Summer Safety Tips - ProHealth Physicians

Summer Safety Tips
Compliments of ProHealth Physicians - Somerset Pediatrics
Fun in the Sun
The first, and best, line of defense against the sun is covering up. Wear a hat
with a three-inch brim or bill facing forward; sunglasses (look for sunglasses
that block 99-100% of ultraviolet rays), and cotton clothing with a tight weave.
Sunscreen works most effectively if applied 30-40 minutes before going
outdoors. Sunscreens with PABA and aloe are not recommended because
either may be an irritant to children’s skin. Look for “broad spectrum”
sunscreen. This means it protects against not only UVB (so called “burning”)
wavelengths of the sun, but also the longer UVA (“tanning”) rays. Choose a
sunscreen with an SPF of at least 15. SPF’s above 30 are probably not
advantageous. Read the “active” ingredients list for either zinc oxide or
titanium dioxide.
These are the non-chemical ingredients preferred for
children’s skin. Sunscreen is not recommended for children under 6 months
of age, because this age group should avoid direct sunlight. White sunscreens
are less irritating to the skin than colored sunscreens. Remember to reapply
sunscreen every two hours and after swimming or sweating.
Pool Safety
Never leave children alone in or near the pool, even for a moment.
Make sure adults are trained in life- saving techniques and CPR so they can
rescue a child if necessary.
Surround your pool on all four sides with a sturdy five-foot fence.
Make sure the pool gates open out from the pool, and self-close and self-latch
at a height children can’t reach.
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Keep rescue equipment (a shepherd’s hook – a long pole with a hook on the end
and life preserver) and a portable phone near the pool.
Avoid inflatable swimming aids such as “floaties.” They are not a substitute for
approved life vests and can give children a false sense of security.
Children are not developmentally ready for swimming lessons until after their
fourth birthday. Swim programs for children under 4 should not be seen as a
way to decrease the risk of drowning.
Whenever infants or toddlers are in or around water, an adult should be within
arm’s length, providing “touch supervision.”
Bug Safety
The most effective repellents include DEET. The concentration of DEET varies
significantly from product to product, so read the label prior to purchase. Use
the following guidelines when selecting and using repellent:
Concentrations of up to 30% DEET are safe for children 2 months of age and
older. Apply to the exposed skin and/or clothing. Do not use under clothing.
Do not apply to the hands or over cuts and irritated skin. Wash off after
returning indoors. Recent studies have shown that products containing about
30% DEET last 8-12 hours.
A natural insect repellent is 2% concentration of soybean oil. It is sold as Bite
Blocker. According to the manufacturer, this product is as effective as DEET,
but more studies are needed to support this claim.
Studies suggest Oil of Lemon Eucalyptus (30%) is comparable to 20% DEET,
but requires more frequent reapplication. It is not recommended for children
under 3 years of age. Citronella-based repellents and lavender oil are not well
studied and show less protection time, despite popularity. Neither citronella oil
nor lavender oil is recommended for children under age 2 due to lack of data.
Permethrin is a natural insect repellent made from chrysanthemum flowers. It
is safe. Some clothing products have permethrin. Studies have shown that
permethrin remains potent for up to 70 washes.
To remove a visible stinger from the skin, gently scrape it off horizontally with a
credit card or your fingernail.
CAUTION!!!! Joining together a DEET repellent with sunscreen in a single
product has been marketed recently. This is NOT a good idea because DEET
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degrades the sunscreen, decreasing its efficacy up to 30%. In addition, though
frequent reapplication of sunscreen increases its efficacy, reapplication of
insect repellent increases potential toxicity.
Insect Bites
Reactions to insect bites may vary considerably in size depending on the
sensitivity of the person.
Bites should be cleansed with soap and water daily and Calamine lotion or 1%
Hydrocortisone cream (both nonprescription), applied for itching. If insect bites
occur on the scalp, lymph nodes (“glands”) on the back of the neck may enlarge
as a reaction to the scalp irritation. The nodes will be raised, firm to touch,
and sometimes mildly tender. The skin overlying the lymph nodes is normal
(not red) in color. Frequently the nodes enlarge to 1 inch in diameter. No
treatment is necessary for the nodes, just for the insect bites (as previously
mentioned). It may take several weeks for the lymph nodes to get smaller.
Some completely disappear. Some small (pea-sized) nodes stay at the back of
the neck. This is not a problem.
Tick Bites
Ticks should be removed by grasping with tweezers and pulling straight up
very firmly. If a tick has been embedded for awhile, it may be difficult to
remove the tick and some of the body parts may remain in the skin. This is not
a problem. The area should be washed daily with soap and a washcloth and
the remaining body parts will come out.
The rash of Lyme Disease comes 3-30 days after the bite. After the rash
appears, it expands very quickly. Usually a single spot appears at the site of
the bite but sometimes there are multiple spots.
Ticks must remain embedded at least 24 hours (probably longer) to transmit
Lyme disease. Therefore, we strongly recommend a “nightly tick check.” Don’t
forget to check the groin, underarms and hairline at the back of the neck.
Bicycle Safety
Do not push your child to ride a 2-wheeled bike until he or she is ready, at
about age 5 or 6. Consider the child’s coordination and desire to learn to ride.
Stick with coaster brakes until your child is older and more experienced.
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Take your child with you when you shop for the bike, so that he or she can try
it out. The value of a properly fitting bike far outweighs the value of surprising
your child with a new bike.
Buy a bike that is the right size, not one that your child has to “grow into.”
Oversized bikes are especially dangerous.
How to test any style of bike for proper fit:
o Sitting on the seat with hands on the handlebar, your child must
be able to place the balls of both feet on the ground.
o Straddling the center bar, your child should be able to stand with
both feet flat on the ground with about 1 inch clearance between
the crotch and the bar.
o When buying a bike with hand brakes for an older child, make
sure the child can comfortably grasp the brakes and apply
sufficient pressure to stop the bike.
A helmet should be standard equipment. When buying a bike, be sure
you have a Consumer Product Safety Commission (CPSC) – approved helmet
for your child.
Poison Ivy, Poison Oak, Poison Sumac
The oil in these plants produce a similar rash in persons allergic to the plants.
The rash may appear soon after plant exposure or several days after plant
exposure. Pet fur may carry the oil for several days. The rash is NOT
contagious to others. Swimming is fine when the rash is present. It is
common for this to take 7-10 days to resolve.
Benadryl by mouth my be given for the itching. The recommended dose of
Benadryl is 1 tsp per 20 pounds. Benadryl may be given every 4-6 hours.
Drowsiness is a common side effect. Topical Benadryl is not recommended.
Hydrocortisone cream 1%, Burrows solution, Domeboro soaks or Calamine
provide some relief from itching. Fingernails should be cut short. If itching is
severe or the rash is concentrated on the face, genitals, or spreading rapidly,
call our office.
“Barrier creams” are products applied to the skin by susceptible individuals
before going outdoors to decrease their skin’s contact with the oil. A product in
this category is called Ivy Block. It is available over the counter. It should be
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applied to the skin at least 15 minutes before potential exposure and should be
reapplied every 4 hours to maintain protection.
The product is not
recommended for children under age 6.
Washing exposed skin and scrubbing under fingernails for 10 minutes as soon
as possible after coming indoors will reduce the absorption of oil into the skin.
Swimmer’s Ear (Otitis Externa)
This is an infection of the skin lining the ear canal. Symptoms include
itchiness, pain, and a feeling that the ear is plugged. The key to prevention is
drying the ear after swimming. Turning the head to the side and pulling
earlobe in different directions to help the water run out is helpful. You may
briefly put the tip of a Kleenex in the ear to absorb water or hold the hair dryer
(on low setting) about one foot from the ear to dry the ear.
Treatment of the infection is antibiotic ear drops (prescription item). Generally
your child should not swim until their symptoms are gone.
A mixture of ½ white vinegar and ½ rubbing alcohol is helpful for preventing
recurrences. Three to four drops of the mixture in each ear every time after
swimming is recommended.
Motion Sickness
Motion sickness occurs when the parts of the inner ear that help control
balance are stimulated too much, as can occur when motion is excessive.
Motion sickness commonly occurs during boat travel, when the boat rolls and
rocks. It may also occur in a moving car, amusement park rides, or other
moving vehicles. Some people are more susceptible than others.
Prevention and Treatment Measures Include the Following:
Using visual fixation (for example, watching the distant horizon on a
rocking boat; sitting in the driver’s seat and looking ahead)
Choosing a seat where motion is felt least (such as the front seat of a car
– if over 13 years of age, a seat over the wings of an airplane, or the
forward or middle cabin or upper deck of a ship).
Keeping the head and body as still as possible
Sitting face forward and in a reclining position
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Not reading
Getting fresh air by opening a window, opening an air vent, or going to a
ship’s top deck.
Eating small amounts of low-fat, starchy foods and not eating strongsmelling or strong-tasting foods
Avoiding food and drink on short airplane trips, especially on small
Over the Counter Medications:
1. Dramamine® (dimenhydrinate) should be taken ½ to 1 hour before
starting activity. Dramamine® will cause drowsiness, and some younger
children may be agitated from it.
children 12 years and over: 1 to 2 chewable tablets every 4-6 hours; do
not take more than 8 tablets in 24 hours, or as directed by a doctor
children 6 to under 12 years: ½ to 1 chewable tablet every 6-8 hours; do
not take more than 3 tablets in 24 hours, or as directed by a doctor
children 2 to under 6 years: ½ chewable tablet every 6-8 hours; do not
take more than 1-½ tablets in 24 hours, or as directed by a doctor
2. Regular Strength Bonine® and Dramamine® Less Drowsy (meclizine) should
be taken one hour before starting activity. They may be less sedating.
children 12 years and over: 1 to 2 tablets once daily
Bonine for Kids
children 6 years of age and older: chew 1 tablet thoroughly every 6 to 8
hours. Do not exceed 3 tablets in 24 hours unless directed by a doctor.
Prescription Medication:
Scopalomine (Transderm Scop), a drug that comes as a patch may be used if
your child is 12 years or ≈ 90 pounds.
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