Pediatric emergency physician offers insight for a safer summer
FRANKLIN, Tenn.—There’s no shortage of activity in pediatric emergency departments during summer months, and Nashville is no exception. Cristina Estrada, M.D., pediatric emergency physician at Monroe Carell Jr. Children’s Hospital Vanderbilt at Williamson Medical Center, said a large percentage of the Franklin ER’s 10,000 annual visits consist of acute traumatic injuries sustained during the summer. “Sometimes despite our best efforts accidents do happen, and that’s why we exist,” Estrada said. “We’re here to be a parent’s support system and help them through those scary times.”
Beating the Heat
Heat-related illness is incredibly common during summer months, when kids are too busy to rest and drink. “Children are more vulnerable than adults to heat-related illness because they emit more heat and sweat less, and their bodies adjust more slowly to rising temperatures,” said Estrada, noting the added risk for children with chronic diseases. Heat cramps are a common complaint among kids, especially those playing sports. Children experiencing heat cramps often have flush, moist skin, and should be moved to a cool place and given cold sports drinks with sugar and salt to help fight dehydration, while slow stretches can help alleviate muscle cramps.
Heat exhaustion is a more serious condition characterized by pale, moist skin, fever of 100.4 or higher and nausea, headache, weakness, fatigue or anxiety. Heat exhaustion patients unable to cool down are at increased risk of heat stroke, a less common but life threatening condition requiring immediate medical attention. Heat stroke patients often have a temperature of 104 or higher accompanied by a high heart rate, vomiting, confusion and sometimes seizures or unconsciousness. Patients should be moved to a cool place while emergency services are called. Estrada said heat stroke often results from rigorous athletic training including two-a-days football drills.
Bites and Stings
Insects are another common childhood culprit in summer months. “If you can see the stinger, gently scrape it out and wash the area well before applying ice,” Estrada said. While most stings and bites require no medical intervention, severe reactions including difficulty swallowing or speaking, chest tightness and vomiting can prove life-threatening. Prevention is key, which means bare feet and bright colors should be kept to a minimum while outdoors. Bug spray also is useful against a number of pests including ticks – the biggest insect-born health threat in Tennessee. “Everyone is concerned about Lyme disease, but around here we see far more cases of Rocky Mountain Spotted Fever,” Estrada said. Symptoms vary and can include fever, headache, abdominal pain and rash. “When you’re hiking or in a wooded area, wear long pants, stay on the path and avoid tall grass,” Estrada advised. “Check daily for ticks because they can be as small as a poppy seed and are often found on toes, ears, the back of the head and the neck. Shower daily and use tweezers to firmly grasp the tick, pulling rather than twisting, and wash the area with soap and water afterward.”
Falls are the leading cause of non-fatal injuries in children, with fall-related deaths spiking each summer. As curious children venture outdoors to balconies and fire escapes, parents are urged to help minimize risks. “Children are learning to explore and grasp the world around them, which is how they develop,” Estrada said. “Risks can’t be completely removed, but supervision and precautions like window guards can make a difference.” Trading flip-flops for rubber-soled tennis shoes helps prevent falls on the playground and concrete, while trampolines should be equipped with safety walls and covered springs to help avoid head injuries and broken limbs.
Supervision also is imperative in preventing drowning deaths. “We can’t stress enough that lack of adult supervision and drowning go hand-in-hand in summer months, when drowning rates double,” Estrada said. She recommends touch supervision, meaning an adult should be close enough to reach out and touch a child at all times. And while swim lessons are valuable, she warns they’re not fail-proof. “Swim lessons are viewed as a magic bullet, and while they might help kids avoid panic and buy time, parents shouldn’t overestimate their protective value,” she said. Backyard pools should be fenced on all sides and equipped with a locking gate, and added features like retractable pool covers and gate alarms are helpful as well. Meanwhile, life vests should be worn by children and adults in lakes or rivers.
“Knowledge is power, and we want every family to enjoy their summer,” Estrada said. “Kids are resilient, but when parents are concerned we are too, and we want them to bring their children in and not feel embarrassed about an accident. We’re experienced nurses and physicians who are committed to caring for children 24/7.”
About Dr. Estrada:
Cristina Estrada, M.D., is a pediatric emergency physician with Monroe Carell Jr. Children’s Hospital Vanderbilt at Williamson Medical Center. For more information, please visit www.WilliamsonMedicalCenter.org.
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