Jayne Laurin Kinney DNP, PPNP- BC

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Are you ready for summer? We are too! Summer is the perfect time to pack the kids up for the beach, picnic in a park, hike in the mountains or hang out in your own back yard. Here are some tips on staying safe while having fun.

Sun and Heat

Just a few serious sunburns can increase your risk of getting skin cancer.  Sun rays are strongest between 10:00 am and 4:00 pm.  Up to 80% of the sun’s UV rays can get through clouds so you can get a sunburn even on cloudy days. Wear protective clothing and apply sunscreen and lip balm with an SPF of 15 or higher. For the best protection, apply sunscreen generously 30 minutes before going outdoors.  Pick sunscreens that will block both UVB and UVA rays, the label will say “broad spectrum”. Don’t forget to reapply every couple of hours and after swimming, sweating or drying off with a towel. Seek shade to avoid harmful UV rays during midday. Trees, umbrellas and pop-up tents are good sources of shade. Wear a hat that shades the face, scalp, ears and neck. Sunglasses will protect eyes from UV rays.

The American Academy of Pediatrics recommends babies under age 6 months avoid direct sun exposure. If you cannot avoid sun exposure, dress your baby in lightweight long pants, a long- sleeved shirt and a brimmed hat to shade the neck. You can apply a minimal amount of sunscreen with at least 15 SPF to small exposed areas of the skin like the face and backs of hands and feet.

Sunscreen comes in different types: creams, gels, sprays, and sticks. Creams are best for dry skin areas, sticks help around the eye area, and gels are good for areas with hair (like the scalp). Sunscreen sprays can make it hard to know if you’ve applied enough, and there’s a chance that kids could breathe in the fumes. Some sprays are also flammable, so you need to avoid sparks or flames when using it.

Our bodies normally cool off by sweating or by body heat radiating through the skin. In extreme heat or humidity, our natural cooling system may not function properly. This can cause heat illness such as heat cramps, heat exhaustion or heatstroke.  To keep safe during very hot weather, make sure you are drinking plenty of water, wear loose fitting, light color clothing and reduce strenuous activities during times when the heat is extreme. Never leave infants, children or pets in a parked car, even if the windows are cracked open. Stay cool with cool showers or baths.

Heat exhaustion starts slowly, but if it’s not quickly treated it can progress to heatstroke. In heatstroke, a person’s temperature reaches 105°F (40.5°C) or higher. Heatstroke requires immediate emergency medical care and can be fatal.


Signs and Symptoms Of Heat Exhaustion Signs and Symptoms of Heat Stroke
·         Increased thirst

·         Weakness

·         Fainting

·         Muscle cramps

·         Irritability

·         Headache

·         Increased sweating

·         Cool, clammy skin

·         Elevated body temperature

·         Severe headache

·         Weakness

·         Dizziness

·         Confusion

·         Rapid breathing or rapid heart rate

·         Loss of consciousness

·         Seizure

·         May not be sweating

·         Flushed, hot, dry skin

·         Elevation of body temperature to 105 degrees


Treatment of heat illness

If your child has symptoms of heatstroke, seek emergency medical care immediately. In cases of heat exhaustion or while awaiting help for a child with possible heatstroke:

  • Bring the child indoors or into the shade immediately.
  • Undress the child.
  • Have the child lie down; elevate feet slightly.
  • If the child is alert, place in cool bath water. If outside, spray the child with mist from a garden hose.
  • If the child is alert and coherent, give frequent sips of cool, clear fluids.
  • If the child is vomiting, turn onto his or her side to prevent choking.


Every day, about ten people die from unintentional drowning. Of these, two will be children aged 14 or younger. Drowning is the fifth leading cause of unintentional injury death for people of all ages, and the second leading cause of injury death for children ages 1 to 14 years.  In fact, more children 1-4 years die from drowning than any other cause of death except birth defects.

Tips from the CDC

  • Supervise When in or Around Water.Designate a responsible adult to watch young children while in the bath and all children swimming or playing in or around water. Supervisors of preschool children should provide “touch supervision”, be close enough to reach the child at all times. Because drowning occurs quickly and quietly, adults should not be involved in any other distracting activity (such as reading, playing cards, talking on the phone, or mowing the lawn) while supervising children, even if lifeguards are present.
  • Use the Buddy System.Always swim with a buddy. Select swimming sites that have lifeguards when possible.
  • Seizure Disorder Safety.If you or a family member has a seizure disorder, provide one-on-one supervision around water, including swimming pools. Consider taking showers rather than using a bath tub for bathing. Wear life jackets when boating.
  • Learn to Swim.Formal swimming lessons can protect young children from drowning. However, even when children have had formal swimming lessons, constant, careful supervision when children are in the water, and barriers, such as pool fencing to prevent unsupervised access, are still important.
  • Learn Cardiopulmonary Resuscitation (CPR).In the time it takes for paramedics to arrive, your CPR skills could save someone’s life.
  • Air-Filled or Foam Toys are not safety devices. Don’t use air-filled or foam toys, such as “water wings”, “noodles”, or inner-tubes, instead of life jackets. These toys are not life jackets and are not designed to keep swimmers safe.
  • Avoid Alcohol.Avoid drinking alcohol before or during swimming, boating, or water skiing. Do not drink alcohol while supervising children.
  • Don’t let swimmers hyperventilate before swimming underwateror try to hold their breath for long periods of time. This can cause them to pass out (sometimes called “hypoxic blackout” or “shallow water blackout”) and drown.
  • Know the local weather conditions and forecast before swimming or boating.Strong winds and thunderstorms with lightning strikes are dangerous.

If you have a swimming pool at home:

  • Install Four-Sided Fencing.Install a four-sided pool fence that completely separates the pool area from the house and yard. The fence should be at least 4 feet high. Use self-closing and self-latching gates that open outward with latches that are out of reach of children. Also, consider additional barriers such as automatic door locks and alarms to prevent access or alert you if someone enters the pool area.
  • Clear the Pool and Deck of Toys.Remove floats, balls and other toys from the pool and surrounding area immediately after use so children are not tempted to enter the pool area unsupervised.

If you are in and around natural water settings:

  • Use U.S. Coast Guard approved life jackets.This is important regardless of the distance to be traveled, the size of the boat, or the swimming ability of boaters; life jackets can reduce risk for weaker swimmers too.
  • Know the meaning of and obey warnings represented by colored beach flags.These may vary from one beach to another.
  • Watch for dangerous waves and signs of rip currents. Some examples are water that is discolored and choppy, foamy, or filled with debris and moving in a channel away from shore.
  • If you are caught in a rip current, swim parallel to shore.Once free of the current, swim diagonally toward shore.


Insects and Repellents

Mosquitoes, ticks, stinging bees, and wasps tend to come out in full force during the summer. Insect bites normally cause a small itchy bump on the skin. Sometimes the bite itself may be visible, as a tiny hole. The lump may be filled with fluid. The area around the lump is sometimes swollen. Insect bites normally disappear within a few days without medical attention. Some people may have an allergic reaction to insect bites, but bites rarely cause a severe allergic reaction, unlike insect stings.

Hives, breathing difficulties, chest pain, cramps, faintness or dizziness, nausea, rapid heartbeat, severe swelling, which may be far from the bite area, such as the tongue or lips, very severe itching and wheezing can be signs of a severe allergic reaction and requires immediate medical attention. Pus  inside or around the bite, swollen glands, fever, a feeling of being unwell and flu-like symptoms can be a sign that the insect bite is infected and also requires medical attention.

Mosquitoes are generally found near water (pools, lakes, birdbaths) and are attracted by bright colors and sweat. Bites result in stinging sensation followed by a small, red, itchy mound with a tiny puncture mark at the center. Bees are usually found near flowers, shrubs, picnic areas, trash containers and beaches. Immediate pain and rapid swelling occur following a sting. A few children have severe reactions. Seek medical attention immediately if you see a person having difficulty breathing and hives or swelling all over their body. Ticks are found in wooded areas. They may be hidden on hair or on skin. When attempting to remove a tick do not use matches, lit cigarettes, or nail polish remover. Grasp the tick near the head with tweezers, and gently pull the tick straight out.

One way to protect your child from biting insects is to use insect repellents. However, it’s important that insect repellents are used safely and correctly. Insect repellents prevent bites from biting insects but not stinging insects. Currently no insect repellent is approved for children less than 2 months of age. When you are outside, you can protect your baby for insect bites my covering them up with long sleeved shirts, pants and socks.  For children 2 months of age and older, The American Academy of Pediatrics and the CDC recommend insect repellants that contain 10% to 30% DEET.  Products with DEET amounts around 10% protect for about 2 hours.  Products with DEET amounts closer to 30% can protect for up to 5 hours. Don’t use products that combine DEET with sunscreen. The DEET may make the sun protection factor less effective. These products can overexpose your child to DEET because the sunscreen needs to be reapplied often.

All of us at Pediatrics West want to wish you a happy and safe summer. As always, call us whenever you have any questions or concerns.

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