Summer Safety Digest: 13 Things You Need to Know for a Safe, Sane Season

LifeSigns-FB-2Yo, summer! You think you’re pretty hot here in North Texas, don’t you? Well, okay, you are … but we’ve got tips for how to chill and enjoy all you have to offer without ending up in the ER. Here’s a roundup of our best summer safety advice.

Top 3 Summer Safety Tips from an Emergency Medicine Physician.

Manisha Gupta, MD, an emergency medicine physician at Medical City Denton, gives her 3 top tips for sailing through summer safely and injury-free:

10 More Tips for Summer Safety.

There’s nothing quite like a top 10 list. In this case, we’re actually giving you 13, but who’s counting? All that really matters is that your family stays safe so you can stay sane.

Your comprehensive guide to mosquito-borne illnesses.

zika

Alison Wortman, MD, a maternal and fetal medicine physician with Medical City Alliance, discusses the signs and symptoms of Zika virus.

HCA Medical City Ask a Nurse Infographic_RevisedIf your summer plans get derailed by breaks, aches, bug bites or snakes, one of our many Medical City ER locations across North Texas has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you.

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Summer Camp Safety: What You Need to Know Before They Go

Summer-CampFBEvery year in the U.S., more than 14 million children and adults attend camp. The American Camp Association (ACA) counts 8,400 resident (overnight) camps and 5,600 day camps from which to choose. In addition to staples such as horseback riding, archery, swimming, hiking and crafting, camps are adding new programs to appeal to a wider audience. Some of these include gardening, college planning, health and wellness, community service and cooking.

From the most adventurous to the tamest, there’s one thing all camps have in common: illness and injuries. Nothing ruins a camp experience faster than a trip to the ER, so we’ll tell you how to keep your kids safe from the most common camp injuries and what they should do in a lightning storm.

Something in the food, water or my cabin mate made me sick.

Kids at camp (and the camp staff) are more than twice as likely to get sick than injured. Possible problems and helpful tips to avoid them include:

  • Gastroenteritis, food poisoning and other stomach pains from contaminated food or water
    • Have a discussion with kids about food safety, including washing hands before meals; eating raw or uncooked foods; sharing food; and eating from potentially contaminated sources such as salad bars
    • Teach kids not to swallow pool or lake water
  • Asthma and allergies
    • Make sure kids pack adequate amounts of medication, including epi-pens if needed
  • Infectious illnesses, such as colds, flu and even mumps and measles, which are making a comeback
    • Make sure kids are up to date on their vaccinations, including tetanus; get yours (and a physical for camp, if necessary) at one of 29 DFW CareNow locations
    • Teach kids to cough and sneeze properly and the correct way to wash their hands

 

Camp — it’s a trip.

According to the ACA, trips, slips and falls are the injuries most commonly reported at camp. In fact, sprains and strains make up nearly 30% of all camp injuries and are often related to rough terrain and improper footwear. Here’s how to protect your kids from fall and collision injuries, including broken bones and concussion:

Kids_Sack_Race-FB

Make sure your kids can swim like a fish.

If the camp you’ve selected offers recreational swimming — and 86% of them do — it’s imperative that children know how to swim and have a good grasp on water safety rules. Drowning is the leading cause of accidental death in children ages 1-4 and the second leading cause for ages 5-14.

In addition to the obvious safety implications, most camps require kids to pass a swim test on the first day. Those who don’t pass must stay in designated areas designed for younger kids, which can be awkward and embarrassing for older children.

Packing over-the-counter ear drops and insisting that kids use them before and after swimming and showers can help keep moisture out of the ear canal and prevent swimmer’s ear.

When thunder roars, go indoors.

According to NOAA (National Oceanic and Atmospheric Administration), there are an average of 25 million cloud-to-ground lightning strikes during some 100,000 thunderstorms each year in the U.S. Lightning storms can happen anytime but are more frequent — and cause more deaths and injuries — in spring and summer. In fact, the Fourth of July is historically one of the most deadly times of year for lightning.

Here are some tips for weathering a lightning storm:

  • Teach your kids this rhyme: When thunder roars, go indoors. Even if they can’t see lightning, it can strike as far as 10 miles away from the storm
  • If your hair stands up, get inside quick: This could be a (very bad) sign that positive charges are rising through you, reaching toward the negatively charged storm — seek shelter immediately
  • Choose shelter wisely: The safest place is a building with plumbing and electricity because those provide a path for lightning to travel down to the ground. Stay away from windows and anything that conducts electricity, including landline telephones, which are the No. 1 way people get struck by lightning indoors. A car with a metal roof is also a safer place to be than outside (but don’t touch anything metal), near water, under a tree (No. 2 cause of lightning casualties) or in a building without plumbing or electricity
  • If you’re unavoidably caught outside: Don’t be, be near, or be under the tallest object — and ditch the umbrella!
  • When it’s safe, you can help someone who’s been struck by lightning: Unlike someone in contact with a telephone line or other live wire, a lightning victim is not electrified and may need immediate emergency medical treatment for cardiac arrest, burns or other injuries

HCA Medical City Ask a Nurse Infographic_Revised

If your child gets injured at camp, one of our many Medical City ER locations across North Texas has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you.

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How Much Water Do You Need to Drink Every Day?

Woman-Drinking-Water-FBDid you know that you’re mostly made of water? If you’re an adult female, you’re about 55% water. Men are about 60% because they typically have more lean tissue (which contains more water) and women have more fatty tissue (which contains less water). Younger people have more (babies are born at about 78%) and older folks have less (about 50%).

Approximate percentages of water in various body parts:

  • Blood 92%
  • Lungs 83%
  • Muscles and kidneys 79%
  • Heart and brain 73%
  • Skin 64%
  • Bones 31%

Yes, even your bones are nearly one-third H2O. And yet two-thirds of us — nearly 70% — aren’t drinking enough water to keep our bodies functioning properly. It doesn’t take much to throw off the balance and become dehydrated. Don’t let something as simple as drinking enough water send you to the ER — it’s really not a story you’ll look forward to telling around the water cooler.

dehydration-FB

When does dehydration occur?

  • At just 1% dehydration, or when you’ve lost 1% of your body’s water, mental performance and physical coordination start to become impaired — and you’re not even thirsty yet
  • At 2-3% dehydration, you’ll feel thirsty and possibly some of these other symptoms:
    • Fatigue, lethargy, fuzzy thinking
    • Irritability
    • Dizziness
    • Headache
    • Dry mouth and skin
    • Muscle cramps
    • Rapid pulse (100 beats/minute or higher)
    • Fever and chills

Bryan Thibodeau, MD, an emergency medicine and pediatrics specialist at Medical City Children’s Hospital, cautions parents to look for these signs of dehydration in infants and babies:

  • Sunken fontanelle (soft spot on the head)
  • Limp/inactive
  • Dry lips/tongue/mouth
  • Crying without tears
  • Pale or mottled skin

Dehydration can be very dangerous, especially for infants, children and older people. If someone you know shows signs of dehydration, seek immediate emergency medical treatment.

Why our bodies need water.

Besides being the primary building block for all cells, water is vital to the health of every system in our bodies. Among other important functions, water

  • Regulates body temperature
  • Transports nutrients and waste materials
  • Aids digestion
  • Cushions the brain and spinal cord
  • Keeps eyes and mouths moist
  • Lubricates joints
  • Can prevent heartburn, constipation and kidney stones
  • Manages heartbeat, blood pressure and electrolyte (sodium) balance

Did you know water can also help prevent heart attacks? A study at Loma Linda University found that dehydration thickens the blood, making it harder for the heart to pump and increasing the risk of blood clots. Study participants who drank just 40 ounces of water a day cut their risk for heart attacks by 54% for men and 41% for women.

How much water is enough?

The old advice to drink at least eight 8-ounce glasses of water a day is just that — a good starting point but outdated because it was never really accurate. According to the Cleveland Clinic, there isn’t a one-size-fits-all recommendation for daily water intake. How much you need depends on:

  • How much you weigh (a larger person needs more water)
  • Your activity level
  • Your metabolism
  • Your geographic location (people who live in hot, dry climates need more water)
  • The weather
  • Your diet (how much water are you getting from the foods you eat?)
  • Your health (fever, vomiting, diarrhea and some medications and conditions can increase your water needs)

HCA Medical City Ask a Nurse Infographic_Revised

The Mayo Clinic suggests that if you drink enough water so that you’re rarely thirsty and your urine is colorless or light yellow, you’re probably doing fine. If you’re always thirsty and your urine is dark yellow with a strong odor, you need to get chugging. If you just don’t like water, try getting it in soups, smoothies and high-water content fruits and vegetables.

If someone in your family is feeling the effects of dehydration, one of our many Medical City ER locations across North Texas has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you.

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Do You Need to Be Worried Your Kids Are Getting Too Much Caffeine?

Caffeine2-FBIf you’re among the 64 percent of American adults who drinks at least one cup of coffee every morning, you may know exactly how much to drink and what time to stop drinking to avoid any unpleasant caffeine side effects such as jitters and insomnia. What you may not know is that an increasingly wide variety of foods and beverages contain significant amounts of caffeine, making it nearly impossible to accurately gauge yours and your children’s daily intake.

The tragic story of 16-year-old Davis Allen Cripe underscores why counting caffeine milligrams is important. The South Carolina teen, who was found to have no undiagnosed heart condition, died from a rapid, irregular heartbeat called arrhythmia caused by an overdose of caffeine. Cripe’s friends told the coroner that within two hours of his death, he drank a large diet Mountain Dew®, a McDonald’s café latte and an energy drink.

Dale Yoo, MD, a cardiac electrophysiologist at Medical City McKinney, confirmed that caffeinated drinks can absolutely affect your heart rhythm.

“Anything that’s a stimulant or increases the stress on your heart will increase your adrenaline and your heart rate,” Dr. Yoo said. “Things like coffee, tea and herbal supplements will increase your adrenaline and heart rate. Drinks like 5-hour ENERGY®, Red Bull® and Monster Energy® have a lot of taurine and caffeine that can also increase the stimulant effect on your heart and increase the risk of arrhythmia.”

In addition to soft drinks and energy drinks, caffeine is being added to a growing list of products, including marshmallows, oatmeal, jelly beans, waffles, gum, mints, sunflower seeds, syrup and even water. It can be found in chocolate, ice cream (those with chocolate or coffee flavors) weight loss pills and over-the-counter pain relievers  This prompted the FDA last year to announce an investigation into the safety of caffeine in food products, with special attention paid to its effects on children and adolescents.

Because caffeine is not a nutrient, but a naturally occurring chemical found in items such as tea leaves, coffee beans and cacao (used to make chocolate), the FDA does not require the amount in a food or beverage to be listed on nutrition labels unless it is added. Many of these products also contain hidden caffeine or other stimulants. Here’s what to look for:

  • Sugar
  • Guarana
  • Taurine
  • Kola nut
  • Yerba mate
  • Cocoa or cacao

How much caffeine is too much?

According to the FDA, a safe amount of caffeine for healthy adults is up to 400mg a day. That’s anywhere from three to five eight-ounce cups of regular coffee, depending on the bean source and brewing method. For children and adolescents, the American Academy of Pediatrics’ recommendation is to avoid energy drinks entirely — which the CDC says sent 1,499 adolescents to the ER in 2011 — and limit caffeine for ages 12 to 18 to 100mg daily.

We’ll never know for sure exactly how much caffeine Davis Cripe ingested, but we can estimate it thanks to his friends’ report:

Large diet Mountain Dew: “Large” is a relative term, but even if he had a “small large” at 20 ounces, that’s 91mg of caffeine — nearly the AAP-recommended limit of 100mg. A Long John Silver’s large is 40 ounces with a whopping 180mg of caffeine and 7-11 has soda cups much bigger than that.

McDonald’s café latte: These espresso-based drinks come in small, medium and large. Espresso has about 64mg of caffeine per ounce.

Small cafe latte (12 ounces)

Medium café latte (16 ounces)

  • 142mg caffeine, 13g sugar

Large cafe latte (20 ounces)

  • 178mg caffeine, 16g sugar

Red Bull energy drink (12 ounces): The type and size of energy drink Cripe had is unknown, so we’ll use this popular one.

  • 111mg caffeine, 37g sugar

In our example, Cripe would have ingested a minimum of 273mg and a maximum of 468mg of caffeine in a short period. And this may be a very low estimate, as the American Academy of Pediatrics says some energy drinks can contain more than 500mg of caffeine.

Research debunks myth that coffee improves alertness and mood.

We all know the negative effects of caffeine. The FDA says that it can make you:

  • Jittery and shaky
  • Unable to fall asleep, stay asleep or get a good night’s sleep
  • Experience
    • rapid, uneven heart rate (arrhythmia)
    • raised blood pressure
    • headaches, nervousness, anxiety and dizziness
    • dehydration
    • heartburn
    • dependency and the need to drink increasingly more

But other than that, coffee is good for you, right? While coffee in moderation has been shown to reduce the risk of several diseases, including certain cancers and stroke, it’s most likely the health benefits of coffee’s antioxidants that are responsible, not the caffeine. Look for other ways to get antioxidants, including eating lots of healthy fruits and vegetables.

As to coffee’s magical brain-enhancing powers, study results from Johns Hopkins Medical School (featured on Forbes.com) show that caffeine-related performance improvement (a boost in mood and alertness) is nonexistent without caffeine withdrawal. In other words, the kick that you get from your morning cup of Joe is really just caffeine taking you back to “normal” for a short time.

If someone in your family is feeling the effects of too much caffeine, one of our many Medical City ER locations across North Texas has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you.

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Five Opportunities and Insights from “13 Reasons Why”

Sad-Girl-FB“13 Reasons Why” is a Netflix series produced by Selena Gomez, a celebrity artist who has struggled with depression and anxiety for several years. Based on Jay Asher’s 2007 novel “Thirteen Reasons Why,” it tells the story of 17-year-old Hannah, who takes her own life and leaves behind a suicide note in the form of 13 cassette tapes. All 13 episodes became available March 31 and the controversial show is so popular that a second season has already been renewed by Netflix.

The show deals with some heavy topics in addition to suicide, including bullying, rape and other mature subjects. It has prompted schools to send warning letters home to parents with recommendations from the National Association of School Psychologists.

Suicide by the numbers.

Suicide:

  • Is the second leading cause of death for ages 10 to 34
  • Is attempted every day by an average of more than 5,240 children in grades 7 through 12
  • Is the cause of death for more teens and young adults than cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza and chronic lung disease, combined
  • Was the reason for an average of 420,000 emergency room visits every year during the 16 years of an NCBI study (1993-2008)
    • ER attempts more than doubled from 244,000 in 1993-1996 to 538,000 in 2005-2008

Studies show that 90 percent of those who died by suicide had an underlying mental illness, so we asked Dr. Elizabeth Ucheoma-Cofield, a psychiatrist and the medical director for the adolescent unit at Medical City Green Oaks Hospital, for her thoughts on the show. As both a parent and an adolescent psychiatrist, she feels there are five pivotal points highlighted by “13 Reasons Why.”

Five opportunities and insights provided by the Netflix show “13 Reasons Why.”

Platform for Discussion: Mental illness is still taboo, especially in children and adolescents. “13 Reasons Why” provides the opportunity for parents, teachers, mental health providers and other adults to begin discussions involving depression, suicide and a variety of other topics that are pertinent to teens, including sexual assault and cyberbullying.

Asking for Help/Paying Attention: “13 Reasons Why” highlights the fact that teens in distress need to reach out for help sooner. There were many people in Hannah’s life who could have been very helpful resources for her in her time of distress, but she didn’t utilize them when needed. Conversely, the show is also a cautionary tale for parents regarding the slippery slope of depression and may serve as a catalyst for parents to start researching and paying attention to the warning signs of depression and suicidal thoughts in their children and providing them with professional help sooner.

Perception of Invincibility: Children and adolescents can be impulsive. Many completed suicide attempts in children and adolescents are actually the result of impulsive behavior. Children and teens sometimes do not have the perspective to be able to realize that present crises are temporary. Sometimes children and teens don’t really digest the fact that suicide is permanent and that they will no longer see their friends and family and will no longer have a future.

The main character in the series, Hannah, makes multiple cameo appearances (usually as flashbacks from one of the other characters who are the subjects of her tapes) almost as if she is not really dead. She also controls the actions of the people that she left behind through instructions that she has left on the tapes. This is a very dangerous representation of suicide that alludes to the fact that people who have completed suicide aren’t really gone but exist in some other form that enables them to interact in some way with the people they left behind. This perception of invincibility and lack of finality is actually a soft suggestion to children that suicide is merely an alternate life path and this is not the case.

Attention Seeking Through Suicide: “13 Reasons Why” highlights the fact that Hannah achieved the attention and validation that she didn’t get in life through her death. Many children and teens with depression already feel isolated and invisible. Arguably, the show could give impressionable kids the idea that suicide might be an option to get the same results that Hannah did.

Need to Process: Although “13 Reasons Why” does have a discussion panel at the end of the series to talk about the heavy subject matter presented, it would be much more beneficial for children and teens to have a panel discussion built in after every episode to process the topics discussed more pointedly and frequently.

Clearly, there are a variety of reasons that “13 Reasons Why” can be both adverse and beneficial. At the end of the day, it does help kids understand how important it is to be kind and respectful to others. It also might help them feel empowered to reach out to educators, counselors and other adults when they think that someone (child or adult) is struggling.

If you’d like to talk to your kids about the subjects highlighted in “13 Reasons Why” but aren’t sure where to begin, here are some resources:

The JED Foundation, a nonprofit that aims to prevent suicide in teens and young adults, has developed a series of talking points for children and adults.

The Society for the Prevention of Teen Suicide offers helpful information on how to know if suicide is a risk for your family.

The National Suicide Prevention Lifeline (800-273-8255) provides free and confidential resources and support for people of all ages in distress or crisis.

For fast, emergency help in a crisis, look to one of our many Medical City ER locations across North Texas. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you.

About Elizabeth Ucheoma-Cofield, MD dr-ucheoma-cofield-bio

Elizabeth Ucheoma-Cofield, MD (lovingly known as “Liz” by friends and family), is an avid reader and writer who enjoys spending time with her family, catching up on her fair share of reality TV and engaging in clothes and shoe shopping at frequent intervals. She loves to travel and visiting multiple countries on every continent is on her bucket list. Exercise is her passion and she is very much interested in holistic health (mind, body, and soul) for all of her patients. She truly believes that working with children is her calling and life’s work.

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