Archive for June, 2018

The Difference Between Dehydration, Heat Exhaustion, and Heat Stroke

Dehydration

One of the most important things you can do to prevent heat illness is staying hydrated. Without the right amount of fluid intake, your body can’t keep its temperature at a normal, consistent level. Dehydration happens when your body lacks the proper amount of fluids and electrolytes to keep working properly.

Dehydration symptoms include:

  • Thirst
  • Less frequent urination than normal
  • Darker urine color
  • Dry skin
  • Tiredness
  • Dizziness and/or fainting
  • Headache

Signs of dehydration may be slightly different for younger individuals. In young children and infants, dehydration symptoms can include a dry mouth and tongue, crying without tears, an extended period of time (around 3 hours) without a wet diaper, high fevers, and an unusual amount of sleepiness or drowsiness.

Heat Exhaustion

Heat exhaustion is a serious condition. Heat exhaustion happens when the body loses a great deal of water and salt (which is usually caused by profuse sweating). Cases of heat exhaustion are made much worse whenever there is a high level of humidity or physical activity involved. Notably, heat exhaustion can cause any pre-existing conditions to worsen or become more apparent. It is important to know the signs of heat exhaustion, as it could take place within a very short period of time.

Heat exhaustion signs and symptoms include:

  • Muscle cramping
  • Fatigue
  • Headache
  • Nausea and/or vomiting
  • Dizziness and/or fainting

Someone with heat exhaustion may have cool or even slightly wet skin, which indicates the body is still working toward cooling itself; however, the individual will likely have a fast and faint pulse and exhibit quick and shallow breathing.

Heat Stroke

Heat exhaustion left untreated may result in heat stroke. This is a life-threatening condition which can result in damage to the brain or other important organs. In some cases, heat stroke may cause multiple organ systems to fail and can ultimately cause death. During heat stroke, the body’s core temperature rises above 106° F within a time frame of 10 to 15 minutes. This rapid increase in body heat, coupled with a failing sweating mechanism, leaves the body without the ability to cool itself.

Heat stroke symptoms include:

  • Confusion
  • Altered mental state
  • Slurred speech
  • Unconsciousness
  • Hot, dry skin or extreme sweating
  • Seizure
  • Extremely high blood pressure

Treatment

If you find you are experiencing any of the symptoms from a condition listed above, follow these tips:

Dehydration – The only effective method of treating dehydration is to replace lost fluids and electrolytes.

Heat exhaustion – Remove all unnecessary clothing, including socks and shoes. The individual should take frequent sips of cool water, making sure not to take in too large a quantity too quickly as it may induce vomiting, which would further dehydrate.

Heat stroke – Make sure someone is with the person at all times until medical services arrive, and ensure that the person experiencing the heat stroke is moved into a cooler, shaded area. Placing cold, wet cloths or ice wrapped in cloths on the individual’s head, neck, armpits, or groin may help as well.

Know Where to Go

Getting the right care at the right time and place depends on the kind of symptoms you’re experiencing — and their severity.

For milder symptoms or if you’re not sure which kind of care you need, start with your primary care physician. Because your PCP knows your complete health history and how you respond to medication, he or she can develop the best course of treatment. If your symptoms warrant more advanced treatment, they can guide you to the right care facility.

A MinuteClinic location is a good alternative for milder symptoms if you can’t see your PCP right away.

However, for more severe symptoms, visit an urgent care center are good alternatives if you need to see a health care provider sooner than you can see your PCP, or if you need care outside of your PCPs normal office hours.

Emergency departments are best for life-threatening health issues. In the case of heat-related illnesses, go to the nearest Emergency Department or call 911 if you experience any of the following:

  • Nausea and vomiting
  • Fainting
  • Unconventional behavior/hallucinations

When in doubt, don’t hesitate to call your PCP or the Emory HealthConnection at 404-778-7777 and speak to an Emory nurse for assistance.

We’re Here to Help

The Emory Healthcare Network partners with MinuteClinic locations and Peachtree Immediate Care urgent care locations throughout metro Atlanta and surrounding communities. Together they provide nearly 60 locations for convenient care close to home.

About Dr. Colovos

Nick Colovos, MD, received his degree from the University of Miami School of Medicine in 1993, and completed his residency in emergency medicine at St. Vincent’s Medical Center in Toledo, Ohio, in 1996. His work experiences in the academic, public and private sectors of medical care have allowed him to develop a unique perspective on the business of healthcare and its delivery to patients. He currently serves as medical director for the Emory Healthcare Urgent Care and MinuteClinic Strategy and assistant clinical professor of Emergency Medicine, Emory University School of Medicine, in Atlanta, Georgia.

Sunscreen 101

School is out and it’s time to enjoy the sunshine. After all, you deserve it! But don’t forget, your skin deserves some protection. The skin is a living organ system that interacts with the external environment while protecting our internal organs. Thus, it is important to know about proper sun protection for your skin.

What is SPF?

SPF stands for sun protection factor, meaning there is an extra layer of protection that an individual receives from the application of sunscreen. According to the Food and Drug Administration, the recommendation is to use a sunscreen with at least SPF 15 and labeled as “broad-spectrum SPF.” The American Cancer Society recommends sunscreens with SPF 30 when engaging in outdoor activities.

What exactly do these numbers mean?

A broad-spectrum sunscreen that has SPF 15 means that particular bottle of sunscreen will offer sun protection against both UVA and UVB rays 15x longer than without sunscreen at all.

UVA vs UVB Rays

UVA and UVB rays are two types of radiation from sunlight that, in excess, can be harmful to the skin. UVA rays penetrate the skin deeper than UVB rays and are the ray responsible for skin aging, wrinkling, and tanning. UVB rays damage the outermost layers of the skin and are primarily responsible for sunburns and reddening of the skin.

Which SPF Sunscreen is Right for Me?

When considering which level of SPF to use, it is important to know that an SPF of 30 does not necessarily offer twice the protection of an SPF of 15; while higher SPF sunscreens offer more protection, it is not a linear scale. The higher the SPF the greater percentage of harmful rays are prevented from reddening the skin.

• SPF 15 protects against 93% of UVB rays
• SPF 30 protects against 97% of UVB rays
• SPF 50 protects against 98% of UVB rays

Applying Sunscreen

Picking the right sunscreen is just as important as applying the sunscreen correctly. If you are going to be using insect repellent and sunscreen, be sure to apply the sunscreen first and wait at least 30 minutes before applying the insect repellent. Apply the sunscreen liberally and be sure to follow the directions listed. To get a sense of how much sunscreen you should apply, the recommended amount is at least two tablespoons.

According to the Food and Drug Administration, no sunscreen is waterproof. Some sunscreens may have water or sweat resistance. These water/sweat resistant sunscreens should detail a specific amount of time the labeled SPF level of protection lasts for an individual when swimming or sweating. Finally, it is important that you reapply sunscreen at least every two hours, regardless of the level of SPF.

Protective Clothing

Protective clothing is another way to ensure your skin is optimally protected against UV radiation. Long sleeve shirts, long pants, and wide-brimmed hats protect against just that! If the clothes are tightly woven or dark, it’s even more protection. Sunglasses with lenses that protect 100% against UVA and UVB radiation are also strongly recommended. If you have a history of skin cancer or increased risk of getting sunburns, protective clothing is very important and should be worn whenever exposed to sunlight. These clothes help to keep rays from harming skin.

How to Treat Sunburn

Sunburn is defined as a sign of skin damage from spending too much time outdoors without wearing a protective sunscreen, according to the National Institute for Occupational Safety and Health. If you find yourself with a sunburn, taking an over-the-counter anti-inflammatory medication (such as ibuprofen or aspirin) and applying cold compresses or ice packs aids the pain relief. Additionally, taking cool baths or showers frequently may help. After the bath, gently pat yourself dry but leave some water on the skin and apply a moisturizer. The use of moisturizing creams and lotions (including aloe) will also help prevent drying and cracking. If a blister does form, leave it intact for a faster healing process. If you have a sunburn, stay out of the sun for a few days in a cool, shaded, or indoor space and drink plenty of water.

Sun poisoning is when an itchy, red rash has appeared on the skin after being exposed to sunlight, also known as a sun allergy. It may take only minutes for signs of sun poisoning to appear after exposure to the sun. These signs are redness, itchiness/pain, elevated red patches, blisters, scaling, or even bleeding.

Summer is a great time to relax and have some fun in the sun. Keeping your skin properly protected allows for you to enjoy this time frequently and safely. If you are in the sun often, it is beneficial to do self-screenings at least once a month to make sure everything is all right.

Know Where to Go When it’s Not Life Threatening

Go to your primary care physician, family doctor, or pediatrician if you have concerns about your sunburn, or for questions regarding over-the-counter remedies, contact your primary care physician.

If you can’t get an appointment at a time that works for you, or your doctor’s schedule is all booked up, you have options.

MinuteClinics are good alternatives if you need to see a health care provider sooner than you can see your PCP, or if you need care outside of your PCP’s normal office hours. MinuteClinics can treat many minor illnesses and injuries and prescribe medications.

When to Go to Urgent Care or the Emergency Room

In some cases, sunburns can be bad enough to require advanced care. Go to urgent care or the ER if your symptoms include:

• Severe pain
• Severe blistering
• Severe headache
• Confusion
• Nausea or vomiting
• Faintness or dizziness

Those with a severe burn who also suffer from a serious health condition – such as cancer, HIV/AIDS, diabetes – should seek emergency care.

If you’re not sure if which type of care you need, call your family doctor or HealthConnectionSM at 404-778-7777 and speak to an Emory nurse for assistance.

To learn more about getting the right care at the right time and in the right place, or to find locations, visit emoryhealthcare.org/wheretogo.

About Dr. Colovos

Nick Colovos, MD, received his degree from the University of Miami School of Medicine in 1993 and completed his residency in emergency medicine at St. Vincent’s Medical Center in Toledo, Ohio, in 1996. His work experiences in the academic, public and private sectors of medical care have allowed him to develop a unique perspective on the business of healthcare and its delivery to patients. He currently serves as medical director for the Emory Healthcare Urgent Care and MinuteClinic Strategy, and assistant clinical professor of Emergency Medicine, Emory University School of Medicine, in Atlanta, Georgia.

Drowning and Water Safety

Summer is finally here and it’s time to spend some time in the water cooling off whether it’s at the pool, lake, or beach. As we’re enjoying this weather near the water, injuries are not the first thing many people think of, but it should be. It is important to make sure that you, your family, and friends are staying safe in the water and not increasing your risk of drowning.

You may be thinking, “This won’t happen to me,” or “I know how to swim, I’ll be fine.” While you or others may be excellent swimmers, it only takes a few seconds for an individual to drown. It is important to confirm that everyone in the group has basic swimming skills and to have a designated supervisor while at any body of water, especially if there is not a lifeguard on duty.

Who is at risk for drowning?

There are many factors that may increase a person’s risk of drowning. Here are the five most common risk factors as outlined by the CDC.

  • Swimming Ability: There are many adults and adolescents who lack swimming ability but still enjoy being near the water. Not being able to swim makes drowning an unfortunate, but more likely, reality.
  • Barriers: Without fencing, or other barriers to bodies of water, children may wander into a pool area and could fall into the water.
  • Supervision: Drowning may take place quickly and quietly anywhere that there is water. It’s important to pay attention constantly to people around any body of water.
  • Location: Depending on the age of the individual, the likelihood of drowning may change with the location. For example, children under four have a higher likelihood to drown at in home swimming pools, while those fifteen and older tend to drown in natural water settings.
  • Alcohol: The use of alcoholic substances is involved in nearly 25% of an Emergency Department visit due to drowning, and 70% of deaths due to recreational use of water.

What are some tips to keep drowning from happening?

  • Learn CPR: Mere seconds can be the difference between greatly improving and influencing the outcome of a drowning incident.
  • Always swim with a buddy!
  • “Water wings” and other toys designed for water are no substitute for a life-jacket. Wearing one greatly reduces the risk of drowning.
  • If you are going to the beach, know what each of the different colored flags indicates (these may vary by beach) and obey all warnings.

What to do if someone is Drowning

  • Use anything around you to try and bring the drowning victim in from the water without putting yourself at risk.
  • Call others for help.
  • Lie the victim on their back, and move their head and chin backwards to try and clear their airway.
  • Pinch their nose as their head is tilted backwards and breathe into their mouth with yours to function as a rescue breath.
  • After five rescue breaths, begin performing CPR.
  • After performing CPR for at least one minute, and if no one around you has already called 911, do so.
  • Continue performing CPR until the ambulance arrives.

What is dry drowning?

“Dry drowning” or “secondary drowning” is when a serious amount of deterioration take place after nearly drowning and also after a period of appearing relatively fine. This is when an individual essentially inhales water through the nose and/or mouth. The water provokes a spasm that impacts breathing, by slowly closing the airway (this is different from drinking a lot of water, as the process the body absorbs it is different).

Symptoms of Dry Drowning

Although symptoms of dry drowning typically occur after a water incident, symptoms can also appear up to 24 hours after a near drowning experience. It is important to watch for these signs:

  • Trouble breathing
  • Cold or bluish skin
  • Chest pain
  • Abdominal swelling
  • Vomiting

Know Where to Go

If an individual is coughing profusely, sputtering and showing other signs of respiratory distress as listed above, it is best to contact your healthcare professional, call 911 or go to an emergency department immediately.

About Nick Colovos, MD

Nick Colovos, MD, received his degree from the University of Miami School of Medicine in 1993, and completed his residency in emergency medicine at St. Vincent’s Medical Center in Toledo Ohio in 1996. His work experiences in the academic, public and private sectors of medical care have allowed him to develop a very unique perspective on the business of healthcare and its delivery to patients. He currently serves as Medical Director for the Emory Healthcare Urgent Care and CVS MinuteClinic Strategy. Assistant Clinical Professor of Emergency Medicine, Emory University School of Medicine, Atlanta Georgia.

 

Or call HealthConnection at 404-778-7777.