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Melanie Cole (Host):  Welcome. Today we are talking about tips for keeping children safe during the summer especially around water and heat and sun exposure. We have a lot to talk about today. and my guest is Dr. Darrin Privett. He’s an Emergency Department physician at Henry Mayo Newhall Hospital. Dr. Privett, so glad to have you with us today. I’d like to start with swimming safety. Because we have a lot to go through. But tell us some of the statistics, what you see as an ER doc about drowning.

Darrin Privett, MD (Guest):  Well I mean that’s a great introduction because summer is here and it’s so important that we actually can talk about some tips to keep our kids safe. Some people are really excited that summer is here like my kids are and others not so much like some of my kids’ friends parents trying to keep their kids entertained throughout the summer. And one of the great ways that we can keep our kids entertained is for them to cool off in the pool. And so, water is a great way to kind of make sure that we can have fun but also keep us cool and so it’s important that we all enjoy the water safely and I think the main message that usually when I talk to people about water safety is they need to understand that the scary thing is that kids drown without a sound. And it’s not like we see in the movies when kids splash around, and they flail around, and they scream, and they yell, and it seems like nobody can hear them, but they really do drown without a sound. And that’s the take home point. Is that they are extremely quiet, their clothes can be like an added weight and their mouth is usually full of water, so they don’t really yell for help and they will silently slip below the surface.

And so that really important because time is of the essence if a kid drowns and they potentially are without any oxygen. And according to the CDC, one in five people who die from unintentional drowning are children 14 and younger and so unfortunately, it’s very prevalent. But the key here is that it is preventable and preventative medicine is the best type of medicine so it’s something that we have to be vigilant about and be aware of so, there are some things that we can do.

Host:  So, then let’s talk about some of those. People think that if they start early with swim lessons that their children will be safe from this or they use those arm floats. Me, when my kids are around water, they are in life jackets especially like at a lake or anything like that when we are on a boat, always, always life jackets. But when they are at pools, people don’t think so what do you want us to know and what skills do you want to make sure that they do know?

Dr. Privett:  Well that’s a great point. I get a lot of my wife’s friends who have kids and ask me when’s the best time that they should start swimming and there are a bunch of different safety tips and I think if you were to look online with the way the technology is today, there’s so many different resources out there and there is a lot of different recommendations for water safety but I think the main key is to never leave your children alone when they are in or near water, not even for a minute because it takes only approximately 20 to 60 seconds for a child to drown. So, we have to be very vigilant and watching our children with care in and around water. It’s almost like you should have an adult that takes turns to kind of watch the kids.

We just had a after school party the last day of the year kind of swim party at our house and we literally hired my oldest daughter who is 15 to be the lifeguard because sometimes as parents we think we got this, next thing you know we are on our phones or texting, we get caught up in a conversation that talk, we take our attention away from the water and just it takes seconds for something to happen and unfortunately a child can drown. And so, one of the ways like you mentioned too is that get kids in the water early, teach them to swim, get them into swim lessons and so that they can be comfortable and be strong and get them early, depending upon the resources that you look at some even talked about as early as two years and we definitely got our kids going right after they turned two and getting around the pool. And so, swim lessons really help, get them strong around the water, they feel confident in the water.

You talked about inflatables. Some people rely too much on those blow ups thinking it’s kind of like a false safety net that they think they have these floaty devices on, they are okay but most of those are fairly cheap and they are not really made well, and you brought up life jackets. Those are typically pretty safe and recommended by most government agencies. And so those are really the only floatation aide that you can truly rely on. You can’t rely on those blow up plastic toys or mattresses that you can use, because they don’t really keep kids safe. The other thing if you are around water, you just got to make sure that if you have a swimming pool, a pool sensor is great, make sure it has four sides and the pool is secure. Even like something like a spa or a sauna, you have to always make sure that there might be some type of cover so you can keep it covered.

When the kids are in the sauna or around the pool, be very – If your children have long hair, you got to be careful about their long hair because that can take them into the intake drain. When you are in a boat, make sure you are really aware of safety laws and rules. There’s classes that you can get online. There’s like I said before, there’s a lot of resources available. Young children always need to wear life jackets when they are either on a boat or either playing in or near water to keep them safe. And the key too is that you don’t really have to be around a swimming pool and a big body of water, even a small five gallon bucket which like how in the world could your child play in water, but when we lived in New York City, that was kind of what we used in the summers.  We filled up a bucket of water and it was so hot, and they used that to kind of cool off and a toilet, a five gallon bucket of water, these little wee pools that they have. They are all drowning hazards so, we just need to be – make sure that we are aware of all of this and like I said before, the take home point is children can drown without a sound.  

Host:  It’s so true and so scary. So, now, let’s talk about heat stroke and heat related emergencies. Tell us how fast it can happen and what happens in our body when we are exposed to extreme temps. It get’s pretty hot in the summer and if you are not around a pool; then how do we know our kids and ourselves for that matter are not subject to heat exhaustion, heat stroke any of those things?

Dr. Privett:  Well yeah, and you brought up the two main things that we need to be worried about when we are exposed to extreme heat with as far as like heat exhaustion and heat stroke. But you’re right, not everybody is around water to stay cool and it’s so important that we do stay cool in the summer heat and a hot day and sometimes our bodies struggle to stay cool. And regulating body temperature is especially hard for young children and elderly patients as well. I think the key is that when it does get hot, we have to make sure that we really keep ourselves hydrated and so fill up on water regularly. And remain hydrated and if you are thirsty then you are really not hydrated.

And temperatures can rise fairly quick and so, especially when you think about an enclosed vehicle, never leave a child or a furry child, your pet enclosed in a vehicle on a hot day because temperatures inside enclosed vehicles can surpass over 100 degrees within mere minutes. So, if you are out and about and you are enjoying the great weather, try to avoid strenuous exercise on particular hot days. They recommend that early morning and late evening are the coolest times to work out and probably optimal because you will enjoy it a lot better.

You obviously want to focus on the type of clothing that you wear. Make sure it’s loose and breathable and lightweight. So, I think the key is like I mentioned in the very beginning is you just have to make sure, let me repeat it again, that you just stay hydrated and fill up on water regularly through to remain hydrated and if you are thirsty, you are not hydrated. There are so many different devices out there that you can use to keep water with you. Our family has a color coded hydro-flask, so we have our own little hydro-flask. We fill it up with ice and water, we carry it around with us and so we kind of have something available and so I think that’s an important issue that you really need to keep yourself hydrated and stay cool in the summer and if you don’t, unfortunately, like you mentioned, there are some consequences and when temperatures do rise, and we don’t keep ourselves hydrated, we unfortunately can expose ourselves to heat exhaustion and to heat stroke.

Sometimes people can also have- get a bad rash or they can even have a fainting episode and a couple of my friends want to know the difference between heat exhaustion and heat stroke and sometimes there’s a lot of overlap there and so one of the things that we can do to prevent heat exhaustion is to make sure that we understand the signs and symptoms and that we can take the necessary precautions to avoid us from developing it. So, typically, if you start sweating heavily, if you feel kind of nonspecific weakness, lightheadedness, dizziness. If you skin becomes cold or pale or clammy, you feel like you are a kind of - heart rate is beating really fast and rapid and you are developing some palpitations; you can get nauseous and you can get to the point where you can also vomit and if it gets really severe; you can faint and interventions are pretty simple, right, just remove yourself from the hot environment, find a cool place, get out of the heat, get into the shade, loosen up your clothing, drink some fluids. I think electrolyte fluids are the key because when we sweat, we lose a lot of salt unbeknownst to us but clearly if you are sweating, you lick yourself, it’s really salty so you want to replenish that salt.

And so you got to really stay hydrated. The other thing you can do is really, you can apply cool wet clothes so you can get kind of a fan and get a water bottle and kind of spray yourself. If you don’t really intervene with heat exhaustion, it can progress to heat stroke and typically heat stroke is the same as heat exhaustion except for you can develop more neurologic symptoms, you can become altered, confused and progress to the point where you can lose consciousness and even when it becomes severe, you can have a seizure and so you want to make sure that you stay hydrated. If you develop symptoms that progressively are worse, then you want to call 9-1-1 and seek emergency help, emergency assistance right away.

Host:  What great information. So important Dr. Privett, before we wrap up, I want to ask you, get sunburned, people get sunburned. What do we do? You are an Emergency Room physician, if we get a bad sunburn or even maybe one that’s not so bad, what do you recommend people do?

Dr. Privett:  Well, and that’s the unfortunate consequence of being in the sun is that the sun as we soak it up, we can get burned by it. So, it’s really important that we have fun in the sun, but we do whatever we can to protect our skin. It seems like my family, we love to soak up the sun and every chance we get, we are at the beach or at the pool so we are always doing particular activities out and about and my wife is very vigilant and making sure more so than me and she’s really good at making sure that before our kids even go out, before they even get involved in the activity, we apply that sunscreen and most people don’t really realize but skin cancer is the most common form of cancer in the US. And it’s all about sun damage that starts out from overexposure of our skin to the sun. And so you want to protect your skin from the sun’s harmful ultraviolet rays, and you do that by putting the specific sunscreen on to protect the skin.

Obviously, you like try if you can, the sun’s at its worst between 10 and 2 depending on resources that you look at some say 10 to 4, so we can stay indoors during that time when the sun is strongest, that’s the best recommendation which is sometimes not doable for most activities but otherwise, you make sure you cover up with some protective breathable clothing and then as I mentioned, use sunscreen with at least an SPF of 15 to protect the skin. It doesn’t have to be extremely sunny, even on cloudy overcast days, the sun rays are pretty strong and so you want to make sure that your skin is protected.

Some recommendations by the Academy of Pediatrics recommend that whenever children are outside, they should use sunscreen with an SPF of 15 to 30 and choose one that protects against UVA and UVB rays. Typically, you want to apply it at least 30 minutes before going outside. You want to reapply it every two hours especially if you are in water and swimming a lot. And for children under one, you want to try to keep them out of the sun as much as possible because their skin is super sensitive and after a minimum amount of exposure can be burnt a lot quicker than older children. Always try to keep their head covered and be careful with children under six months with the sunscreen but you can use it on them just small amounts on their faces and the back of their heads.

You might want to wear some glasses to protect your eyes so, and if it extremely hot outside, try to limit the amount of activity that you are outside and like I mentioned earlier with as far as heat exposure, try to seek out shade as much as possible. If you are to the point where your skin does burn, you treat it just like any other burn, a bad sunburn is just a prevalent as a first degree burn and so if it hurts, you know you try to put some different type of cooling agents on it whether it be just direct, get a wet towel and soak it in ice water and put it directly on you skin, that will help. There are some other different moisturizers that you can use particularly some that have aloe vera in it and Motrin or Tylenol as needed for pain. Sometimes the skin can flake off but if you just like any other burn if you have a certain amount of percentage throughout your body, you may need to seek medical attention. You have to keep yourself hydrated because the body will utilize fluid that you have in to the area where you are burned to try to keep it cool and sometimes that can increase problems as far as vascular collapse and dehydration.

So, summer is great but some of the things that we talked about today although it was fairly quick and we only hit on really three main points here, are really important to keep us safe and enjoy our summer with ourselves and especially with our families since our kids are out of school.

Host:  It’s so true all of it and yes, we did only get to those three main ones, but you covered so much information Dr. Privett. You are so great and what a great guest you are. Thank you so much for joining us today and really giving us really excellent information. Thanks again. That wraps up another episode of It’s Your Health Radio with Henry Mayo Newhall Hospital. Head on over to our website at www.henrymayo.com for more information and to get connected with one of our providers. If you found this podcast as cool as I did, and Dr. Privett is just such a great guest; share with your friends, with your family on social media and be sure to check out all the other interesting podcasts in our library. Until next time, I’m Melanie Cole.