Get Bugs to Buzz Off And Leave Your Kids Alone This Summer

As far as Kay Klebba is concerned, “summer is for turning cartwheels.” She loves it when her four kids — 15-, 12- and 11-year-old twins — play in the yard of their Shelby Township, Mich., home. Unfortunately, so do the bugs. “We’ve had a really wet spring, and we live right across from a lake. The kids stayed out until just after dark the other night and came in covered with mosquito bites.”

Avoiding the six-legged beasties is next to impossible. “There are about 10 million insect species, and about 75 percent of the world’s animals are insects,” says Tim Forrest, Ph.D., a professor of biology at the University of North Carolina, in Asheville. Most people have a reaction to bites and stings — ranging from barely noticeable bumps to saucer-sized welts. But while you can’t escape bugs altogether, there’s plenty you can do to manage them better.

To Avoid Bugbites …

• Dress to repel Bright colors and flowery prints make kids more attractive to insects, as do scented soaps, perfumes and hair sprays, according to the American Academy of Pediatrics (AAP).
• Stay out of their way Most bugs will leave humans alone, Forrest says, “unless you mess with their nest.” Steer clear of known nests and avoid areas near trash cans (beloved by yellow jackets,) stagnant water (mosquito heaven) and fruit trees.
• Squirt on the good stuff For kids, the AAP recommends products with at least 10 percent DEET, to be effective but no more than 30 percent. Spray on only as much as needed to cover skin and clothes, have kids wash with soap and water when they go back inside and wash clothes before wearing again.
• Make friends with the enemy Children who are excessively frightened by insects tend to overreact and are more likely to be stung. Help your child tap into his curiosity about nature and explore the insect world — on his terms. Watch a spider spinning a web or a bee gathering nectar from a flower. “Just explain that they should be calm and not make any sudden movements,” says Forrest.

How to Handle a Bug Bite or Sting

• Go on high alert If your child has been stung, check if there’s a stinger left behind. If so, scrape it away — carefully — with a fingernail or knife blade, says Richard F. Lockey, M.D., a professor of Medicine, Pediatrics and Public Health at the University of South Florida. Then wash the area with soap and water, and apply ice to the sting. Watch your child carefully for signs of wheezing or difficulty breathing, tightness in the throat or chest, swelling of the lips, tongue or face, or any dizziness, fainting, nausea or vomiting. While such intense allergic reactions are relatively uncommon — only an estimated 3 percent of adults and 1 percent of children react that way — they can happen within moments. And in rare instances, they can be fatal. If your child has any of these symptoms, head straight to the emergency room.
• Soothe the sting or bite If there’s no allergic reaction, continue with occasional ice for 24 hours. There are other things you can use to relieve the swelling and discomfort, but there’s no solid proof that any of them work. Still, it’s worth a try. “Cortisone cream helps some people, and so do antihistamines,” says Lockey. Some people find relief with a paste made from baking soda or meat tenderizer and water. Others find that applying aloe vera, calendula leaves and even a slice of onion can help.
• Keep an eye on it As kids scratch, bites can become infected, and some — like certain spider bites — can leave ugly, ulcerated wounds. “Keep it clean and covered,” says Lockey. “And be patient. While there isn’t much you can do to speed healing, it will go away eventually.”

Are Your Children At Risk for Dehydration This Summer?

Welcome to summer, the kids are out of school, summer camps are in full swing, family trips all over the country have begun and just in case you haven’t noticed, it’s hot outside. It is turning out to be one of the hottest summers on record with temperatures reaching triple digits in many parts of the country. As it heats up, summer safety becomes a serious issue. With all this fun and traveling going on please don’t forget to ask yourself one very important question, “are my children hydrated well enough to handle this heat?” the answer is most likely no.

Thousands of children each year are admitted to hospitals with heat-related illnesses and most go home, but there are the cases every year where children end up overheating and dying because they were not hydrated properly. As I write this, it’s a beautiful 94 degree Saturday here in Miami with all the humidity you can handle and that means one thing for us here at the fire department. A huge increase in the amount of heat illness related calls we are going to run and most of them will be on children.

As parents when we think of dehydration, we think of our children being sick and having a bout of diarrhea and or vomiting, and the doctor tells us to keep them hydrated with plenty of fluids. That is all well and good and as good parents we make sure our little campers get plenty of fluids and are back healthy A.S.A.P., But the kind of dehydration I am talking about is the kind we as parents tend to overlook in the rush of our day to day lives and that is the everyday dehydration of our very active children. By the time a child says he is thirsty, he is already dehydrated, and with studies finding that 50% of children participating in sports activities were already dehydrated we need to be hydrating our children before, during, and after physical activity as well as keeping an eye out for the signs of heat-related illnesses.

Recommendations for hydrating children ages 6 to 12 include:

• 4-8 ounces 1 to 2 hours before activity
• 5-9 ounces every 20 minutes of activity
• After activity, replace lost fluids within 2 hours

Recommendations for hydrating young athletes ages 13 to 18 include:

• 8-16 ounces 1 to 2 hours before activity
• 8-12 ounces 10-15 minutes before activity
• 5-10 ounces every 20 minutes of activity

Being able to recognize the signs of heat-related illnesses is critical and should be done by us the parents as well as the coaches. A basic awareness of the signs of heat-related illnesses could make all the difference, so here are some key points to be on the lookout for as recommended by Susan Yeargin, PhD, ATC.

Types of heat illnesses

Athletes who exercise in hot or humid weather are particularly at risk of heat illnesses:

• Heat cramps
• Heat exhaustion
• Heatstroke

Symptoms of impending heat illness

In addition to educating young athletes about both the importance of hydration and the dangers of heat-related illness, ensuring that they are drinking enough fluids, and taking precautions to reduce the risk of heat injury in children in hot and humid weather, you need to watch your child for symptoms of impending heat illness:

• Weakness
• Chills
• Goose pimples on the chest and upper arms
• Nausea
• Headache
• Faintness
• Disorientation
• Muscle cramping
• Reduced or cessation of sweating

A child continuing to exercise when experiencing any of these symptoms could suffer a heat illness.

Heat cramps

Symptoms:

• Thirst
• Chills
• Clammy skin
• Throbbing heart
• Muscle pain
• Spasms
• Nausea

Treatment:

• Move child to shade
• Remove excess clothing
• Have child drink 4 to 8 ounces of fluid with electrolytes (sports drinks) every 10 to 15 minutes

Heat Exhaustion

Symptoms:

• Nausea
• Extreme fatigue
• Reduced sweating
• Headache
• Shortness of breath
• Weak, rapid pulse
• Dry mouth
• Rectal temperature less than 104?F.

Treatment:

• Move child to cool place
• Have child drink 16 ounces of fluid containing electrolytes for every pound of weight lost
• Remove sweaty clothes
• Place ice behind child’s head
• Seek medical attention, if no improvement

Heat Stroke

Symptoms:

• No sweating
• Dry, hot skin
• Swollen tongue
• Visual disturbances
• Rapid pulse
• Unsteady gait
• Fainting
• Low blood pressure
• Vomiting
• Headache
• Loss of consciousness
• Shock
• Excessively high rectal temperature (over 105.8F.)

Treatment:

• Call 911
• Remove sweaty clothes
• Immediate and continual dousing with water (either from a hose or multiple water containers) combined with fanning and continually rotating cold, wet towels on head and neck until immersive cooling can occur.

As parents we tell our kids to study and do their homework so they will be prepared, well we as parents need to do our homework as well when it comes to recognizing the signs of heat-related illnesses and staying on top of hydration. Luckily for those parents who live and breathe on their iPhone there is help. iHydrate is an app that reminds you to hydrate yourself and your children before, during and after activities. App or no app, stay alert, keep those children hydrated and please remember, when in doubt call 911.

Ticks and Lyme Disease: a Pediatrician’s Perspective

Lyme disease has gotten a bad name. Originally described in Connecticut and New York, on the coast, near the town of Old Lyme, it was found to be carried by the deer tick (the vector), a far less common tick than the tree or dog tick. It now has also been found in most parts of the country and cannot be transmitted from person to person. The deer tick is very small, about the size of the head of a pin, and as opposed to a wood (dog) tick will not engorge with the blood of other mammals, so it is often times very difficult to see when scanning the skin. This tick must remain attached and feeding for 24 to 48 hours before it is capable of transmitting disease. Only about 5% of tick bites with the deer tick in an endemic area will result in Lyme disease in the human. Ticks and tick bites are far more common during the summer months so that is when your powers of observation need to be finely tuned. You should carefully examine your children at least twice a day for the presence of any tick attached to your child’s skin. Be sure to look in those places not easy to observe such as the scalp, between the fingers and toes, and in the pubic and the perineal areas (between the genital area and the anus).

When found, these ticks should be removed from the skin by applying a tweezer to the mouth parts firmly very close to the skin, and with firm steady traction (not sudden and jerky) pull the tick from the skin. You may leave some dark mouth parts in skin; don’t try to remove them but cleanse the area well with soap and water and treat as you would for any abrasion or cut. Those mouth parts may very well come out on their own or may remain and not cause a problem. Of course these areas can become secondarily infected ( as any cut or abrasion might) with bacteria and that would result in redness, swelling, warmth over the area and pain or tenderness Since ticks actually breathe very infrequently the idea of smothering them with petroleum jelly or other thick substance would not be practical. Do not try to burn them off with a heated pin or freshly lit match head as the only thing you will probably burn is your child’s skin.

If the disease is transmitted to your child (let me point this out again, this is rare) a mild illness with feverinitially might occur in some, this is more likely not the case however, and chronic long term vague illness is also not necessarily what you will see. The rash of Lyme’s disease also does not occur in all cases and is fairly characteristic: initially a reddened bump that subsequently clears in the middle leaving a red ring that slowly and inexorably enlarges. Sometimes there is more than one ring and other times that ring may enlarge significantly to cover entire body parts and extend to others. As a result, it is sometimes difficult to recognize this as a ring. There are blood tests that can detect the presence of Lyme disease but these might not be positive for several weeks. Treatment is easily accomplished through the use of an antibiotic for 21 – 28 days and there is time to begin treatment, up to a week to 10 days without fear of the disease progressing. The antibiotics used are common to everyone generally without side effects: Amoxicillin for young children and doxycycline (a form of tetracycline) for children 8-10 years and older.

This is a diagnoses made usually on clinical grounds; that is as a result of your child’s doctor’s experience in light of a certain constellation of signs and symptoms. Checking the tick for the presence of Lyme disease (if you have the tick) is not recommended and neither is preventive treatment if living in a high density tick area. There are reports of “chronic Lyme disease” and the treatment of such a suspected occurrence is not clear- probably the services of a specialist (infectious disease) should be sought.

Summary– Lyme disease is not very common even though you may hear of cases in your area. If you are concerned after a tick bite take your child to his/her doctor and he/she will make the diagnosis and suggest treatment if necessary. Check your child twice a day for the presence of any ticks and remove as described above. There is plenty of time to begin treatment and the antibiotics used are well tolerated; once treated it is not recommended to repeat lab work if done originally, and it can be assumed that the illness is gone and will not leave long lasting problems.

Caution! Beware of Snowmobiles with Kids. As Risky as ATV’s

Having the opportunity to write for this amazing website has given me the opportunity to bring awareness to a wide range of topics which mostly come from experiences I have had responding to calls here in south Florida at my fire department. What I would like to speak out today is something I have NO experience with, Snowmobiles. I want to cover this because while planning a family ski trip I kept seeing snowmobiling as a thing to do and wanted to know more and how I can relate to them. What I found is that snow mobiles are ATV’s on snow. I wanted to compare the two. I looked at size, weight, speed, passenger room, and of course injuries, and here is what I found.

• Both are gas powered.
• Both have “dry weights” that can be 300lbs or higher!
• Both can reach speeds well over 50 mph with some snowmobiles going well beyond that.
• Both come in single or multi-passenger models.
• Both have varying laws about operating age depending on the state you are in.
• Both have caused fatal injuries to all age groups with snowmobiles having drowning added to its list.
• Both list striking stationary objects such as trees as a major factor in accidents.
• Both have leading causes of non-fatal injuries listed as head, neck, and face injuries.
• Both list leading causes of head trauma due to a lack of proper helmet protection.
• Both list excessive speed as a contributing factor in many accidents.
• Both are susceptible to hidden dangers in the mud or snow respectively.

Having looked at all these factors, I found that snow mobiles are no different SAFETY wise than ATV’s. Yes driving on snow offers some obvious differences but the safety aspects are the SAME.

SNOWMOBILE vs. ATV: SAFETY FEATURES

• Both are not recommended to be driven by anyone under 16 years of age.
• Both should always be ridden with a proper helmet and any extra safety restraints when available.
• Both should be ridden with reflective gear that can be seen at night.
• Both should be driven cautiously and preferably by experienced drivers.
• Both weigh a lot and require strength to drive properly.
• Both should be driven away from bystanders and other traffic as to avoid collisions.
• Both should be given the respect they deserve as powerful machines.

Having said all this and hopefully made you aware of how safety is similar in many recreational machines, I do not wish to discourage you from going out and riding these machines, I just want you to do it safely.

Good luck and stay warm.

Teachers, Counselors, Coaches: How To Keep Your Kids Hydrated

Welcome to Fire Academy! It is now 7am and the PT or Physical Training is about to begin. The instructor for the class has many things on his/her mind but none more important than two things we preach most, Safety and Hydration. Before any work is done it is the job of the instructor to make sure that the class has hydrated and is prepared for what is about to take place. The importance of being safe no matter what you do can never be understated, hydration has a role in your safety as well.

While you may not be a Fire Academy Instructor, if you are caring for kids this summer you have the same job and should be thinking in the same way. How can I keep these children safe and have we hydrated for what we are about to do, what we are doing, and what we have done?

Teachers, it does not matter if you are at a large school or a small daycare. You have had these children placed in your care and it is your job to incorporate regular hydration into your schedule. Hydration should be done before going out to play or recess, the children should have access to water while playing by a water fountain or bottle of some kind, and the children should be given an opportunity to hydrate when outside time is through. This will ensure that the kids are properly hydrated at all times and ready for whatever activity you have planned next.

Parents, if you are in charge of mommy or daddy daycare then you too have the job of making sure your kids are properly hydrated. It will be easy to let the kids play and drink whatever they can grab out of the fridge but having a supply of water on hand rather than super sugary drinks will pay dividends for your family by not only keeping them hydrated, but also not loading them up with a ton of sugar as well. Parents please remember that kid’s bodies burn at a much higher rate than ours so even if the kids are not as active as they should be and they are lounging around the house, they still need to have plenty of water.

Counselors, if you are in charge of children then you need to be the one looking after the hydration of the group. I know that camps during the summer plan constant activities and go many places, so not only do you have the responsibility of watching the kids in multiple situations, but you also need to be monitoring their hydration as well. Make sure everyone has water on or near them during activities. You know the kids have some sort of juice in the lunch they brought with them, so please do your part to make sure they are getting plenty of water before, during, and after activities.

Coaches, You, out of all the other categories, are the closest to Fire department instructor. Your job is to make safety and hydration a priority. Have you thought about the safety involved in what your team is about to do? And has your team hydrated properly so that they can not only perform, but avoid risking dehydration? It is your added responsibility to monitor the hydration status of your team. Some sports may have helmets and uniforms that make it difficult to see faces and other signs of dehydration, so the job of hydration becomes that much more important. Before, during, after, and even on the days off as well.

Parents, Teachers, and Counselors can get creative with younger children and have them color their own water bottles or something along those lines to make it fun while making sure they are drinking enough water.

The goal of hydration is to avoid Heat Related Emergencies.

There are varying levels of Heat Related Emergencies and signs that can let you know if a Heat Emergency is near or already happening.

When looking for heat related emergencies be on the lookout for the following:

• Nausea / vomiting
• Cramps
• Dizziness
• Skin is red in color but dry to the touch
• Loss of consciousness / Fainting
• Headaches
• Altered mental status ( not acting how they normally do )
• Low Energy / Weakness

While these are all signs of dehydration, please be aware that these are the signs seen most during activities such as playtime or sports.

All of these require bringing the child out of the sun, into a cool place, and re-hydrating the child slowly. If the child faints, has any other medical issue, or has an altered mental status please take them to a cool place, hydrate them slowly and call 911. There are many causes for altered mental status and severe dehydration is one of them so having an emergency unit there will only help the situation.

• To slowly re-hydrate a child let them drink slowly, a little bit at a time. Having them drink too much, too fast may cause them to vomit.
• To slowly cool a child down you can place a cool wet towel over the back of their neck and/or ice-packs in the under arm area, as well as between the thighs. I know we have all seen the NFL players jump into huge garbage cans of ice, Please do not attempt this with any children as this is a last resort option and one that should be done only by trained professionals under medical supervision.

As, always I will tell you that when in doubt call 911. These are children and while they may not be your children, you have a responsibility to them to keep them safe and act in their best interest. Mom and Dad will thank you later.

Good luck, Have a great summer and be safe!

Summertime Bugs, Bites and Burns: A Pediatrician’s Perpective

The beginning of summer signals a time of spending more active hours outdoors. The weather is warming up, the days are longer and children are getting out of school and probably staying up longer than they did during the school year. It is a time to let loose and enjoy the sunshine and freedom that comes with the season.

Certain issues should be addressed and some summer safety tips followed in order to keep everyone as healthy as possible. While exposure to sunlight is important to the innate production of vitamin D and hence calcium metabolism, there are dangers that our dermatology friends have been warning about for quite some time: too much sun can be as dangerous as too little. The highest rates of Melanoma (serious form of skin cancer) occur where there is an increased and constant exposure to sunshine, such as the southwestern part of this country. Why is this? It has been determined that both UVA and UVB light frequencies can at times alter the structure of DNA, that is the microscopic building blocks for forming all types of life forms. This is most prominent in the largest organ in our bodies, our skin. This can lead to the formations of all types of skin growths- melanoma being the most serious as it can shorten one’s life.

So avoiding sunlight would be the best way of avoiding this problem, but this is virtually impossible. Therefore try to avoid the maximum sunlight times of the day and spend more time outdoors before 10 AM and after 3PM, and cover up as much as is practical. At all times children should have a good sunblock on their skin- one that will block both UVA and UVB frequencies, and if continued exposure to sunlight is taking place or if one enters the water, this sunblock should be re-applied; the higher the SPF the less often it need be applied.

One blistering sunburn in a child can raise the chances of developing melanoma as an adult manifold. Once a sunburn is present there is practically nothing you can do except to keep your child comfortable with cool compresses and Tylenol if he/she is very uncomfortable.

Not only are bugs a nuisance but some may carry diseases. Just as an example, the recent concentration on the Zika virus highlights the need to be alert to insects (mosquitoes), as the Zika virus was not even recognized 5 years ago. There are known illnesses that can be transmitted through the bites of insects, but as a rule these are not very common- it still makes sense to wear appropriate clothing and use insect repellent at appropriate times. These repellents should contain DEET in concentrations up to 30% for children and should not be used under the age of 6 months.

In general the ubiquitous honey bee usually will not be interested in stinging humans unless they are threatened- inadvertently sat on, or a child is actively trying to catch them. Even the large black and yellow bees seen buzzing around certain plants and flowers are not particularly aggressive.

This is not necessarily true of other stinging insects in the same family (hymenoptera). Hornets and wasps can be aggressive depending on the situation, and the fairly new “Africanized bee” population has grown in size- they tend to swarm and have been responsible for deaths in the past. So better off to avoid these creatures altogether. Of course if there is a known bee allergy present in your child certainly more stringent avoidance procedures should be undertaken as this can be a life threatening situation.

So summertime is a wonderful time for families and especially children; be sure to keep your child safe from the indigenous dangers that summer presents.

Other summer topics to be discussed in the near future include water hazards, plant contact (poison ivy, etc), heat exposure, dog and cat bites not to mention animal safety in general.

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