for a tow to safety. If you attempt a rescue, keep the victim calm so you both don’t end up under water. If unconscious, pull the victim to shore. Administer CPR if there is no pulse, and mouth-to-mouth resuscitation to restore breathing. If the victim seems to have swallowed a lot of water and is coughing, gently place the victim on his or her left side and wait for the water to be expelled from the lungs. Let emergency personnel take over when they arrive.
- Wear A Life Jacket – No life jacket? No boating! Every boat passenger must wear a life jacket, even strong swimmers. If you capsize, aquatic plants or ropes can entangle arms and legs preventing you from surfacing yourself, or you could hit your head on the boat, leaving you unconscious.
+ Head Trauma – Lay the victim down on a flat surface. Apply pressure to a bleeding wound. Call 911 if the victim is unconscious, has excessive bleeding, difficulty breathing, trouble speaking, nausea or vomiting.
- Take Five Before you Dive – Check out diving conditions first. 1. Is the water too shallow? 2. Are there rocks or other obstacles under the water? 3. Never run on a diving board. 4. Always dive with your hands in front of you. 5. Give space between other divers.
+ Stabilizing a back or neck injury – Remove the victim from immediate danger. Call 911. Have a bystander stabilize the head and neck while you carefully roll the victim onto his or her back. Hold the head steady and keep the back and neck in alignment until emergency help arrives.
- Walk, Don’t Run – Pool decks, docks, and jetties are slippery. Every pool owner should post rules and make sure everyone reads and practices them.
+ Lacerations and Abrasions – For a minor laceration or abrasion, clean the area with fresh water, pat dry, apply antibiotic ointment and cover with an adhesive bandage. Check periodically to make sure the wound is free from infection and healing properly. Seek medical treatment for deeper cuts, as more intensive cleaning, or stitches might be necessary.
+ Fractures – If a person takes a fall and is in pain that is greater than expected, keep the traumatized area stabilized and seek medical treatment as soon as possible.
+ Sprains and Strains – A sprain is a stretching or tearing of ligaments – the tough bands of fibrous tissue that connect one bone to another in your joints. A strain is a stretching or tearing of muscle or tendon. A tendon is a fibrous cord of tissue that connects muscles to bones. For immediate self-care of a sprain or strain, try the R.I.C.E. approach – rest, ice, compression, elevation. Avoid over-use of the area. Immediately apply ice to the area using an ice pack (or a bag of frozen peas) for 15-20 minutes 3-4 times daily for the first few days. To help stop swelling, use an elastic bandage to provide gentle compression to the area and elevate the area above the level of the heart. Seek advice from a medical professional for further injury management.
- Don’t Rub Your Eyes – Beach sand can cause corneal abrasions. Don’t shake the beach blanket violently and send sand airborne. Get a partner on the other side of the beach blanket, grab it at the middle, let the sides fall and gently shake the sand to the ground. Fold it up together and you’re done.
+ Foreign body in the eye – Flush the eye out with clean water from a cup or water bottle (use saline solution if available). Blink several times. This movement may remove small particles of dust or sand. Pull the upper eyelid over the lower eyelid. The lashes of your lower eyelid can brush away a foreign object from the undersurface of your upper eyelid. Don’t rub. If the eye is painful, sensitive to light or vision is blurred seek immediate medical treatment.
- Avoid “Lobster” Skin – Lobster red, sunburned skin is painful and irreversibly damaged. Skin cancers can develop on skin that was sunburned in the years to come. Avoid extended sun exposure between 10 a.m. and 4 p.m. The sun’s rays are much stronger during these hours. Wear tightly woven clothing that covers your arms and legs and a broad-brimmed hat. Use sunscreen frequently and liberally. Apply sunscreen 30 minutes before going outdoors and reapply about every two hours
+ Sunburn – Get out of the sun to prevent further damage. Apply cold compresses – such as a towel dampened with cool tap water – to the affected skin, or take a cool bath or shower. Apply a moisturizing cream, aloe vera lotion or a low-dose (0.5-1%) hydrocortisone cream to affected skin. If blisters form, don’t break them. They contain your natural body fluid (serum) and are a protective layer. When blisters break on their own, apply an antibacterial cream. Drink plenty of fluids. Sun exposure and heat can cause fluid loss through your skin. Be sure to replenish those fluids to prevent dehydration. Within a few days, the affected area may begin to peel. This is simply your body’s way of getting rid of the top layer of damaged skin. While your skin is peeling, continue to use moisturizing cream. See a doctor if the sunburn: is blistering and covers a large portion of your body, is accompanied by a fever, extreme pain, headache, confusion, nausea or chills, or it doesn’t respond to your care within a few days.
- Alcohol and swimming don’t mix – Alcohol and water activities are always a bad combination. Alcohol impairs your vision and depth perception, makes you move slower, and makes it harder for you to stay warm in the water. If you drink alcohol in the sun, and take on physical activity, you are also more at risk for heat exhaustion and heat stroke.
+ Heat exhaustion – Physical outdoor activity during warm humid weather can deplete water and salt balances in the body and cause heat exhaustion. Symptoms include: cool, moist skin with goose bumps when in the heat, heavy sweating, faintness, dizziness, fatigue, weakness, rapid pulse, low blood pressure upon standing, muscle cramps, nausea, and headache. In most cases, you can treat heat exhaustion yourself by doing the following: Rest in a cool place. Getting into an air-conditioned building is best, but if not available, find a shady spot. Rest on your back with your legs elevated higher than your heart level. Drink cool fluids. Stick to water or sports drinks. Don’t drink any alcoholic beverages, which can contribute to dehydration. Apply cool water to your skin. If possible, take a cool shower or soak in a cool bath. Don’t use alcohol on your skin. Loosen clothing. Remove any unnecessary clothing and make sure your clothes are lightweight and nonbinding. If you don’t begin to feel better within one hour of using these treatment measures, seek prompt medical attention.
+ Heat stroke – Heat stroke occurs if your body temperature continues to rise and reaches a temperature of 104 F (40 C) or higher. Symptoms include: a lack of sweating, nausea and vomiting, flushed skin, rapid breathing, racing heart rate, headache, confusion, unconsciousness, muscle cramps or weakness. At this point, emergency treatment is needed. In a period of hours, untreated heatstroke can cause damage to your brain, heart, kidneys and muscles. These injuries get worse the longer treatment is delayed, increasing your risk of serious complications or death.
- Barbeques & Fireworks – Grill food, not your face and arms. Apply lighter fluid carefully. Keep S’more – seeking kiddies a safe distance away from flames with extra-long skewers for marshmallow toasting. Keep a fire extinguisher handy, and know how to use it. Have your own fireworks? Keep spectators a safe distance away and have a hose or water buckets handy for errant ignitions.
+ Burns – There are three levels of burn severity; first, second and third degree burns. A first-degree burn is minor. Treat it by running the area under cool water for 10-15 minutes. Cover loosely with a sterile gauze. Bandaging keeps air off the burn, reduces pain and protects blistered skin. If blisters appear on the burned area, this is a second degree burn. If the area is less than 3 inches in size, treat like a first degree burn. Leave the blisters intact. If the burn area is large, seek medical treatment. Third degree burns involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. If you suspect a major third-degree burn, call 911. While help is arriving don’t remove burned clothing, elevate the burn above the heart if possible and place a moist cloth or sterile bandage over the burn. Make sure the victim is conscious and breathing. Administer CPR if necessary.
Drive carefully going home. Fatigued drivers who have been out in the sun may have consumed too much alcohol, or are just too wiped out to be careful. If you suspect a drunk driver, call 911. Please stay safe and enjoy the summer!
Jeannie M. Kenkare, D.O. is an osteopathic physician board certified in Family Medicine by the American College of Family Practitioners. She is Chief Medical Officer for Urgent Care of Connecticut, which has locations at 31 Old Route 7 in Brookfield, 900 Main St. South in Southbury, 346 Main Ave in Norwalk, and 10 South Street in Ridgefield. A fifth location will open in Glastonbury, CT this summer. For more information, visit www.ucofconnecticut.com.