Dealing with summertime emergencis
by Dr. David Barlas
Jul 18, 2017 | 744 views | 0 0 comments | 56 56 recommendations | email to a friend | print
Warmer weather invites activity and adventure, but what happens when things go awry? Here's some tips on what to do if you or a loved one experiences a summertime injury.

• Exposure to Extreme Temperatures. We all know that summer in New York can quickly heat up. Being in the heat can cause a range of symptoms from dehydration, to severe dehydration, to heat stroke.

Most are familiar with dehydration, which is a loss of body fluids through sweating and physical exertion, which can be replenished by drinking fluids.

If early signs are not heeded, dehydration can lead to heat exhaustion. This form of severe dehydration is characterized by weakness and muscle cramps. If symptoms become debilitating, individuals should come to an emergency department to get evaluated and treated. Treatment may include salt solutions, and sometimes intravenous fluids are necessary.

The next progression of heat exhaustion is heat stroke, which is when the body stops being able to release its own heat. The body becomes so dehydrated it can’t sweat anymore, causing the body temperature to reach dangerous levels, impeding organ function.

This can lead to confusion, kidney damage, heart problems, and it can be fatal. The elderly and the young are very susceptible to heat stroke and succumb most easily. Every patient with heat stroke needs to be brought to the emergency room so they can be rapidly cooled and a thorough physical examination can be performed to determine if there is any damage.

• Trauma. As the weather gets warmer, trauma incidences rise since there is typically a lot more physical activity this time of year.

The best way to treat a concussion is to prevent a concussion. Always wear the right protective gear for your activity of choice, including knee pads, elbow pads, eye protection, and helmet. When the bikes come out, it’s very important to also check the helmet to make sure it fits properly, there’s no damage, and wear it every time.

Without a helmet, if an injury is sustained, the risk for concussion is greatly increased. If a head injury is sustained, monitor for any headaches as this could be a sign of concussion. Some symptoms can last long time and are difficult to treat.

Another injury that’s particularly common this time of year are puncture wounds. These are often deep injuries that need to be cleaned thoroughly to ensure no foreign objects remain in the wound, in order to prevent infection.

One of the most dangerous scenarios is stepping on a nail through a shoe since the material and fibers from the shoe can embed in your foot, causing an infection. Sometimes antibiotics need to be prescribed.

Another frequent scenario is stepping on glass on the beach. Glass can very easily become embedded and require surgery to remove it.

• Burns. Summer often means campfires, fireworks, and sun. So what should you do if you get burned?

First, it’s helpful to understand that there are three degrees of burns: first degree is red skin, second degree is when there are blisters, and a third degree burn is when the skin is burnt off and you can see the muscle and tissue under the skin. If you believe you are experiencing a third degree burn, call 911 immediately.

If the burn is from a flame or hot object, run it under cool water to reduce the severity of the burn, clean the area with a mild soap and water, and apply an antibacterial ointment or cream. Similarly, for sunburns, you should treat a bad sunburn by applying a cool compress, washing the area with a mild soap and water, and apply an antibacterial ointment or cream.

If symptoms do not improve after several days, or if an infection develops, seek medical attention.

• Water Related Injuries. According to the CDC, about one in five people who die from drowning are children aged 14 and younger. But for every child who dies from drowning, another five receive emergency department care for nonfatal submersion injuries.

The key to remember is it’s important to keep children in sight at all times. It can take less than a minute to drown, especially if a child is a beginner swimmer. Children can even drown in wading pool if there is enough water to cover the nose and mouth.

If there is a water emergency, immediately pull the individual out of the pool, and if there is no other trauma, you can roll them onto their side to help drain the water. Then call 911.

When it comes to diving, look for and adhere to signs. If it says “No Diving,” don’t even try it. It is very easy to get a cervical spine injury from diving.

Life guards are trained on the proper procedure to rescue diving injuries, but if none are nearby, rescue the individual from the water by holding their neck completely still, in line with their body.

Once on solid ground, put heavy objects on either side of head to stabilize so they don’t move around and risk paralysis. Bottles of water or sand bags can be used to do this.

• Bug Bites. We see a lot of bug bites in the ER during the summer for stinging insects, mosquitos, and ticks. Bug bites and/or stings should always be cleaned to help prevent infection.

If the bug bite isn’t rapidly improving, then infection might be setting in. Seek medical treatment especially if the site of the bite is warm, tender, growing in size, is getting more painful, or, if there is any red streaking, which is a warning of a serious infection.

For those with severe allergies, always carry an Epipen if one is prescribed to you when traveling to places where you might be stung. Before leaving for any outdoor activities, check to make sure that it is not expired.

When hiking, wear long sleeves and pants to prevent ticks. If you do get a tick bite, do not squeeze the tick to try to get it out. This could actually cause more saliva to be released and could cause an infection.

The tick should be removed with tweezers by someone who has experience to ensure that the mouth parts that are attached to the skin are completely removed. After identifying a tick bite and it is removed, watch for signs of a rash, which is a sign of Lyme disease. The classic rash is a bullseye around the tick bite or another part of the body.

The rash is not raised and does not cause an inflammatory reaction, like itchiness. I recommend being seen by a medical provider since sometimes the rash can occur on the scalp, which is difficult to see.

Dr. David Barlas runs NYU Langone Cobble Hill’s full-service, 24/7 Emergency Department.

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