Prevent injury while having fun in the great outdoors.
For many kids and their families, spring/summer is the best time to play outside. Beautiful, sunny days afford them the opportunity to enjoy nature, along with many open-air activities. Your family’s safety should always be a priority. Here are tips on avoiding injury while having fun in the fresh air.
Mosquitoes: Most people are familiar with these annoying, uninvited picnic guests. As the vampires of the insect world, they will feed on your blood through skin bites — creating itchy, sore, red bumps in the bite area. The best treatment for mosquito bites is applying hydrocortisone cream or calamine lotion to the site. An antihistamine such as diphenhydramine and a cold pack may help with itching and discomfort. Do not use both a cream and an oral dose, as this can quickly cause an overdose of diphenhydramine, especially in kids. Most mosquito bites are completely harmless; however, some mosquitoes carry certain viruses and parasites that can transmit infections such as yellow fever, malaria and West Nile virus. These mosquito-borne infections sometimes can cause encephalitis, otherwise known as a brain infection. If you or your child experiences a high fever, headaches or body aches after a mosquito bite, see your health care provider.
The best way to prevent mosquito bites is to take appropriate steps to limit exposure to this pest. You can find insect repellents at your local pharmacy, or grocery stores selling over-thecounter medicines. Insect repellents contain DEET, picaridin, or a plant-based compound called oil of lemon eucalyptus. Always use insect repellents according to the package directions. Do not use DEET-containing products on infants younger than six months of age, and avoid applying such products to the hands or the face. Use repellents only on exposed areas of skin (not underneath clothing). When you return home, wash away any remaining repellent. If you know you will be in an area with lots of mosquitoes, wear long sleeves, long pants, a hat and lighter colors.
Ticks: Deer and dog ticks — which are about the size of the head of a pin — are found throughout the U.S. Ticks bites can transmit bacteria and cause Lyme disease, anaplasmosis, and Rocky Mountain spotted fever. If left untreated, some of these infections can spread to the cardiovascular system, the nervous system and the joints.
To prevent diseases that are spread by ticks or mosquitoes, apply insect repellent prior to going into the woods or camping. After being near tall grass or in a wooded area, or on a hiking trip, always inspect for ticks with careful attention to hiding spots such as behind the knees, ears, underarms and the groin area. If you find a tick, remove it promptly. Don’t wait for it to detach on its own. Avoid methods of tick removal such as painting with nail polish or using petroleum jelly. Never use heat or a match to remove ticks. The best way to remove a tick is by grasping the tick as close to the skin as possible, using fine-tipped tweezers. Pull upward with a steady, even pressure. Assure none of the mouthparts are left in the skin, and then clean the area with soap and water. You should also check your pet for ticks, as dogs and cats can easily pick up these insects as well.
Avoid Dangerous Plants
Poison ivy: Keep in mind “leaves of three, let them be” when spotting this ivy plant. The urushiol oil from poison ivy plants can cause an itchy skin rash when ingested or with skin contact to the plant. Also called contact dermatitis, this skin rash is not contagious. Only contact with the urushiol oil causes the dermatitis. The rash appears wherever the skin came in contact with the urushiol oil. Usually, the more urushiol touched from the plant, the more severe the skin reaction. A typical poison ivy rash is red and swollen with blisters that can become crusty. It normally takes one to two weeks to heal. However, your health care provider must check more severe rashes or those on the face, mouth, neck, genitals or eyelids. In cases of severe contact dermatitis from poison ivy or a rash in one of these areas, your provider may prescribe steroid pills or cream, or even a cortisone injection, to help decrease the inflammatory reaction. Go to the emergency room immediately if you or your child has trouble breathing after coming into contact with poison ivy. Sometimes the rash can also become infected. If you notice increased pain, swelling or warmth to the affected area, you may need an antibiotic as well. Wash your skin with soap and water immediately if you accidentally touch poison ivy. Use a wet compress and take cool baths to help relieve symptoms. Over-the counter antihistamines and calamine lotion can also help. The oil can also rub off onto clothes or pets. Prevent poison ivy rashes by wearing long sleeve shirts and pants when hiking, and avoiding these plants when you see them.
As the summer heat makes you sweat, it also puts you at higher risk for dehydration, meaning your body has lost too much water and fluids.
Dehydration can be mild, moderate or severe. Severe dehydration is a life-threatening condition, and infants and kids are at much higher risk than adults. Children have a higher metabolic rate, so their bodies use more water. Also, a child’s kidney does not conserve water at the same rate as an adult’s, so preventing dehydration is very important in babies and young children. Dehydration can occur from losing fluids through diarrhea, vomiting or sweating, especially from being outdoors in the hot sun. Signs of dehydration include lethargy, dry mouth, not making tears, sunken eyes and fontanels (the soft spots on an infant’s head), complaints of dizziness, and dark or decreased urine output.
Electrolyte solutions can help replace lost fluids. Sometimes, IV fluid may be needed, which requires an overnight stay in the hospital. Never wait to see your health care provider if you suspect you or your child may have dehydration. Untreated dehydration can lead to seizures, brain damage or even death.
You can prevent dehydration by drinking plenty of fluids daily and even more water when the weather is hot or you and your child are playing outside. Bring a water bottle to the park or any outdoor activity you may have planned for your family. Take cool-down breaks when playing outside. Always dress appropriately when the outside temperature is going to rise, wearing layers you can shed easily when the sun comes out.
Keep Camping Fun
Kids should never go into the woods or go camping by themselves. If your family is going camping, make sure you know the safety considerations regarding insects, poison ivy and extreme hot or cold temperatures.
If you are camping in a tent, keep it zipped at all times to keep out bugs and other small creatures that might wander into your sleeping space. Remember that water can attract bugs, so pitch your tent away from a nearby lake or riverbed. Always check for ticks after you’ve been in the woods. Adults must closely supervise campfi res and assure that they are put out with water or dirt when you are sleeping or leave your campsite. Never drink from water in the great outdoors, even if it looks clear. It may contain germs that can cause serious illness. Keep your arms and legs covered while hiking, to avoid ticks and insect bites. Wear comfortable walking boots to support the ankles, avoid blisters, and prevent snakebites if you walk in a snake’s path. Make sure your child knows not to go near any wild animal you may encounter. Teach kids to watch only, and not touch. Give them a whistle to blow in case they get separated from the group. Also, remember that you cannot rely on cell phone service while in the woods.
Use Caution With Outdoor Machinery
All terrain vehicles (ATVs), lawnmowers and tractors are a major cause of death and injury each year in the U.S. ATVs are responsible for more than 700 deaths and 136,000 injuries per year. Kids younger than 16 should not drive or operate an ATV. Riders and drivers should take a hands-on safety course before operating ATVs, and should always wear a helmet, eye protection and closed-toe shoes. Lawnmower-related incidents are responsible for over 9,000 injuries a year — usually to the hands, feet and face. Never allow kids to ride as passengers on ride-on mowers. Children younger than 16 should not be allowed to use ride-on mowers, and those under 12 should not use walk-behind mowers. While mowing, wear sturdy, closed-toe shoes. Injury and amputation can occur as a result of wearing sandals or flip-flops. Don’t mow while young kids are on the lawn. Loose objects or debris can fly upward and cause them extreme harm.
Drowning is a leading causes of death in children ages one to four. Death can occur in a matter of minutes, especially when infants and kids are unsupervised near a pool or other body of water. Active adult supervision is the most important aspect of water safety. If you have an above ground pool, remove stairs or ladders when the pool is not in use. Install a fence with a minimum height of four feet around the pool, and use self-closing/latching gates so no one can use the swimming facilities while you’re away. The American Academy of Pediatrics recommends teaching kids as young as one year of age to swim. Knowing how to swim is the best way to prevent drowning and water death. Supervise kids closely near open water in a lake or an ocean, as undercurrents and undertows can make a fun family pastime turn tragic quickly. Wear a life jacket around oceans, rivers and lakes, or during any water sport or activity. Teach your kids basic water-safety tips before they participate in water activities.
Remember, injury prevention is the key to outdoor safety. Think before you venture out to the park, mountains, beach or even the backyard. Don’t leave home without essentials such as water, bug spray and the appropriate clothing.
Anna Tielsch-Goddard, MSN, BS, RN, CPNP-PC, is a PNP at Children’s Medical Center Dallas at Legacy. She works in the perioperative services department in pre-surgical assessment. She is also a PhD student at Vanderbilt University School of Nursing.