First things first With many children off to camps, or being watched by grandparents or other relatives, Bruce A. MacLeod, MD, president of the Pennsylvania Medical Society and an emergency medicine physician from Pittsburgh, suggests parents provide the caregiver with a medical consent card, such as ones available via download for free from the Pennsylvania Medical Society. "For parents who will be relying on others to watch their child over the summer, they may want to make sure to have medical consent paperwork completed," says Dr. MacLeod. "In an emergency, this could help health care providers with background information on the child and expedite care." According to Dr. MacLeod, a medical consent form should provide information on the child such as any allergies, current medications, or known medical conditions. The parents' contact information should also be included as well as insurance information. Medical consent forms can also provide authorized caregivers to make emergency medical care decisions on behalf of the parent should the parent not be reachable. "Just a little information can make a big difference," Dr. MacLeod says.
Camps and Separation While most school-age children view going away to camp as an adventure, some may find it to be a scary thought as separation from parents may cause homesickness. "Homesickness is common," says Shivkumar S. Hatti, MD, MBA, president of thePennsylvania Psychiatric Society who practices psychiatry in Media, Pa. "It's normal for a child to feel some degree of homesickness when they're away from mom and dad, particularly if they've never been away before." Dr. Hatti suggests that parents not give their child an easy way out if that's the case. "Parents are often tempted to tell their children they'll bring them home if they're not enjoying being away. But doing so will make them less likely to stick around, even if they're having a great time," Dr. Hatti says. "Camp counselors are trained to know how to handle them. If there is a serious problem, they'll contact you if they feel your child should come home." Dr. Hatti recommends a test run first, such as a sleepover at a friend's house.
Recognize (and avoid) heat stroke. No sweat! The first sign of dangerous heat stroke can be just that - no sweat. As the temperature rises, your body's natural cooling mechanism, sweat, evaporates and helps to cool your body. But on those hot, humid cut-the-air-with-a knife days, evaporation is slowed and your body may not be able to keep itself cool. "The best defense against any heat-related illness is prevention. Be extra careful when the heat index is 90 degrees or above. Always have your child drink plenty of water when the heat index is high and avoid caffeine. If your child must be outdoors for sports or maybe a summer job, they should take frequent breaks inside or in the shade," says Allen Nussbaum, MD, president of the Pennsylvania Chapter of the American Academy of Pediatrics. "Schedule breaks every 10 to 15 minutes during any activity that lasts longer than one hour." "If you take precautions and know the warning signs, you generally can prevent heat stroke." Dr. Nussbaum, who practices in York, Pa., suggests paying close attention to the following warning signs:
- Flushed, moist skin
- Fatigue, weakness
- Dizzy or nauseous
- Sweating profusely
- Rapid pulse
- Fast, shallow breathing
- Muscle weakness or cramps
"These are signs that your child or anyone experiencing them should get out of the heat quickly and rest in a cool, shady place. Drink plenty of water or other fluids containing sugar and salt. If your child doesn't feel better within 30 minutes, contact your doctor. If heat exhaustion isn't treated, it can progress to heat stroke," explains Dr. Nussbaum. In addition, Dr. Nussbaum says to seek treatment immediately if any of these warning signs are present:
- Skin that feels hot and dry, but not sweaty
- Confusion or loss of consciousness
- Throbbing headache
- Frequent vomiting
- Shortness of breath or trouble breathing
"If you suspect heat stroke, don't waste time. Simply call 911 immediately," Dr. Nussbaum says. "While waiting for emergency personnel, move the victim to a cooler location, remove heavy clothing, fan the body and wet it down with a cool sponge or cloth, and encourage the individual to drink cool fluids."
Protect Skin As the weather warms up and children start heading outside more often, parents need to think about using good sun protection measures. Dr. Justin Vujevich, president of the Pennsylvania Academy of Dermatology and Dermatologic Surgery and a practicing physician in Pittsburgh, instructs parents and their children to use a moisturizer with sunscreen every day, no matter what they are doing that day. "Most of us receive our ultraviolet (UV) exposure in short exposure times, whether it's through the windshield riding in a car or walking home from a friend's house, but it adds up during the day. If you apply a moisturizer with sunscreen to your face, arms and neck first thing in the morning, you won't forget. Other tips Dr. Vujevich recommends:
- Keep the sunscreen handy. Apply sunscreen 20 minutes before going outside and 30 minutes after sun exposure. Reapply often outdoors and immediately after swimming or vigorous exercise. Choose a sunscreen containing a "broad spectrum" sunscreen (one that protects against both UVA and UVB sun rays) with a sun protection factor (SPF) of 30.
- Cover them up. Have them wear a wide brimmed hat (baseball caps don't provide enough protection for the face), wear sunglasses (UV exposure to the eyes can lead to melanoma of the retina), and wear a shirt and pants if possible. Consider purchasing a long-sleeved swim shirt made of a SPF-protecting material while at the beach or pool. "Remember, the sun's rays reflect off water and sand, so the rays hit you from both sky and land, " Dr. Vujevich adds.
- Play smart. Avoid the outdoor sun peak hours of 10 am until 3 pm, when the UV rays are the strongest. Try to play in shade when possible. If at the beach, play under an umbrella.
Finally, Dr. Vujevich feels that parents also need to follow these sun precaution measures because kids copy their parents' behaviors. "If the kids see mom and dad doing it, they are more likely to use these good habits."
Don't forget your eyes Drew Stoken, MD, FACS, an ophthalmologist from Carlisle, Pa., and president of thePennsylvania Academy of Ophthalmology, says the sun can also damage your eyes. "Studies have shown that, in addition to skin cancers, accumulated ultraviolet exposure from the sun can heighten the risk of eye diseases such as eye cancer and cataracts, a leading cause of blindness," Dr. Stoken says. "It's best that a person wear 100 percent UV-safe wrap-around sunglasses." According to Dr. Stoken, for those who wear contact lenses, there may be some UV protection but the lens won't protect the entire eye. Those individuals should also wear sunglasses. Dr. Stoken says that it's important that glasses block both UV-A and UV-B rays. These glasses are typically labeled as either "UV400" or "100% UV protection." "Don't use darkness of the glasses as a gage of the level of UV protection," says Dr. Stoken. "Look for the label and also how close fitting the glasses are."
Helmets saves lives If your child enjoys activities like bike riding and longboarding or rides an ATV, then make sure they have a helmet and that they wear it properly. Smacking your head off the ground can do significant damage that a helmet might prevent. "Every year, we see school-age children being rushed to the hospital, sometimes via helicopter, because the stunt they tried on their bike or longboard went horribly wrong," said Michael A. Bohrn, MD, FACEP, president Pennsylvania Chapter, American College of Emergency Physicians. "A properly fitted helmet can provide some protection and possibly save a child's life." Dr. Bohrn, who practices emergency medicine in York, Pa., also suggests that parents be sure to properly equip their child with all necessary safety devices, whether the child is on a bike or some type of skateboard. According to the Children's Hospital of Pittsburgh, brain injuries are often life-threatening and life-changing, yet only 29 percent of children admitted to Children's for bike injuries were wearing helmets when the injury occurred. The hospital, which helps run the "Kohl's Hard Heads Program," says that more than 85 percent of all head injuries could be prevented if helmets were worn.
There's plenty of fun to be had over the summer, and it's most enjoyable when all are injury-fee. Time outside enjoying summer activities is great for your health and wellbeing. Pennsylvania's physician community encourages you to take advantage of the summer by being active while practicing healthy habits. That way, you'll have a safe and fun summer.
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The Pennsylvania Health News Service is a collaborative project consisting of 16 Pennsylvania medical and specialty associations and societies. The Pennsylvania Medical Society was founded in 1848. To learn more about PAMED, visit its web site atwww.pamedsoc.org or follow on Twitter @PAMEDSociety. You may also follow Dr. Bruce MacLeod via @PAMEDPrez. Members of the media are encouraged to follow Chuck Moran on Twitter @ChuckMoran7.
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