Summer time injuries and the ER

             
Summer time injuries that come into the Emergency Department can vary from very minor to horrible and traumatic. A mixture of the heat, late nights, holiday parties, alcohol, summer sports and the water/water sports can cause many different injuries in ages from very young all the way up to our elderly seniors. As an ER nurse I am amazed each summer with the trouble people can get themselves into. The poor choices they can make, the stupidness they can exhibit and how selfish parents can be sometimes when they choose to not watch their children. For pete's sake people use your brain some time, you do have one you know.

According to Colin Dircks, M.D., an emergency medicine physician at Piedmont Hospital in Georgia, three of the most common summer injuries are heat-related illness, head injuries and fireworks-related injuries.
“Heat cramps are common in the summer months and are caused by loss of sodium and other electrolytes. We see heat exhaustion and as heat illness progresses, you can develop nausea, headaches and even heat stroke,” says Dr. Dircks. With heat stroke, “the body core temperature elevates significantly – oftentimes more than 104 degrees Fahrenheit.”
To avoid heat-related illnesses, Dr. Dircks recommends “staying hydrated and replacing lost sodium by drinking sports drinks.”
In addition to heat-related illness, head injuries also increase in warm weather months. “The most common activity during the summer months responsible for head injuries is bicycle accidents,” he says. “Water sports-related injuries are also very common and are responsible for almost 30,000 ER visits annually. It is very important if you have a pool that children are under supervision at all times. Be sure to minimize horse play in and around the pool.”
When it comes to fireworks-related injuries, “these are commonly burns, foreign bodies, or lacerations, predominately in the hands, fingers and eyes,” says Dr. Dircks.
And be cautious with so-called “safe” fireworks, especially around children. “People think of sparklers as ‘safe’ fireworks and often give them to kids,” says Dr. Dircks. “They burn at about 1,000 degrees Fahrenheit and we see a lot of burns associated with them. They are responsible for as many ER visits as firecrackers.”

Stay tuned tomorrow for those dangers of fireworks

Extreme Heat and the Dangers! Summer Safety Series

With the temperatures rising and summer now upon us we have got to be more cautious and think, I myself almost got overheated yesterday simply being outdoors to long and not drinking fluids like I should have. Felt tired, dizzy and my body was not producing sweat much anymore, my husband could look at me after we got home and said sit!! drink now! and I did. Even nurses are not so smart some days, busy and forget to pay attention to the temperature gauge in the car.
Credit to CDC website for some great information shared:

These are the main things affecting your body's ability to cool itself during extremely hot weather:

• High humidity. When the humidity is high, sweat won't evaporate as quickly, which keeps your body from releasing heat as fast as it may need to.
• Personal factors. Age, obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, and prescription drug and alcohol use can play a role in whether a person can cool off enough in very hot weather.

Here are some facts about which people are at greatest risk for heat-related illness and what protective actions to take to prevent illness or death:

• People who are at highest risk are the elderly, the very young, and people with mental illness and chronic diseases
• But even young and healthy people can get sick from the heat if they participate in strenuous physical activities during hot weather.
• Air-conditioning is the number one protective factor against heat-related illness and death. If a home is not air-conditioned, people can reduce their risk for heat-related illness by spending time in public facilities that are air-conditioned.

 
You can take these steps to prevent heat-related illnesses, injuries, and deaths during hot weather:
Stay in an air-conditioned indoor location if that is possible.

• Drink plenty of fluids.
• Wear loose, lightweight, light-colored clothing and sunscreen.
• Schedule outdoor activities carefully.
• Pace yourself.
• Take cool showers or baths to cool down.
• Check on a friend or neighbor and have someone do the same for you.
• Do not leave children in cars.
• Check the local news for health and safety updates

What happens to the body as a result of exposure to extreme heat?

People suffer heat-related illness when the body’s temperature control system is overloaded. The body normally cools itself by sweating. But under some conditions, sweating just isn’t enough. In such cases, a person’s body temperature rises rapidly. Very high body temperatures may damage the brain or other vital organs. Several factors affect the body’s ability to cool itself during extremely hot weather. When the humidity is high, sweat will not evaporate as quickly, preventing the body from releasing heat quickly. Other conditions that can limit the ability to regulate temperature include old age, youth (age 0-4), obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, and prescription drug use and alcohol use.

Who is at greatest risk for heat-related illness?

Those at greatest risk for heat-related illness include infants and children up to four years of age, people 65 years of age and older, people who are overweight, and people who are ill or on certain medications.

What is heat stroke?

Heat stroke is the most serious heat-related illness. It occurs when the body becomes unable to control its temperature: the body’s temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. Body temperature may rise to 106°F or higher within 10 to 15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not provided.

What are the warning signs of a heat stroke?

Warning signs of heat stroke vary but may include the following:

• An extremely high body temperature (above 103°F)
• Red, hot, and dry skin (no sweating)
• Rapid, strong pulse
• Throbbing headache
• Dizziness
• Nausea
• Confusion
• Unconsciousness

What should I do if I see someone with any of the warning signs of heat stroke?

If you see any of these signs, you may be dealing with a life-threatening emergency. Have someone call for immediate medical assistance while you begin cooling the victim. Do the following:

• Get the victim to a shady area.
• Cool the victim rapidly, using whatever methods you can. For example, immerse the victim in a tub of cool water; place the person in a cool shower; spray the victim with cool water from a garden hose; sponge the person with cool water; or if the humidity is low, wrap the victim in a cool, wet sheet and fan him or her vigorously. 
• Monitor body temperature and continue cooling efforts until the body temperature drops to 101-102°F.
• If emergency medical personnel are delayed, call the hospital emergency room for further instructions.
• Do not give the victim alcohol to drink.
• Get medical assistance as soon as possible.

What is heat exhaustion?

Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids. Those most prone to heat exhaustion are elderly people, those with high blood pressure, and those working or exercising in a hot environment.

What are the warning signs of heat exhaustion?

The warning signs of heat exhaustion include the following:

• Heavy sweating
• Paleness
• Muscle cramps
• Tiredness
• Weakness
• Dizziness
• Headache 
• Nausea or vomiting
• Fainting

The skin may be cool and moist. The pulse rate will be fast and weak, and breathing will be fast and shallow. If heat exhaustion is untreated, it may progress to heat stroke. See medical attention if symptoms worsen or last longer than one hour.

What steps can be taken to cool the body during heat exhaustion? 

• Drink cool, nonalcoholic beverages.
• Rest.
• Take a cool shower, bath, or sponge bath.
• Seek an air-conditioned environment.
• Wear lightweight clothing.

What are heat cramps and who is affected?

Heat cramps are muscle pains or spasms – usually in the abdomen, arms, or legs – that may occur in association with strenuous activity. People who sweat a lot during strenuous activity are prone to heat cramps. This sweating depletes the body’s salt and moisture. The low salt level in the muscles causes painful cramps. Heat cramps may also be a symptom of heat exhaustion. If you have heart problems or are on a low-sodium diet, seek medical attention for heat cramps.

What should I do if I have heat cramps?

If medical attention is not necessary, take the following steps:

• Stop all activity and sit quietly in a cool place.
• Drink clear juice or a sports beverage.
• Do not return to strenuous activity for a few hours after the cramps subside because further exertion may lead to heat exhaustion or heat stroke.
• Seek medical attention for heat cramps if they do not subside in 1 hour.

 Stay tuned for next in a series of topics about summer safety, see ya tommorrow!
Leslie