Transcription:

Melanie Cole (Host): There’s so much to do and enjoy outside and in nature, however you don’t want to put an end to the fun because of an injury or possibly end up in the emergency room. My guest today is Dr. Seth Sushinsky. He’s an emergency medicine physician and a member of the medical staff at Henry Mayo Newhall hospital. Welcome to the show Dr. Sushinsky. So let’s start with some outdoor safety, water safety. When you think of pool safety, swim safety, even lake and ocean, what do you want the listeners to know about being safe and having a great time around the water?

Dr. Seth Sushinsky (Guest): I think with any kind of safety, outdoor safety, you’ll kind of hear the same throughout our talk today, it’s prevention. Prevention is the number one thing. And being prepared. You know here in California so many people have pools and so many local pools that it’s important to be prepared. I would say what we see a lot, the number one thing I think is to make sure that no kids, especially toddlers, young kids, have access to a pool unsupervised. Meaning there’s to be expected that if you own a pool, or have kids, that there should be a fence around that pool. If you have a pool but don’t have kids your neighbors may have kids so the side gate to your backyard needs to be locked and not accessible by young kids. I think that’s the number one rule there for prevention and to limit access to a pool or a lake or anything unsupervised.

Melanie: And what about if they’re at the ocean with riptides and such, what would you like them to know about those?

Dr. Sushinsky: Again, you know any kid in a water should be directly supervised. That doesn’t mean just having a parent nearby. One of the common myths we see with swimming safety whether it’s in a pool, ocean, or lake is that a drowning event is a loud commotion as you see in the movies. That’s not true at all. A drowning event is a silent event. A child can go underwater and not come up. There’s going to be no noise, no commotion. So if a child is not directly supervised it can be missed. So when it comes to ocean safety just knowing what beach you’re at. What is the landscape under that water? Does it drop off really quickly or does it stay shallow? Is the beach prone to riptides? Is there a life guard at the beach? A lot of beaches don’t have lifeguards in recent years due to budget cuts. And you could also know the signs of riptides; the murky water and the swirling waters that define the riptides. If you’re an adult and you happen to get caught in a riptide one of the common things people do is they try to get out of it, they panic, and try to swim into the water. That’s the last thing you want to do. You actually want to turn parallel to the shoreline and swim either up or down shore to get out of the riptide and then swim in towards the beach.

Melanie: That’s great advice. Now as long as we’re talking about things in the outdoors and hot and sun if they’re at a pool or if they’re at the beach, what do you want them to know about sun safety? Because sunburn can be a nasty business and can also really contribute to skin cancer. Even young kids don’t think so much about that, but adults do, so what do you want them to know about sun safety?

Dr. Sushinsky: Again, it’s prevention. One, know the weather for the day. Go on your phone, your mobile device, your computer or watch the local weather and know what the weathers going to be that day. Is it going to be a cool day or a hot sunny day in the 90s or even higher? So be prepared which means drink plenty of fluids, water, electrolyte drinks. Do that before you go out, don’t go out to the beach or to the sun or to the park dehydrated. You want to make sure you’re hydrated even before you get there and then bring plenty of water. And also dress appropriately. You know, shorts and a tank top is actually not the best clothing for a hot sunny day. If you think about any movie where somebody is walking through the desert, they’re not in shorts and a tank top, they’re actually in clothes that are covering most of their body but it’s light weight, a light color, and usually a fabric like cotton, a breathable fabric. That’s good to block the sun but is still breathable. So you know the shorts and tank tops is going to exposure your skin to that blaring sun. The next thing of course is sunscreen and there’s a couple things we do wrong with sunscreen. One I think you absolutely need a waterproof sunscreen at this point, there’s very few sunscreens that aren’t waterproof, those are more the cosmetic ones. But actually a waterproof sunscreen because even if you’re not going in the water you’ll be sweating and perspiring and that’s going to wash off those non-waterproof sunscreens. And again you have got to be prepared. Sunscreens work best if they’re applied at least 15 minutes prior to going into the sun. So you know I always try to, and I’m not perfect I sometimes forget to, but if we’re going to go to the local pool I try to get the sunscreen on my kids before we leave so by the time we get there and unpack the sunscreens been on their skin for at least 15 minutes before they jump in the water. So I think that’s one of the number one things that people forget, I see this all the time. Someone at the pool or at the beach or at the lake and they’re spraying that sunscreen on and they immediately jump in the water. It’s going to be much less effective.

Melanie: And then what about things like insects, I mean we have Zika but that’s a whole other topic for us. But rattlesnake bites, bee stings, bug bites, what would you like people to know if they’re out hiking in the desert or if they’re out on a lake and they get stung by a bee. What would you like them to know about these types of injuries?

Dr. Sushinsky: Let’s talk about rattlesnakes. We’re here in southern California north of LA and we just recently have a bad snake bite come into the emergency room about 3 weeks ago. Again, number one thing is prevention. Know how to avoid that rattlesnake bite. That means walking on the trails, making noise. Rattlesnakes are not aggressive. They’re aggressive towards rodents, but they’re really not aggressive to larger animals and human people. They’re afraid of us. And they won’t strike unless we surprise them, so don’t surprise them. Walk on the trails, make noises, have a walking stick you can kind of get on the ground or rattle some bushes ahead of time, wear high boots because they’re most likely to strike near the ground, and don’t put your hands in anything you can’t see like a bush if you lose a ball and it goes into the bush, don’t go and grab it. That’s where the snakes live. I would say I think my last four or five rattlesnake bikes have been gardeners and maintenance people putting their hands into a bush and they’ve gotten bitten. So that’s very important. Don’t pick up a large rock, there could be a rattlesnake underneath it. Putting your hands into crevices that you can’t see all the way down or picking up debris. So rattlesnakes like to hide in those places and they can bite if you surprise them, if you stick your hand right in their house they’re going to protect themselves.

Melanie: What do you do if they bite you?

Dr. Sushinsky: So the first thing to do is move away from the rattlesnake, you don’t want to get bitten twice, once is bad enough. So move at least 20 feet away. Usually once you’re about 20 feet away they will not feel threatened and they will scurry off in the other direction as well. Very important to stay calm and stay immobile, just relax, sit or lie down. The area that’s bitten you actually want it to be below the level of your heart. A lot of people know that if they sprain an ankle or sprain their wrist they want to raise it and keep it elevated, it’s actually the opposite for rattlesnake bites. You want to keep it below the level of your heart. You want to immediately remove any jewelry around that area. If you got bit around the hand or arm, take off any rings or watches or bracelet, take off anything because there’s usually swelling. So take any jewelry off before any swelling happens. Call for help. This so something that you want to seek medical attention immediately. If it’s an arm or a leg you can make a little splint or sling to keep it immobile. And then avoid things like alcohol and caffeine, anything that can raise your heart rate. And there’s a couple things you don’t want to do as well. There’s some myths out there. You don’t want to suck the poison out, people always ask about that and if they should have done that. Absolutely not. Once you’re bitten, the venom is usually in the wound. Don’t cut the wound. If fact when you do get bitten there will often be some bleeding. You actually want to let it bleed for about 30 seconds, that might help wash some of the venom out. So actually let it bleed for about 30 seconds before you apply any bandages to it. Do not apply a tourniquet. People sometimes think that if they put a tourniquet on they can stop the poison from spreading. That’s not true. Once you’re bitten it’s in your blood stream, it’s already gone. The tourniquet will make things worse. Don’t apply ice to the wound. Again, with a twisted ankle we always apply ice and that’s great but not for a rattlesnake bite. The rattlesnake bite can cause some tissue damage and applying ice can make that even worse. So those are the things that you don’t want to do. And of course you’ve already called for help. You do want to seek medical attention, usually in an emergency room right away to receive the appropriate care.

Melanie: And we don’t have a whole lot of time left, but what about bee stings and other bug bites? Are there some that you’re concerned with Dr. Sushinsky that you would like people to know self-care and what they should do?

Dr. Sushinsky: I would want you to know what types of bugs are in your area. For example, in California there are black widows, there are non-poisonous brown recluse. Out here they are not the same as the ones out in Arizona, New Mexico, and Texas, those are a little but more damaging than the ones we have out here. You want to know what’s in your area and be aware of where they are. Again, prevention is the main thing. But let’s talk about bee stings because that seems to be everywhere that I’ve traveled at least in the US, there’s bees. So if you get bit by a bee and the stinger is often still in the skin. And the immediate reaction is if you have a splinter you use tweezers, but that’s not the case with a bee sting. At the top of that little barb there is a little pocket with the bee venom and if you use tweezers you’ll actually squeeze that and push more of the venom into your tissue. So do not pinch or use tweezers. Instead use a credit card and gently slide it along the skin like scraping the skin to scrape it out. That’s usually the best way to avoid adding any more venom into the tissue. And then you want to wash the area and then unlike the rattlesnake bite it is ok to apply ice to bee stings. And again unlike a rattlesnake bite it is ok to elevate it because this is more of an allergic type reaction where you’re going to have swelling and an allergic type response. Also, again, if it’s in the hand or finger or wrist, remove any jewelry, rings, or watches, bracelets, any jewelry around the area. And then they’re usually pretty painful and people often forget good ole ibuprofen, acetaminophen work very well for pain. Antihistamines such as Benadryl might help for the itching, the localized itching. Even a topical hydrocortisone cream might help. You can also use some homemade remedies like a mixture of baking soda and water right on the wound or calamine lotion. And then if you haven’t had a tetanus shot in the last ten years make sure you go get a tetanus shot. Wash the area because you will often get some redness and swelling around it the next day, that’s usually normal and ok. But if that becomes hot or starts progressing or if you get fevers, there could be a little infection associated with that so you would want to seek help. But again, there are sometimes where bee stings can be an absolute emergency. So if you have any trouble breathing, any swelling or tightness in your throat or your tongue, you start to feel faint or dizzy, you start to develop hives or rashes on your body that are not right where the bee sting was, your tongue becomes swollen or if you have a history of an allergic reaction to stings in the past, you need to immediately call 911 and seek emergent attention right away.

Melanie: Then wrap it up for us Dr. Sushinsky, with your best advice for outdoor safety so people don’t end up in the emergency room visiting room, what you really want them to know about having a great time outside but doing it safely.

Dr. Sushinsky: Again, I think as I mentioned many times, be prepared for whatever activity you’re doing. If you’re going to be in the sun, get those loose light colored clothing, bring plenty of water, get that sunscreen on early, know any hazards, are there riptides are the waves really strong, does everybody know how to swim, and who’s going to be watching who should be figured out ahead of time. If you’re bringing more than one young child make sure you have a plan of who is watching who before you get there. Going hiking or going into nature make sure you know what is out there, go one the internet it is so easy to access and find this information now. Are there rattlesnakes in the area, are there brown recluse spiders, are there black widow spiders, what do they look like? What plants should I avoid? And you should be prepared before you start any activity and you should have a great time.

Melanie: Thank you so much. What great information. Thank you so much for being with us today. You’re listening to It’s Your Health radio with Henry Mayo Newhall Hospital. And for more information you can go to HenryMayo.com. This is Melanie Cole, thanks so much for listening.