Five Rules for Summertime Safety

When spring fever gives way to the summer season, many of us (especially those living in colder climates) are eager to take things outside. Whether workouts or recreational pursuits, it’s undoubtedly more pleasurable to be actively involved in the outdoors rather than to be looking at it from an interior window.

Because of the increased outdoor activity, summer is the time for higher numbers of emergency room visits, too, with heat stroke, poison ivy, insect-borne illness and allergies, and severe sunburn – just a few maladies bringing people for medical help. It’s also the high season for traumatic injuries such as strains and sprains, broken bones, and brain and spinal cord injuries, said Akram Alashari, MD, trauma surgeon and critical care physician at the University of Florida. “People tend to jump into things rather than start out slowly,” he said.

And risky behaviors, such as failing to wear protective equipment or combining alcohol with certain sports or recreational activities, increases the problem, added Dr. Alashari.

How to enjoy a safe summer? If you follow these five rules for summer safety, you’ll greatly minimize your risk of spending time in the ER or sidelined on the couch.

Rule 1: Condition, condition, condition.
Even if you’ve kept up your workout routine during the cooler months, you need to condition yourself to the weather conditions, said Kristine Arthur, MD, an internist practicing at Orange Coast Memorial Medical Center in Fountain Valley, California. “Even the best trained athlete can have trouble with strenuous activity in peak temperature and humidity,” she explained. “You have to build up to it; ‘pushing through it’ can be dangerous.”

This means increasing your outdoor workout time slowly, making sure to hydrate frequently and paying attention to signs of heat illness such as muscle cramps, weakness, dizziness, nausea or headache. If any of these occur, move to a cool place until you recover. And if muscle soreness and weakness persist, seek health care immediately, said Dr. Arthur. “These may be symptoms of rhabdomyolysis, or a severe breakdown of muscle tissue that can occur with intense exercise and heat stroke, which may damage the kidneys.”

Rule 2: Use proper equipment.
Even if you’re just taking a leisurely bike ride around the block or playing a friendly game of baseball, it’s important to use protective equipment recommended for the activity, including helmets, pads and guards, said Dr. Alashari, who sees numerous bicycle, motorcycle, skateboard, baseball and rollerblading injuries through the ER during the summer months. “If you’re not wearing a helmet, an injury that might not have caused severe problems can cause irreversible damage,” he cautioned. That said, “Know you’re not immune to injury, even with protective equipment,” he added, citing a study that showed that people who are wearing helmets tend to do riskier things, such as tricks, that they might not have done if not wearing the protective equipment.

Rule 3: Know your flora and fauna.
Many a camping trip has been disrupted by a severe case of poison ivy, wild plant poisoning or a snake or insect bite or sting. It’s important to be able to identify the things that can cause problems so that you can avoid them if possible. Learn what poison ivy and poison sumac look like, which poisonous snakes are endemic to the area, and if you’re going to eat berries or mushrooms in the woods, make sure you’re proficient in identifying them – or have someone along who is – before consuming them.

As for bee or other insect stings, if you have even a moderate reaction the first time you’re stung, such as severe swelling and redness at the site of the sting, you should discuss this with your physician, said Glenn Hardesty, DO, emergency medicine physician on staff at Texas Health Arlington Memorial Hospital. “An allergy like this is a progressive problem,” he said. “It gets worse over time and can turn into a life threatening allergic reaction.”

Rule 4: Be careful about mixing alcohol with activities.
Who doesn’t like to wind down with a beer at the end of the day? But a few too many drinks can impair your ability to reason, said Dr. Hardesty. It’s easy to throw caution to the wind and try to do that crazy stunt dive you used to do in high school and end up with a spinal cord injury. Or even forget to reapply your sunscreen and suffer a severe sunburn. “A full 50 to 60 percent of what we see in the ER is a direct or indirect result of alcohol or illicit drugs,” he added. So err on the side of caution and save the alcohol for after your activity.

Rule 5: Be prepared.
Okay, we all know the scout motto for readiness in case of an accident or injury. But how many of us think ahead each and every time we plan an outing or activity – even just a workout or a day trip – to prepare ourselves and to bring along what we need to prevent a disaster?

“To start, it’s important to maintain good nutrition with a well-balanced diet and adequate fluid intake to provide your body with the energy and hydration necessary to engage in your sporting activity of choice,” said Kenton Fibel, MD, a primary care sports medicine physician at Hospital for Special Surgery in New York.

Continued hydration is crucial, too, added Dr. Fibel, who suggested incorporating water breaks into any workout, including mixing in electrolyte drinks, especially in hot and humid weather.

If your activity involves a more remote environment, you should carry your cellphone and let someone know where you are and when to expect your return. Also remember sunscreen and insect repellent, a basic first aid kit, any medications you may need such as an inhaler or an epipen for allergies and a snack with protein and carbs such as a fruit and nut bar.

Preventing Lyme Disease
Planning a trip to Maine? Whenever traveling to the northeast and upper Midwest (or if you live in this area), you should be aware of the potential for tick-borne illnesses like Lyme Disease. This bacterial infection is transmitted to humans primarily by the bite of the black-legged tick or deer tick (although other ticks as well as biting insects such as deer flies and horse flies have been shown to carry the bacteria). Ticks live in wooded and grassy areas, and can also be carried by dogs and other pets into the yard. Not all ticks are infected with Lyme Disease.

Once infected, many people experience a rash and flu-like symptoms, and if left untreated, may eventually develop multi-organ symptoms such as joint and muscle pain, and neurological issues. These symptoms may last for a long time, if not indefinitely.

The best treatment for Lyme Disease is prevention, said Nathan Wei, MD, board certified rheumatologist of Maryland. “In grassy and wooded areas, cover up completely, wear insect repellant and shower immediately after returning.”

If you do find a tick that is attached to your skin, remove it per Centers for Disease Control and Prevention ( guidelines and save it for your doctor. Then seek medical help. If the tick is engorged (has been feeding for some time) and Lyme disease is prevalent in your area, your physician may choose to treat you preventatively for the infection. Treatment consists of two to four weeks of antibiotics.

Otherwise, said Dr. Wei, be alert for symptoms of Lyme Disease, especially an unexplained rash, if you’ve been in an area where it is common – and see your physician immediately if you develop any of them. The vast majority of people who are treated early in the disease recover fully.

By Linda Hepler, BSN, RN