Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
I do want to continue with my series on the skin, but since I
raised the issue of sunburn, it pays to discuss safety issues
for the summer.
Heat intolerance can be a hormonal problem -- such as in
thyroid disease -- but it is definitely true that those who
live in a warm climate tolerate the effects of heat better
than those not so acclimated. Overexposure to the heat can
cause heat exhaustion and heat stroke.
Heat exhaustion is dehydration due to heat. It causes
lethargy, although the skin may still be moist. The
temperature of the patient may be normal. These people need a
lot of fluids, and people with kidney disease or congestive
heart failure -- that is those who must carefully monitor
their fluid intake -- make management of fluid losses
complicated. Babies and the elderly arc also especially
susceptible.
Awake patients can be given fluids orally, but because salts
need to be replaced, fruit juices and the like are preferred
over tea, pure water, and that scourge they call in Israel
"petel."
Heat stroke is when the temperature gauge in the body
breaks and the body is unable to control the inner
temperature. These people are in much danger, and their
temperature can reach very high numbers. Their skin is
usually dry. They need cooling fast and that can mean an ice
bath. The elderly, people taking many medications, and people
working for long hours in the sun are especially susceptible.
Prevention of all these problems is to drink a lot, limit
exposure to the sun at the hottest times of the day and wear
a hat.
Some other safety tips: Barbecues, campfires and Lag B'omer
celebrations should always have parental supervision, and
fires should be thoroughly out before leaving the area. Try
to make fires without lighter fluid, and use earth or water
to extinguish them.
Water safety cannot be overemphasized. Never swim alone and
never at an unsupervised area. An adult who does not know how
to swim is not worth much as a supervisor. You cannot
properly supervise children while speaking on a cellular
phone!
Always tell someone before you go out into the woods or on a
hike. Take a map of the area and plenty of water. If you get
lost, the best bet is to stay put. Don't overdo -- if you are
not in shape, don't attempt a difficult hike.
Never feed wild animals and keep your food locked away. This
advice is important for the ever-present cats in Israel.
While they can be cute, they can cause many diseases. Be
careful with plants as well. While poison ivy is an allergic
disease, eating wild plants and mushrooms especially in the
wild is a treacherous practice.
Driving safely is so important. Passing on the right,
speeding and lane weaving are just plain dangerous. In my
role as an emergency physician, I see that you don't get a
second chance with these behaviors. Seat belts save lives. So
do children's seats.
A message from Glaxo, sponsor of this column. Have a
wonderful summer. Write me in care of the Yated. If you
suffer with asthma as allergy season heats up, you already
know that Ventolin is the drug you reach for when acute
asthma strikes. However, for long term relief of limited
asthma, Serevent is your answer, especially if you have
exercise-induced or night time cold induced asthma. Combine
it with a inhaled steroid and you have the best protection.
This is called Serentide, All from the asthma experts--
Glaxo.
