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Hey, Kids: Put E.R. Docs Out of Work

By Elizabeth Simpson, The Virginian-Pilot - 5/23/2009

TO FAMILIES, Memorial Day weekend screams the beach, the pool, the great outdoors! | To James Schmidt, a pediatric emergency doctor at Children’s Hospital of The King’s Daughters in Norfolk, summer brings water accidents, jellyfish stings, bike wrecks! | Both views take an exclamation point. | Schmidt would just as soon cut down on the excitement at his end of the equation and increase the pleasure at yours, so here are his tips for summer safety.

sun
First, the advice few kids will heed: Wear long-sleeved cotton shirts, full-length pants, brimmed hats and sunglasses (99% UV protection).

Or how about staying inside?

OK, now that you’ve stopped laughing …

Parents, maybe, can manage that with babies and toddlers, but the reality is, sooner or later, kids are going to bare their skin to the sun. And they need the Vitamin D.

Use a sunscreen with at least a 15 SPF, or sun protection factor. Look for a sunscreen that says “broad spectrum,” which blocks both ultraviolet A and ultraviolet B rays. Use about one ounce per sitting, and make sure all areas of exposed skin are covered, paying particular attention to the face, nose, ears, feet and hands and the backs of the knees. Make sure the sunscreen is rubbed into the skin.

Use sunscreen sparingly on babies under 6 months, to the face and backs of hands, if protective clothing and shade aren’t available.

Stay out of the sun – or at least limit yourself – during the peak hours between 10 a.m. and 4 p.m. Apply sunscreen 30 minutes before going outside, even on cloudy days. Reapply every two hours or after swimming or sweating.

Be extra careful around water, snow and sand, as they reflect ultraviolet rays that can cause a fast sunburn.

lightning
As long as it’s not raining, everything’s OK, right?

Wrong.

Follow the “30-30” rule of thumb: If the time between the flash of lightning and the sound of thunder is 30 seconds or less, take cover. Then wait for 30 minutes after the storm has passed to come back out.
If you’re caught outside when it’s lightning, don’t go under a tree or near metal poles or anything that’s tall. Don’t go near water.

Get in a car if one’s available, or find a low-lying place to stay until the storm passes.

water safety
Warm weather always brings drownings and near-drownings. During the past six years, CHKD has treated 115 children in drowning or nonfatal submersion cases. Of those, 82 happened at the beach and 33 in pools.

Those statistics put water safety at the top of Schmidt’s list.

A key piece of advice for parents is to assign a designated water watcher when kids go to the beach or pool. Parents and other adults can take turns.

Have the designated person wear a special hat, whistle or necklace and agree that no one will distract or even talk to that person during the watch.

A lifeguarding tip is to make sure the person can see a child in distress within 10 seconds and get to the child in 20 seconds.

Schmidt said most water accidents happen when there are parents and other adults around.

“What happens is the parents huddle,” he said.

They start talking, and though they think they’re watching the kids, they take their eyes away from the water and children slip under.

In case of trouble, parents also should have CPR training.

And though some kids may surface sputtering and fine, it’s a good idea to keep an eye on them the rest of the day.

jellyfish
When you get stung by a jellyfish, your first inclination may be to douse the skin with cold water or rub it to make the pain go away.

Both are bad ideas.

Schmidt says the tentacles may still be on the skin and can continue to fire toxins, which is why splashing cold water on the sting can make it worse.

A paste of baking soda and water left on for 30 minutes neutralizes the toxin. Then, instead of rubbing, take a credit card or other straight-edged object to scrape off the tentacles.

Never pick up a jellyfish on the beach, even if it looks dead. The tentacles can still sting.

cuts & scrapes
If you cut your foot on a shell or prick your finger on a fishing hook, rinse it with clear water, remove any material, apply a topical antibiotic and cover the wound.

If signs of infection arise – pain, redness, swelling – seek medical treatment, and make sure you tell the health-care provider if you received the injury while in or near the water.

sharks
We live on the coast, so we have to talk about sharks, even though the odds of a shark attack are low.

Avoid swimming at dusk or morning, when sharks like to feed. Stay away from places where people are fishing. If you have an open cut, stay out of the water.

Schmidt said people sometimes think that if there are dolphins about, sharks won’t be.

Don’t believe it.

bikes & wheels
Use a bike that’s the right size. The too-big versions are dangerous.

Wear a helmet approved by the Consumer Product Safety Commission on every bike ride. The helmet should be level on the head, not tipped forward or backward. The strap should be fastened and the helmet snug.

Same goes for kids who ride skateboards, scooters or in-line skates. They should also wear protective gear like wrist guards.

Avoid riding in or near traffic.


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