When schools close their doors for the summer, kids are released from the shackles of homework and tests to enjoy months of action-packed, nonstop fun. Summer reminds me of my weeklong Boy Scout summer camp experience at dear ole’ Treasure Isle: plunging into that frigid pool at 7 am, earning multiple merit badges to become an Eagle Scout, and singing a dirge over the death of poor Cock Robin (horribly, I would add!), I was constantly reminded of the Boy Scout motto, “Be prepared.”

That motto is my recommendation for parents, caregivers, and children this summer: when summer takes its ugly turn, be prepared to take care of your child, however he or she may be affected.

Although summer consists mostly of laughter and creating fond memories, the season can also be one of the most dangerous times of the year. Dr. James Baker, a physician in the emergency department (ED) at Kaiser Permanente in Baldwin Park, California, noted that there is a 15% to 27% overall increase in ED visits between June and August.1 Although there is a correlating increase in ED visits among children, Baker notes common summer-related injuries that parents, caregivers, and children should be aware of, be prepared to prevent, and be ready to treat, if necessary.

Burns
Burns originate from several sources: exposure to the sun’s UV rays, sparks from fires, and touching hot surfaces, to name just a few. They are classified based on the severity of skin and tissue damage, as well as how each burn is treated (see Table 1).1-3

Sunburns
Most sunburns are first-degree burns. However, they can occasionally escalate to a second-degree burn. Points to emphasize for proper skin and sun health during the summer include the following:

  • Stay indoors between 10 am and 4 pm (during the sun’s peak time).
  • Wear long-sleeve shirts and pants that are loose-fitting and lightly colored.
  • Apply sunscreen 15 minutes before going out into the sun, and then reapply at least every 2 hours.

When choosing a sunscreen product, it is important to select one that is labeled “broad spectrum,” as this will protect against UV-A and UV-B rays. Additionally, choosing a product with an SPF between 30 and 50 is advised. Any product with an SPF higher than 50 is not recommended due to there being no additional protection against UV-A and UV-B radiation. Do not expose children 6 months or younger to sunlight or apply any sunscreen product to them.1-4

Spider and Insect Bites and Stings
Summer means camping trips, which may also mean the emergence of bites from ticks, spiders, and other insects. The best way to protect children from stings and bites is to follow these recommendations:

  • Walk in the middle of marked trails.
  • Wear appropriate gear in order to spot insects quicker, such as:
    • Light-colored long-sleeve shirts
    • Light-colored pants
    • Closed-toe shoes and a hat
    • High socks with pants tucked in to them
  • Spray insect repellant on clothes and shoes before entering wooded areas.

If bitten by a tick, use tweezers to gently pull the tick away from the skin until it comes loose and wash the area with soap and water. If either a rash or flu-like symptoms emerge after a few days, talk to your physician. For spider bites, go to the ED if the bite is from a black widow spider or a brown recluse spider; otherwise, washing the area with soap and water will suffice.

For insect stings from a wasp, bee, or hornet, remove the stinger by scraping it out with a knife blade or the side of a credit card; squeezing the stinger will force more venom into the skin. After successful removal of the stinger, apply an ice pack to reduce the swelling. For anyone experiencing anaphylaxis, call 911 or go to the nearest ED.4

Dehydration
Water is essential for nearly every bodily function, including the regulation of core body temperature, and during the summer, its loss is hastened through breathing, sweating, urination, and digestion.

Signs of dehydration may include the following:

  • Severe thirst
  • Dark urine and/ or decreased urine production
  • Fatigue and/or weakness
  • Dry skin and lips
  • Decreased sweating
  • Nausea, faintness, loss of appetite
  • Headache, body aches, muscle cramps
  • Confusion and dizziness

To treat dehydration, encourage children to drink fluids and rest; avoid drinks with caffeine and a high sugar content (eg, soda, energy drinks)1. Move them to a shaded area or an air-conditioned vehicle or building. To prevent dehydration from reoccurring, encourage children to drink plenty of fluids before they feel thirsty.1,2,4,5

Heat Exhaustion and Heatstroke
Although heat exhaustion and heatstroke may sound synonymous, each has different signs (see Table 2) and effective treatment methods. For a child suffering from heat exhaustion, take these steps:

  1. Move the child to an air-conditioned or shady area.
  2. Loosen tight clothing and cool the skin by fanning the child and applying wet cloths.
  3. If the child cannot drink, provide a little cool water and monitor their condition.

For heatstroke, follow the same directions as above and, if available, wrap ice packs in a T-shirt or towel and place them under the child’s armpits and against their neck and groin.1,2,4,5

For additional questions about other summer-related ailments and injuries, such as scrapes, drowning, and foodborne illnesses, contact your pediatrician for more information. Also, sign up to attend a local class on administering proper first aid so that, you too, can follow the Scout motto and truly, regardless of circumstances, be prepared!


Brian J. Catton, PharmD, is the chair of the New Practitioner Network for the New Jersey Pharmacists Association, from which he received the 2014 Distinguished Young Pharmacist Award. His topics of interest include pediatrics, disease state management, professional development, and vaccinations.


References

  1. Baker J. ER visits peak during the summer months. Kaiser Permanente website. http://share.kaiserpermanente.org/article/er-visits-peak-during-the-summer-months/. Published July 2, 2014. Accessed May 26, 2015.
  2. Gottschalk J, Perez H, and Mazzuca RJ. First aid. In: Gottschalk J, Perez H, and Mazzuca RJ, eds. The Boy Scout Handbook. 12th ed. Irving, TX: Boy Scouts of America; 2009.
  3. Catton B. Lyme’s disease and drug-induced photosensitivity. Continuing education presentation presented at: Region 6 Meeting of the New Jersey Pharmacists Association; November 7, 2014; Egg Harbor City, NJ.
  4. Cuan D. Let the summer fun begin [press release]. Pasadena, CA: Kaiser Permanente; June 27, 2014. http://share.kaiserpermanente.org/article/let-the-summer-fun-begin/. Accessed May 26, 2015.
  5. CDC Office of Women’s Health. Keep kids safe this summer. Centers for Disease Control and Prevention website. www.cdc.gov/Features/KidsSafety/. Updated June 9, 2014. Accessed May 25, 2015.

Article Written By: Brian J. Catton, PharmD, Pharmacy Times