Posted in Health, news

Tips to Prevent Childhood Drowning

The leading cause of death in children are “unintentional injuries” including drownings.  According to the CDC, 20% of drowning victims are under the age of 14.  And non-fatal drowning victims could sustain brain damage and long term disability.

Pools, bathtubs and any body of water pose risks, however this time of year is especially dangerous, because activities surrounding pools, such as BBQs and alcohol use, become distractions to the adults supervising.

When it comes to drowning prevention, the following is necessary:

All pools should be enclosed

Fence height should be at least 4-5 feet high and the entry gate should self-close and self-latch.

Even if your pool has a fence, be aware that the house who’s hosting the BBQ, play date, or sleep-over may not.

And any kiddy pools or ice buckets used for drinks should be dumped out after use and flipped over so they do not become a future threat.

All young children should be within arm’s reach of an adult when swimming

The farther you are away from the child you’re supervising, the longer it takes to rescue. With distance between you and the victim, other children may swim in your path and you may lose sight of where the victim submerged.  And seconds count.  A panicked child under water may also aspirate water into the lungs becoming hypoxic quicker.  Moreover they could be at risk of “secondary drowning” in which water in the larynx triggers a spasm closing up the airway, or water falling into the lungs causes pulmonary edema and respiratory failure days after the water incident.

Do not get distracted

Put the phones away.  Adults supervising kids in a pool should not be answering a phone call or on social media.  Moreover, adults should not be drinking alcohol while supervising a child. Reaction time is key, and a drunk adult could become a drowning victim as well.

Remember that drowning is silent

Many drownings occur while others are feet away from the victim. Why? Because a submerged victim makes little sound and nearby splashing visually and auditorily obscures the victim’s splashes.

Parents have long learned that when children get quiet during playtime, something could be going wrong.  Use that same Spidey-sense when they are in the pool.

swimming-pools

Learn CPR and water rescue skills

Most CPR classes teach adult, child, and infant CPR.  Having this knowledge and becoming certified could save a life one day.

If swimming in open waters, know the weather and sea conditions prior to jumping in.  Life jackets/vests, appropriate for the child’s size, should be worn, even if the child is out of the water, such as in a boat.

 

What is “Dry Drowning” and “Secondary Drowning”?

Dry Drowning occurs when water touches the first pass of the respiratory tree, one’s vocal cords, larynx.  When water touches this area a reflex is triggered, causing a spasm (laryngospasm) such that the vocal cords constrict and close up the airway.  It’s a defense mechanism designed to prevent water from falling into the lungs. However, laryngospasm causes immediate hypoxia, lack of oxygen, and if not reversed, the victim will die.  In dry drowning, water never officially reaches the lungs.

 

bronchi_lungs.jpg

IMAGE FROM SEER TRAINING

 

In Secondary Drowning, water gets inhaled and sits in the respiratory tree and if uncleared through coughing, will sit and prevent proper oxygenation.  Moreover the water will irritate the lung linings causing more fluid and inflammation, resulting in pulmonary edema.  This could occur hours to days after the water activity.

According to Florida Hospital Tampa pediatrician, Dr. James Orlowski, these events are very rare, comprising only 1-2% of drowning incidents.

What are the symptoms?

The symptoms for both “Dry” and “Secondary Drowning” are similar in which the victim could have any of the following:

  • Cough
  • Chest Pain
  • Difficulty Breathing
  • Shoulder Pain
  • Neck Pain
  • Confusion
  • Irritability
  • Behavior Changes
  • Fatigue
  • Difficulty speaking
  • to name a few…

Prevention

Horse play in water should be avoided. This includes bathtubs, plastic pools, hot tubs, pools, lakes, ocean, etc.

Never swim alone.

Swim in areas staffed with lifeguards and/or appropriate supervision.

If water does get inhaled watch the child or adult to look for any of the above symptoms. If concerned seek medical help immediately.

Have a safe and healthy summer!

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, Labor Day, news, travel

Labor Day Weekend Safety Tips

Image above from Getty Images

The holiday offers a day of respite for those who labor throughout the week.  But the federal holiday, established in 1894, may come with risks as its one of the most travelled weekends of the year.   Grill injuries can occur, and throughout the US we are seeing record high temperatures. Additionally, water injuries, including drownings may rise this weekend. We need to stay safe out in the sun, by the grill, in the water and on the roads.

 

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Sun Safety

 

Record heat and extended time outdoors can increase the risk of heat illness.  Hydrate, stay in the shade and protect your skin from damaging UV rays.

Sunscreen with an SPF of 30 or greater should be applied 15-30 minutes prior to going outside and reapplied every two hours or more often if swimming.

Avoid excessive alcohol as it could accelerate dehydration and put one at greater risk of injuries and heat exhaustion.

For more on heat exhaustion and heat stroke read here.

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Grill Safety

 

In 2012, a man caught on fire after spraying sunscreen prior to heading over to the grill. He sustained multiple second degree burns.

Sunscreen may be flammable, so make sure it is dry prior to grilling or use a lotioninstead of spray on.

Keep the grill outdoors but away from low roofing, branches, and trees. Watch the little kids and keep them and the pets away from the barbecue.

Assign someone to watch the grill if you need to step a way during grilling.

 

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Do not add lighter fluid to already ignited coals.

If someone does catch on fire, remember to have them stop, drop and roll on the ground until the flames expire.  Call 9-1-1 and remove any jewelry or tight clothes around the area..

If a minor burn injury does occur, run it under cool (not cold) water for 10-20 minutes. Avoid applying ice to the burn as it can damage the skin.  Also remove nearby jewelry.

Bandage and see a medical provider if concerned with your injury.

 

Water Safety

 

Avoid drinking alcohol when swimming or engaging in water sports.

Make sure you are in arm’s reach of your kids in the water.

Use life vests while boating and make sure the kids are wearing appropriate sized vests.

Never swim alone. Always have a buddy.

 

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Road Safety

 

Know your route to avoid you checking your GPS app while you drive.

Allow extra travel time and don’t rush.  Expect travel delays coming home as well.

Consider leaving a day or two early or a day or two late to avoid congested traffic.

Drive the speed limit and avoid tailgating, leaving at least 2 seconds between you and the car ahead of you.

Make sure you have plenty of water, supplies and a first aid kit in the car in case you get stuck on the highway.

 

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Have a happy and safe Labor Day Weekend!

 

                                                                                                      

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news

Poop and Other Nasties in the Pool Can Cause Disease

The CDC reports outbreaks associated with “treated recreational water” due to multiple organisms including Cryptosporidium, Pseudomonas, and Legionella.

Looking at the time period between 2000-2014, the CDC reports the following:

Investigations of the 363 outbreaks identified 24,453 cases; 21,766 (89%) were caused by Cryptosporidium, 920 (4%) by Pseudomonas, and 624 (3%) by Legionella. At least six of the eight reported deaths occurred in persons affected by outbreaks caused by Legionella. Hotels were the leading setting, associated with 157 (32%) of the 493 outbreaks

Hotel pools and hot tubs appear to be the biggest culprits.

Pseudomonas has been known to cause skin infections such as “hot-tub folliculitis” and ear infections, otitis externa, known as “swimmer’s ear.”  Legionella is known for causing Legionnaires’ disease, a severe pneumonia as well as a milder illness known as Pontiac Fever.

The largest number of cases, however, were caused by Cryptosporidium.  Known as “Crypto”, this parasite can cause severe gastrointestinal illnesses. Here’s the breakdown:

What is Crypto?

Crytosporidium is a parasite protected by an outer shell.

This shell allows it to live outside the body on surfaces.  The shell also allows it to be chlorine resistant which explains why it can live in swimming pools.

Crypto-brochure-image.jpg

How common is Crypto?

According to the CDC, Cryptosporidium is a leading cause of waterborne disease among humans in the United States.   Its found in every region of the US and the world.

The CDC reports close to 750,000 cases of cryptosporidiosis occur every year in the US.

How is it spread?

Its spread in drinking water and recreational water, such as swimming pools.  Since it lives in the intestines of humans and animals it becomes spread after one passes stool, or poops.  People coming into contact with an infected individual’s poop could become infected with Crypto.

It is not passed through respiratory transmission or blood.  However if feces comes into contact with one’s mouth, or wound, it can transmit Crypto.

Coming into contact with feces contaminated soil, surfaces, water, food therefore put one at risk.

What are the symptoms?

The parasite can cause any of the following:

Diarrhea

Abdominal Pain and Cramping

Fatigue

Nausea

Vomiting

Dehydration

Lack of appetite

Weight Loss

and sometimes  no symptoms at all.

When do symptoms show and how long do they last?

After one becomes exposed to Cryptosporidium, symptoms could show within 48 hours to 10 days.  Symptoms can last 1-2 weeks.

 

What is the treatment for Crypto?

The infection many times is self-limiting.  Hydration is imperative and initial treatment is making sure one does not become dehyrated.  Young children, pregnant women, elderly, those with weakened immune systems, AIDS, cancer and immunosuppressed transplant patients are at higher risk  of serious infection.

Some medical providers may use Nitazoxanide. According to the National Foundation for Infections Diseases:

Nitazoxanide (Alinia ®) may be used to treat Crypto in both adults and children 12 months of age and over. Nitazoxanide is available as a tablet for adults and as a liquid suspension. A three-day treatment regimen is recommended.

How do we prevent Crypto?

Always wash your hands with soap and water

Avoid eating off of non clean surfaces

Avoid swimming pools that may have just been soiled

Avoid ingesting  water while swimming

Avoid feces of those individuals infected

Avoid sexual contact where oral – anal contact can occur

Change baby’s diapers away from the pool in case it blows into the water

Do not allow any family members with diarrhea to enter the pool

Inform your medical provider if you have any of the above symptoms so he/she can test the stool.

 

Don’t pee or poop in the pool

The Water Quality & Health Council found one in four adults ADMIT to urinating in the pool, which can affect chlorine strength.

Many choose not to wait in line at public bathrooms or use the wet toilets at public water parks and find it easier to relieve themselves in the pool.  For women worried about sitting on wet toilet seats I recommend using a  large soda cup and in the stall standing and urinating into it. Pour it out into the toilet and flush.  Clean, easy and environmentally sensitive.  Men, there’s no excuse. Towel off and head to the potty.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio, KDWN and Board Certified Family Physician

Posted in Health, news

4 Year Old Recovering From “Secondary Drowning”

A 4-year-old girl from Sarasota, Florida is recovering from “secondary drowning” after “inhaling” pool water while playing around with a pool noodle in her grandmother’s pool.  Eliana, was blowing into one end, while another swimmer blew into the other end, forcing pool water to go into her throat.  She immediately threw up, but 2 days later, Eliana developed a fever.  The urgent care physician suspected aspiration pneumonia, or an infection of the lungs due to something being deeply inhaled, and recommended transfer to the emergency room.  The child subsequently was hospitalized, placed on immediate antibiotics and oxygen therapy.   According to FOX News, Eliana has been released from the hospital and is recovering at home.

Last year, another child was a victim of “secondary drowning”.  Unfortunately, he passed away.  Frankie, 4 years old, went swimming at Texas City Dike over Memorial Day Weekend and was fine until a few days later, his father, Francisco Delgado, Jr., said he appeared to be suffering from a minor, stomach ailment.  Then one morning the boy woke up with shoulder pain, and “Out of nowhere, he just woke up. He said ahhh.”  His father told KTRK, “He took his last breath and I didn’t know what to do no more.”

What is “Dry Drowning” and “Secondary Drowning”?

Dry Drowning occurs when water touches the first pass of the respiratory tree, one’s vocal cords, larynx.  When water touches this area a reflex is triggered, causing a spasm (laryngospasm) such that the vocal cords constrict and close up the airway.  It’s a defense mechanism designed to prevent water from falling into the lungs. However, laryngospasm causes immediate hypoxia, lack of oxygen, and if not reversed, the victim will die.  In dry drowning, water never officially reaches the lungs.

 

bronchi_lungs.jpg

IMAGE FROM SEER TRAINING

 

In Secondary Drowning, water gets inhaled and sits in the respiratory tree and if uncleared through coughing, will sit and prevent proper oxygenation.  Moreover the water will irritate the lung linings causing more fluid and inflammation, resulting in pulmonary edema.  This could occur hours to days after the water activity.

According to Florida Hospital Tampa pediatrician, Dr. James Orlowski, these events are very rare, comprising only 1-2% of drowning incidents.

What are the symptoms?

The symptoms for both “Dry” and “Secondary Drowning” are similar in which the victim could have any of the following:

Cough

Chest Pain

Difficulty Breathing

Shoulder Pain

Neck Pain

Confusion

Irritability

Behavior Changes

Fatigue

Difficulty speaking

to name a few…

Prevention

Horse play in water should be avoided. This includes bathtubs, plastic pools, hot tubs, pools, lakes, ocean, etc.

Never swim alone.

Swim in areas staffed with lifeguards and/or appropriate supervision.

If water does get inhaled watch the child or adult to look for any of the above symptoms. If concerned seek medical help immediately.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news

Tips to Prevent Childhood Drowning

The leading cause of death in children are “unintentional injuries” including drownings.  According to the CDC, 20% of drowning victims are under the age of 14.  And non-fatal drowning victims could sustain brain damage and long term disability.

Pools, bathtubs and any body of water pose risks, however this time of year is especially dangerous, because activities surrounding pools, such as BBQs and alcohol use, become distractors to the adults supervising.

When it comes to drowning prevention, the following is necessary:

All pools should be enclosed

Fence height should be at least 4-5 feet high and the entry gate should self-close and self-latch.

Even if your pool has a fence, be aware that the house who’s hosting the BBQ, play date, or sleep-over may not.

And any kiddy pools or ice buckets used for drinks should be dumped out after use and flipped over so they do not become a future threat.

All young children should be within arm’s reach of an adult when swimming

The farther you are away from the child you’re supervising, the longer it takes to rescue. With distance between you and the victim, other children may swim in your path and you may lose sight of where the victim submerged.  And seconds count.  A panicked child under water may also aspirate water into the lungs becoming hypoxic quicker.  Moreover they could be at risk of “secondary drowning” in which water in the larynx triggers a spasm closing up the airway, or water falling into the lungs causes pulmonary edema and respiratory failure days after the water incident.

Do not get distracted

Put the phones away.  Adults supervising kids in a pool should not be answering a phone call or on social media.  Moreover, adults should not be drinking alcohol while supervising a child. Reaction time is key, and a drunk adult could become a drowning victim as well.

Remember that drowning is silent

Many drownings occur while others are feet away from the victim. Why? Because a submerged victim makes little sound and nearby splashing visually and auditorily obscures the victim’s splashes.

Parents have long learned that when children get quiet during playtime, something could be going wrong.  Use that same Spidey-sense when they are in the pool.

drowning.jpg

Learn CPR and water rescue skills

Most CPR classes teach adult, child, and infant CPR.  Having this knowledge and becoming certified could save a life one day.

If swimming in open waters, know the weather and sea conditions prior to jumping in.  Life jackets/vests, appropriate for the child’s size, should be worn, even if the child is out of the water, such as in a boat.

Have a safe and healthy summer!

 

                                                                                                       LearnHealthSpanish.com

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician