Twitter Facebook RSS Feed Print
Daily Dose

How to Treat Poison Ivy

1.15 to read

With the long weekend here, many families are enjoying the outdoors. But with outdoor activity, your children may develop summer rashes like poison ivy, poison oak or poison sumac. Each plant is endemic to different areas of the country, but unfortunately all 50 states have one of these pesky plants. Teach your children the adage “leaves of three, let it be”, so they come to recognize the typical leaves of the poison ivy.

The rash of poison ivy (we will use this as the prototype) is caused by exposure of the skin to the plant sap urushiol, and the subsequent allergic reaction. Like most allergies, this reaction requires previous exposure to the plant, and upon re-exposure your child will develop an allergic contact dermatitis. This reaction may occur anywhere from hours to days after exposure, but typically occurs one to three days after the sap has come into contact with your child’s skin and they may then develop the typical linear rash with vesicles and papules that are itchy, red and swollen. Poison ivy is most common in people ages four to 30. During the spring and summer months I often see children who have a history of playing in the yard, down by a creek, exploring in the woods etc, who then develop a rash. I love the kids playing outside, but the rash of poison ivy may be extremely painful especially if it is on multiple surface areas, as in children who are in shorts and sleeveless clothes at this time of year. The typical fluid filled vesicles (blisters) of poison ivy will rupture (after scratching), ooze and will ultimately crust over and dry up, although this may take days to weeks. The fluid from the vesicles is NOT contagious and you cannot give the poison ivy to others once you have bathed and washed off the sap. You can get poison ivy from contact with your pet, toys, or your clothes etc. that came in contact with the sap, and have not have been washed off. If you know your child has come into contact with poison ivy try to bath them immediately and wash vigorously with soap and water within 5

Daily Dose

Hot Car Deaths

1:30 to read

Did you know that heat stroke is the second leading cause of non-traffic fatalities among children, with the first being backover deaths.  As the summer temperatures are rising these tragic accidents become all too frequent.  

My home state of Texas leads the country in child vehicular heat stroke deaths, followed by Florida and California.  But children who are trapped in vehicles have died in milder climates as well. The temperatures outside may be as low as 60 degrees, but the inside of a car heats up quickly, with 80% of the increase in temperature happening in the first 10 minutes. The reason for this is due to physics.....the sun’s short-wave radiation is absorbed by dark dashboards and seats...the heated objects including child seats then emit long wave radiation which heats a vehicle’s interior air.  All of this leads to tragedy.

A child’s thermoregulatory system is not the same as an adult’s, and their body temperatures will warm 3-5 times faster.  When a child’s body temperature rises to about 107 degrees or greater, their internal organs begin to shut down.This scenario can then lead to death. If you see a child who has been left in a hot car call 911...every minute matters.

The greatest percentage of these tragic deaths are totally unintentional.  These parents are not “bad parents” or “child abusers”, they are loving, good parents who simply forgot that their child was in the car. On average there have been around 37 deaths per year due to vehicular heat stroke and in most cases this is not due to reckless behavior but simply to forgetfulness.  Parents and caregivers both admit to “just forgetting” a child was in the car.  It truly can happen to anyone.

So, how can you remember that your precious, quiet, sleeping child is in back seat. Make it a routine to always look in the back seat before you lock and leave the car.  Try putting your purse, briefcase, or cell phone in the back seat as a reminder to look for your child.

Lastly, if your child is in childcare, have a plan that the childcare provider will call you if you have not notified them that your child will not be coming to school,  and they don’t show up.

Daily Dose

How to Treat Swimmer's Ear

1:30 to read

The entire country seems to be experiencing the “dog days of summer”.  That huge high pressure system has covered most of the weather map, so the only thing to do for the next month is to head to any water you can find…swimming pool, lake, ocean, river or fountain!  But, with swimming comes swimmer’s ear or otitis externa.

I rarely see a child with an otitis externa except during the hot summer months.  Swimmer’s ear is a frequent problem for children who “live in the water” all day long. They are just like a fish. They head to to the pool first thing in the morning and don’t come in until they are water logged…and their ears stay wet all day long and into the night….then back to the water again.  When the ear canal cannot dry out it becomes the perfect dark, damp breeding ground for bacteria to take root.

The most common complaint with swimmer’s ear is pain!! I have seen big stoic teenage athletes in tears from the pain when you just touch their ear.  The pain is due to the inflammation and infection of the ear canal..not the ear drum (an inner ear infection).  So, if you tug on the ear lobe or push the area in front of the ear at the jawline, this causes pain.  Rolling over in bed and laying on that ear will cause pain.  Many people also feel a fullness and complain that they don’t hear as well as the ear canal is so swollen.

The treatment for a swimmer’s ear is not an oral antibiotic, it is rather for ear drops that contain an antibiotic to treat the infection topically at the source. Many of the ear drops used to treat otitis externa also contain a steroid that will help with the inflammation (and swelling) of the ear canal.  Pain control is also important with a combination of acetaminophen and/or ibuprofen.   Keeping the ear canal dry is imperative in order that the ear drops stay in the canal and are not “washed out” right after you put them in the ear. I try to keep the patient’s ear canal dry for several days and have them pain free before getting their ear wet again.

BUT, the best treatment for swimmer’s ear is actually prevention.  Little children who are just learning to swim really do not spend enough time under water or during a bath to have their ear canals become infected.  It is typically seen in children over the ages of 5 or 6 who are now great swimmers and spend a great deal of time in the pool, lake or any body of water.  For these children I recommend putting in “home made” ear drops made with half alcohol and half white vinegar. It is easy to make a bottle and buy a dropper and leave it by the back door to the pool or by the dock…..in this way as the kids come in at the end of the day, everyone tilts their head and gets several drops instilled into both ears before heading inside for the night.  You can also buy “Swim Ear” over the counter if you aren’t “into” making the frugal ear drops.

On occasion, for an extremely swollen ear canal you may need to see an ENT to have the ear canal cleaned and treated…..but if treated early this is uncommon. 

Stay cool, hydrated and avoid swimmer’s ear by using those ear drops routinely!! I learned my lesson the hard way one year….prevention is the key to avoiding a painful otitis externa.

Daily Dose

Life Jackets!

1:15 to read

Summer is here and that means many of my patients are taking off to the beach or the lake to escape the heat and enjoy some water activities.  I recently saw a patient who told me that had just gotten a new boat and were looking forward to getting the kids out on the water.  This brought up the subject of life vests. 

When taking your children on a boat it is important that you have life vests for everyone. It is a law that all children under 13 years of age wear a “coast guard approved” life vest when on a boat that is being operated. This designation is very important, as many of the “life vests” that parents buy are not approved for boating…this includes “water wings” and some of the “cute” wearable t-shirts with life preservers sewn into them. 

Once you have found “coast guard approved” life jackets you might let your child help pick out the one they like the best and that is comfortable. This is important as it will ensure that they are both safe and comfortable. Children’s life jackets are sized by weight, so you might always have a few extras in case a friend or two comes along at the last minute.

Infants life jackets are are a bit different and have a strap that runs between their legs and extra flotation behind the head which guarantees that the baby floats face up at all times. I can attest to this important safety feature as my husband took our son on a little boat one summer day at a friends lake house. The lake was small enough that I could actually see them from the house as they rowed out to try to catch a fish. It was two men and a toddler on the boat…and I watched in horror as our 14 month old (now 32 year old) son leaned over the side of the boat to look at the fish and fell right into the dark murky Texas lake!!  Fortunately, we had followed the boating RULES and he was wearing his bright orange coast guard certified life jacket and bobbed right up to the surface…with a huge scared look on his face!  We have many pictures of our boys in the life jackets every time they set foot on a boat...including this one!

Lastly, get in the habit of applying sunscreen before you even set off for the dock and then have the children put on their life jackets. Kids can just as easily fall off the dock into the water as you prepare to get on the boat.  I would also encourage them to wear a hat for additional sun protection.

A day of boating is a great family activity and there is a lot a child can learn on board as well…how to navigate with a boating chart or GPS coordinates, how to watch for buoys or other water markings and all of the boating jargon.

Bon Voyage! 

Your Child

Make Your Backyard a Safe Haven

2.00 to read

Summertime means backyard time for kids. There’s forts, trampolines, swings, pools, trees –everything you need to spark the imagination and capture the energy of youth. While there is no sure-fire way to prevent all kids from getting injured, there are some strategies that are a good start to creating a safe haven for your kids.

Plants: Make sure there are no poisonous plants in your backyard. Little kids often put things in their mouth that they shouldn’t or crawl into spaces that could cause them to end up in the emergency room.

Keep an eye out for poison ivy, poison sumac and poison oak around fence lines and on trees.

A short list of common posionous plants includes Oleander, the most common toxic plant with every bit of the plant being harmful. Lilly of the Valley can cause nausea, vomiting, pain and diarrhea. Hydrangea blooms will cause stomach pain if ingested and possibly itchy skin, weakness and sweating as well as a possible breakdown in the body’s blood circulation.

You can find photos and more toxic plants at http://www.safetyathome.com.

Home playgrounds. Just like public playgrounds, home playgrounds need to be monitored and checked for loose screws, cracked wood and rusty metal.

http://children.webmd.com has a great list of precautions parents can take to help prevent injuries.

- Cover areas under and around the playground equipment with shock-absorbing material, such as sand, rubber, or mulch, 9-12 inches deep.

- Make sure swing seats are made of soft rubber, not hard wood.

- Don't suspend more than two swing seats in the same section of the equipment's support structure. Most home playground injuries can be blamed on swings.

- The equipment should have ladders with steps rather than rungs for easier access, or rungs with more than nine inches or less than three and a half inches of space between them, to prevent children from getting stuck.

- Cover all protruding bolts.

- Do not attach ropes or cords to the play set, which could become strangulation hazards.

- Plastic play sets or climbing equipment should never be used indoors on wood or cement floors, even if they're carpeted. All climbing equipment should be outdoors on shock-absorbing surfaces to prevent children's head injuries.

- Slides and platforms should be no higher than six feet for school-age children, or four feet for pre-schoolers.

- Platforms, walkways, ramps, and ladders should have adequate guardrails.

- Protect against tripping hazards such as tree stumps, concrete footings, and rocks.

- During hot summer days, check the temperature of the slides and swings, because they can become hot enough to cause burns to the skin.

Treated wood. Treated wood is a common product found in backyard fences and decks. Many treated outdoor wooden structures contain arsenic. The wood industry phased out production of this type of wood in 2003, but there are plenty of wood products around that were manufactured before then. Arsenic in pressure treated wood used in play sets and picnic tables pose an increase risk of cancer according to the EPA.

Pools and spas. Pools and spas pose their own special kind of risks. Drowning is a leading cause of death to children under 5. And many drownings  occur at home. Take these simple precautions:

- Always supervise children who are in and around a pool or spa.

- Have fences or walls at least four feet high completely around the pool. Gates should be self-closing and self-latching, with latches out of reach of children.

- Keep rescue equipment by the pool.

- Steps and ladders for aboveground pools should be secured or removed when the pool is not in use.

- Use a cover for the pool when it is not in use.

- Make sure drain covers are properly fitted and paired or have vacuum suction releases to prevent being trapped under water.

- Consider installing a pool alarm that can alert if someone enters the pool.

- Spa water temperatures should be set to 104 degrees Fahrenheit or lower to avoid elevated body temperature, which could lead to drowsiness, unconsciousness, heatstroke, or death.

- Keep a cell phone with you when you’re at the pool with your kids. Seconds count and you don’t want to have leave your child to find the phone.

These are just a few suggestions for helping parents create a safe backyard where kids can have fun and hang out. Have a great Summer!

Sources: http://children.webmd.com/guide/make-backyard-safe

http://www.safetyathome.com/seasonal-safety/summer-safety-articles/dangerous-plants-in-your-backyard/

Daily Dose

Water Safety

1:30 to read

Memorial Day weekend is almost here and that means summer water activities. While the pool is a great place to stay cool it is also unfortunately associated with drowning.  Drowning is the leading cause of death in children between the ages of 1-4 years and is the second leading cause of accidental death for children under the age of 14.  

 

Drownings are more likely to happen not at the child’s own home, but while a child is at a swim party, or a neighbors house.  Drowning is a SILENT event. While most people think of drowning being noisy with lots of splashing and screaming (as depicted on TV and movies), children rarely scream, call for help or thrash around. They quietly go under water…..and don’t come back up.

 

Statistics show that in 35% of drownings there is no adult supervision, and 57% of drownings occur in residential pools.  About 40% of children drown when not swimming , but after accidentally falling into the water. I have witnessed this myself when filming a segment on pool safety at my own pool! The toddler, who was standing right next to me, slipped and fell right into the pool….but I was literally standing less than an arm’s length away, witnessed the entire event and pulled him right back out of the pool…both of us wet and scared!!! It only takes a second for this to happen.

 

The AAP now recommends that children begin formal swim lessons at younger ages as the risk of drowning is reduced by 88% with formal swim lessons.  The AAP does not endorse “survival swimming” lessons for young children. 

 

Drowning is preventable!! Make sure that your children have adult supervision whenever they swim, and don’t let children swim alone. Even teens can drown and should not swim alone….

When attending pool events, whether at home or away, designate an adult to be the “water watcher” so that no one assumes someone else is responsible. The “water watcher “is dedicated to one task, supervising the children…so no texting, socializing, drinking etc. while on duty.

 

Protecting children around the pool also means having the correct equipment!  Pools should all be enclosed by a non-climbable fence with a self locking gate, which ensures that no one can wander into the pool before there is adult is on duty!  Children who do not know how to swim should wear a Coast Guard approved personal flotation device , and not water wings or floaties. The pool deck should also have appropriate water rescue equipment ready, which includes pool noodles, safety rings and a first aid kit. Keep a phone nearby as well for ready access to call 911 if an emergency should occur. 

 

Swimming is fun and a great way to exercise. Don’t forget the sunscreen and make sure to re-apply throughout the day. Have a good Memorial Day and a safe start to summer!!! 

Daily Dose

4th of July Celebrations!

1:30 to read

The 4th of July weekend is here, which means many families will celebrate with a long weekend with other families and friends. Let’s remember the importance of making it a safe holiday!   

Of course the celebration includes fireworks which are definitely fun to watch, but at the same time, when they are used by consumers (many of whom are children and teens) rather than by trained professionals, there are many associated risks.  Being on call in the ER as a new doctor was one of the scariest and longest nights in my life...and I can remember seeing children with burns...several which were disfiguring. Burns remain one of my biggest fears.

In 2013 there were an estimated 11,400 people treated in emergency rooms for fireworks related injuries, and the risk of fireworks injury was highest for children ages 0- years, followed by children 10-14 years. I know that having fireworks in your backyard or on the beach is fun, but also dangerous. Although I was used to my boys saying, “ Mom, you tell us that everything that is fun is too dangerous...which not only included fireworks, but trampolines, and motorcycles.”  I am sticking to that.

The majority of fireworks related injuries were to the extremities followed by those to the head (eyes, ears, face).  The greatest number of injuries were caused by small firecrackers, sparklers, and bottle rockets. Did you know that a sparkler burns as hot as 1200 degrees F, while water boils at 212 degrees F and wood burns at 575 degrees F!! Even a left over sparkler may cause a significant burn to little hands.

Fireworks are best left to the “hands” of the experts. Fireworks are dangerous and can be unpredictable, especially in the hands of amateurs (including parents).  Public firework displays are equally enjoyable and are carefully planned and executed. Especially with drought conditions and fires already raging in parts of the U.S. it is especially important to be aware of the risk of inadvertently setting a small fire from a misguided bottle rocket.  That small fire may lead to an even bigger fire which destroys acres of land as well as puts firefighters themselves at risk. No one wishes for that scenario but there were over 17,500 fires caused by fireworks in previous years. 

Start planning your holiday fireworks viewing now....from a safe venue! Happy 4th!

Daily Dose

Summer Series: A Lesson in Pool Safety

1.15 to read

Every year, over 900 children (14 years and younger) drown in swimming pool mishaps. Unfortunately, most of these drownings are totally preventable. Swimming pool season is in full swing so it is a good time to reiterate pool safety. Studies have shown that nine out of the 10 children over the age of 1 who died were “supervised”.  The best way to prevent any drowning is by having fencing surrounding all pools. That means four feet high on all four sides. It is amazing how even a young toddler can unlock a door, or climb on a chair and undo a latch or climb out of an open window into a yard with direct access to a pool. Children are clever, quick and quiet when they want to be. Drownings are silent, and many times the last place a parent looks for their missing child is at the bottom of the pool, long after it is too late. So, after fencing a pool with a locking gate, you also need to have the appropriate equipment at the pool while your children are swimming. The first thing that should always be nearby is a telephone. There should also be an appropriate rescue floatation ring available. Anyone supervising a child should be a “designated supervisor” so that they are totally aware that they are in charge and should be within arm’s reach of the “non swimmer” child at all times. Optimally, the supervising adult is also CPR trained (a good summer activity for all...so go take CPR class). Lastly, “The Virginia Graeme Baker Law” which is federal legislation passed in 2007, requires all pools to be retrofitted with new drains to avoid suction entrapment and drowning. Despite this act, it seems that not all pools, both public and private, have complied. It might be wise to inquire if your pool is updated, and new drains have been installed. At the same time it is a good idea to teach children to stay away from drains in general. Swimming is one of the highlights of summer for all ages, and safety is paramount!

Daily Dose

Eeek...Ticks!

1:30 to read

It is the time of year many families are spending time outdoors including camping and hiking. I often get phone calls from worried parents about finding a tick on their children and concerns about what to do.  Ticks are most active in the warmer months (April - Sept), while we are also enjoying vacations.  Many parents are concerned about tick borne illnesses,  as well as just being “grossed” out with the idea of finding a tick on their child. 

The number one thing to remember is to try to prevent a tick bite, which means using insecticide before you plan on hiking etc. It is important to use a product that contains enough DEET, so if you are going to an area with an increased incidence of ticks ( especially that carry disease)  use a product that contains 20-30% DEET, which will provide several hours of protection.  Make sure to avoid your child’s hands, eyes and mouth.   You can also spray your clothes with a permethrin product prior to exposure.  Interestingly, the clothes that have been sprayed with a 0.5% permethrin product remain protective through several washings.  

Now that you have protection before you go out you want to bathe or shower after you return from an outdoor activity, and the sooner the better.  This is the best time to check your child for ticks. Check their head and hair as well as in the ears, belly button, groin, between their legs and under their arms. 

If you find a tick use fine tipped tweezers to grasp the head of the tick as close to the skin as possible. Resist the urge to “yank” the tick, but rather apply slow steady upward pressure to release the tick from the skin. Once the tick is removed wash the area with alcohol or soap and water.  It is a myth that you can remove the tick by painting it with fingernail polish.  

While not all ticks transmit disease, in certain areas of the country the black-legged deer tick may cause Lyme disease.   In most cases a tick must be attached for 36-48 hours before the bacteria (Borrelia burgdorferi) is transmitted. So, back to the bath and look for ticks after you are home for the day. 

Once the tick is removed and the area is cleaned you are generally good to go. You do not need to “save” the tick to show to the doctor. But, if you live in an area known for Lyme disease ( the Northeastern U.S. in particular), watch for a red bull’s eye rash that spreads over several days. This typically occurs within a week after the tick bite. A small red bump left after the tick bite is not the same thing and will resolve in a day or two, rather than “grow”. Lyme disease also causes fever, chills, headache, joint pains and swollen lymph nodes. 

Lyme disease is best treated early with a course of antibiotics….so if concerned seek treatment in the early stages of infection.

Pages

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

DR SUE'S DAILY DOSE

Your child has Coronavirus. Now what?

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.