Family Health Care in “Adventure Mode”

Providers and staff alike have looked forward to today for the past several months with a mixture of apprehension and excitement. As one person put it, we are in “Adventure Mode” as we learn our new medical record system, Athena Health. Of course, it’s only a minor level of adventure, not like “typhoid and death.”

Even after months of training, there is still a bit of “just click and see what happens” and “where do I find…” and “Ohhhhh, now I get it!” as we continue to learn the system. So if you see staff looking at their computers with furrowed brows over the next few weeks, it’s not because they have forgotten all medical knowledge, they’re just trying to find their way around in the new system.

Thankfully, plenty of laughter can be heard as well as “Success!” and “It does that? That is neat!”

While a system change may seem common place, the transition to Athena Health is no small undertaking. Family Health Care was an early adopter of electronic medical records and has used the same system for most of the past 20 years. As one of the providers stated, “It’s like losing your right hand” to make the switch. However, one staff member likened it to switching from a flip phone to an iPhone and it does appear to be a worthwhile change. Overall, we expect the transition to enhance our overall efficiency and continue to raise the quality of health care we provide.

We are grateful for your support and patience while we “learn a new dance” and thankful for the opportunity to continue caring for and serving our patients in “Adventure Mode.”

 

By Diane M. Bowman, CMA, CCRC

Simple Tips for Healthy Eyes

Your eyes are an important part of your health. There are many things you can do to keep them healthy and make sure you are seeing your best. Follow these simple steps for maintaining healthy eyes well into your golden years.

Have a comprehensive dilated eye exam. You might think your vision is fine or that your eyes are healthy, but visiting your eye care professional for a comprehensive dilated eye exam is the only way to really be sure. When it comes to common vision problems, some people don’t realize they could see better with glasses or contact lenses. In addition, many common eye diseases such as glaucoma, diabetic eye disease and age-related macular degeneration often have no warning signs. A dilated eye exam is the only way to detect these diseases in their early stages.

During a comprehensive dilated eye exam, your eye care professional places drops in your eyes to dilate, or widen, the pupil to allow more light to enter the eye the same way an open door lets more light into a dark room. This enables your eye care professional to get a good look at the back of the eyes and examine them for any signs of damage or disease. Your eye care professional is the only one who can determine if your eyes are healthy and if you’re seeing your best.

Know your family’s eye health history. Talk to your family members about their eye health history. It’s important to know if anyone has been diagnosed with a disease or condition since many are hereditary. This will help to determine if you are at higher risk for developing an eye disease or condition.

Eat right to protect your sight. You’ve heard carrots are good for your eyes. But eating a diet rich in fruits and vegetables, particularly dark leafy greens such as spinach, kale, or collard greens is important for keeping your eyes healthy, too.i Research has also shown there are eye health benefits from eating fish high in omega-3 fatty acids, such as salmon, tuna, and halibut.

Maintain a healthy weight. Being overweight or obese increases your risk of developing diabetes and other systemic conditions, which can lead to vision loss, such as diabetic eye disease or glaucoma. If you are having trouble maintaining a healthy weight, talk to your doctor.

Wear protective eyewear. Wear protective eyewear when playing sports or doing activities around the home. Protective eyewear includes safety glasses and goggles, safety shields, and eye guards specially designed to provide the correct protection for a certain activity. Most protective eyewear lenses are made of polycarbonate, which is 10 times stronger than other plastics. Many eye care providers sell protective eyewear, as do some sporting goods stores.

Quit smoking or never start. Smoking is as bad for your eyes as it is for the rest of your body. Research has linked smoking to an increased risk of developing age-related macular degeneration, cataract, and optic nerve damage, all of which can lead to blindness.ii,iii

Be cool and wear your shades. Sunglasses are a great fashion accessory, but their most important job is to protect your eyes from the sun’s ultraviolet rays. When purchasing sunglasses, look for ones that block out 99 to 100 percent of both UV-A and UV-B radiation.

Give your eyes a rest. If you spend a lot of time at the computer or focusing on any one thing, you sometimes forget to blink and your eyes can get fatigued. Try the 20-20-20 rule: Every 20 minutes, look away about 20 feet in front of you for 20 seconds. This can help reduce eyestrain.

Clean your hands and your contact lensesproperly. To avoid the risk of infection, always wash your hands thoroughly before putting in or taking out your contact lenses. Make sure to disinfect contact lenses as instructed and replace them as appropriate.

Practice workplace eye safety. Employers are required to provide a safe work environment. When protective eyewear is required as a part of your job, make a habit of wearing the appropriate type at all times and encourage your coworkers to do the same.


iAge-Related Eye Disease Study Research Group. The relationship of dietary carotenoid with vitamin A, E, and C intake with age-related macular degeneration in a case-control study. Archives of Ophthalmology; 2007; 125(9): 12251232.

iiAge-Related Eye Disease Study Research Group. Risk factors associated with age-related nuclear and cortical cataract. Ophthalmology; 2001; 108(8): 14001408.

iiiU.S. Department of Health and Human Services, Office of the Surgeon General. The Health Consequences of Smoking: A Report of the Surgeon General (Washington, D.C., 2004).

 

Courtesy: National Eye Institute, National Institutes of Health (NEI/NIH).

The Dos, Not the Don’ts, of a Family Fit Lifestyle

January is Family Fit Lifestyle Month and the perfect time to make positive changes that have long lasting benefits. With nearly 13 million obese children and adolescents in the US, one of the ways parents can care for their children’s’ health is by being an example of a healthy lifestyle.

 

Preventing or reversing childhood obesity will reduce the likelihood that your child will have:

  • High blood pressure and high cholesterol, which are risk factors for cardiovascular disease (CVD).
  • Increased risk of impaired glucose tolerance, insulin resistance, and type 2 diabetes.
  • Breathing problems, such as asthma and sleep apnea.
  • Joint problems and musculoskeletal discomfort.
  • Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn).
  • Psychological problems such as anxiety and depression.
  • Low self-esteem and lower self-reported quality of life.
  • Social problems such as bullying and stigma.

 

And, it may even help you fit into those clothes in the back of your closet again.

 

 

Focus on the “Dos” instead of the “Don’ts”

If your plan for a family fit lifestyle is full of things like “Don’t eat junk food.” “Don’t eat fast food.” and “Don’t spend as much time on the couch.” it won’t be long until you don’t follow the plan anymore.

 

 

The “Dos” of Food

  • Do make a meal plan. If you aren’t sure where to start, ChoseMyPlate.gov has resources to help you make your meals both nutritious and affordable.
  • Do make a list before you go grocery shopping. If the paper list on the fridge never seems to come along to the store, make the list on your phone instead.
  • Do prep for your meals ahead of time. When you’re hungry, the faster the food can be ready, the better it looks.

 

 

The “Dos” of Activity

  • Do make it fun. If it’s something you look forward to, you’ll be less likely to skip it. Start a fun bucket list. If you have a 4th grader, every park in the country is free. Suncadia is full of activities year round. Visit the bounce house or learn with Legos. Geocaching adds more incentive for reluctant hikers. Healthy exercise doesn’t need to be expensive. Find kids’ exercise videos online, make an obstacle course inside or outside, take a walk at Irene Rhinehart or right in your neighborhood. Start seeds on your window sill and plant a garden this spring. Kids tend to eat what they grow, especially if you let them pick some fun things like blue potatoes and purple peppers.
  • Do be consistent. Huffing and puffing and sore muscles will come with you on all your activities if you only exercise in infrequent bursts.
  • Do make it doable. Children and adolescents need to average about an hour of activity each day (And the adults need to join in for at least half that time.) but it could be broken into increments. You might want to devote one or two evenings a week and one day each weekend to something active. You may choose to have an hour of energy expending right after school. Any way you manage to add in 300 minutes of activity each week, do it in a way that works for your family.

 

And one more “Do” – Do comment and share how your family has fun being fit.

 

Diane M. Bowman, CMA, CCRC

13 Incentives for Making (and keeping) a Weight Loss Resolution in 2018

If you are one of the many Americans who resolved to drop 20 pounds in 2017 and still have 25 pounds left to lose, you’re not alone. With two out of every three Americans either overweight or obese, it’s no surprise that losing weight was one of the most common New Year’s resolutions last January. But lofty aspirations are not enough since most New Year’s resolutions vanish long before the groundhog even thinks about seeing his shadow, with an estimated 92% never reaching their goal.

 

One of the ways to avoid dealing with what the NIH refers to as False Hope Syndrome is to add some really effective incentives to your dieting arsenal. The Centers for Disease Control (CDC) recently published the results of a study that gives 13 incentives to achieve and maintain a healthy weight. Unfortunately, all 13 are different types of cancers associated with being overweight and obese. While all other types of cancer have decreased, all but one of those affected by excess weight continue to increase. The sole exception to the increase was colon and rectum cancer, which can be detected with screening and treated before becoming cancerous. (Yes, unpleasant as it is, it is worth the discomfort to have those dreaded colon screenings. Approximately 224,800 cases have been prevented since 2005.)

 

Cancer caused by too many calories and too little exercise is expected to soon overtake the rate of cancer caused by smoking, becoming the highest preventable risk of cancer.

https://www.cdc.gov/media/releases/2017/p1003-vs-cancer-obesity.html

 

One significant take-away is the fact that your cancer risk rises with each point that your BMI increases. The rate of risk for these 13 cancers ranges from a 2% increase in risk of breast cancer with each additional BMI point to 9% per point for throat cancer. Studies have shown that even a weight gain as small as 11 pounds can affect your cancer risk.

 

Since even relatively small weight gains/losses can have a big impact in your risk level, make your 2018 resolution SMART.

Specific

It’s not enough to simply decide to lose weight. You need a plan, preferably one that includes both exercise and diet changes. Some options and resources to consider are The Ideal Protein Weight Loss Method,  The Beck Diet Program, MyFitnessPal, and SuperTracker.

 

Measurable

You need a method to determine your progress. While it’s tempting to rely totally on the scale for gauging how well you are doing, it may be better to measure your success by how well you follow the plan you choose.

 

Accountable

There’s nothing quite as motivating as having someone check your progress. This is one area where The Ideal Protein Weight Loss Method is particularly effective. It makes it so much easier to leave that doughnut in the box if you know your coach will quickly be able to tell the level of your self-control at your weekly appointment.

 

Realistic

Sure, you’d like to lose all 50 pounds in the first month but that’s not possible or healthy. Instead, make your goal doable (i.e. eat a specified amount of vegetables and low fat protein or increase your daily steps by 1,000.)

 

Time-bound

Make goals to achieve each day, each week, and each month.

 

 

 

Steele CB, Thomas CC, Henley SJ, et al. Vital Signs: Trends in Incidence of Cancers Associated with Overweight and Obesity — United States, 2005–2014. MMWR Morb Mortal Wkly Rep 2017;66:1052–1058. DOI:http://dx.doi.org/10.15585/mmwr.mm6639e1.

 

 

By Diane M. Bowman, CMA, CCRC

Colds, Influenza, and Stomach “Flu”

THE COMMON COLD

Rhinovirus is the most common cause of the common cold. While a cold can make you feel rather miserable, it is usually milder than influenza and most people recover in 7-10 days without any complications. If you have a weak immune system, asthma, or other respiratory condition, you could develop a more serious illness such as pneumonia after contracting a cold. Colds can also cause sinus and ear infections and trigger asthma attacks.

 

Prevention:

There is no vaccine to protect you from rhinoviruses. To prevent colds, wash your hands often, avoid touching your eyes, nose, and mouth, and limit contact with people who are sick.

 

Treatment:

A “tincture of time” is the best remedy for a cold. Rest and drink lots of fluids to help you recover. Over the counter medications may relieve or decrease some of your symptoms. Antibiotics will not help you recuperate from a virus.

 

When to see a doctor:

You should call your doctor if you or your child has one or more of these conditions:

  • a temperature higher than 100.4° F
  • symptoms that last more than 10 days
  • symptoms that are severe or unusual

If your child is younger than 3 months of age and has a fever, you should always call your doctor right away. Your doctor can determine if you or your child has a cold and can recommend therapy to help with symptoms. https://www.cdc.gov/features/rhinoviruses/

 

 

INFLUENZA

Influenza is caused by an influenza virus and is usually more severe than a cold. One of the key characteristics of influenza is that symptoms start suddenly. Illness from an influenza virus can range from mild to very severe and can result in death, even in previously healthy people. Possible complications include bacterial pneumonia, ear infections, sinus infections, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes. The initial illness typically lasts 3 -7 days but some symptoms such as a cough and fatigue can last for more than two weeks. Because multiple strains of influenza viruses circulate each season, you can contract it more than once per year.

 

Prevention:

The most effective way to prevent influenza is to get a flu vaccine every year. Vaccines are available for everyone 6 months of age and older. Current vaccines cover 3-4 strains of influenza so it is still worthwhile to be vaccinated even if you have already had the illness this flu season. It is also beneficial to wash your hands often, avoid touching your eyes, nose, and mouth, and limit contact with people who are sick.

 

Treatment:

If you are diagnosed with influenza, your doctor may prescribe an antiviral drug to help shorten the duration and severity of your symptoms. These drugs are only effective when taken within the first two days of the illness. Antibiotics will not help you recuperate from a virus.

 

When to see a doctor:

People who are more likely to develop severe symptoms and complications, including children, adults 65 and older, pregnant women, and those with certain types of medical conditions should seek medical care as early as possible after developing influenza symptoms. An extensive list of high risk groups can be found here.  As always, contact your doctor if you have severe symptoms or are concerned about your illness.

 

When to go to the emergency room for influenza symptoms:

In children

  • Fast breathing or trouble breathing
  • Bluish skin color
  • Not drinking enough fluids
  • Not waking up or not interacting
  • Being so irritable that the child does not want to be held
  • Flu-like symptoms improve but then return with fever and worse cough
  • Fever with a rash
  • Being unable to eat
  • Has no tears when crying
  • Significantly fewer wet diapers than normal

 

In adults

  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting
  • Flu-like symptoms that improve but then return with fever and worse cough

https://www.cdc.gov/flu/takingcare.htm#whatshould

 

 

STOMACH “FLU”

Stomach “flu” as gastroenteritis is commonly called, is not related to influenza in any way but is typically caused by a norovirus. Symptoms usually last 1 to 3 days. The most common complication is dehydration.

 

Prevention:

The flu vaccine will not protect you from a norovirus infection. No norovirus vaccine is currently available; however, research is in progress to develop one. To prevent the illness, always wash your hands with soap and water after using the toilet or changing diapers and before eating, preparing, or handling food. Wash fruits and vegetables carefully before preparing and eating them. Cook seafood completely before consuming.

 

Treatment:

Drink plenty of fluids. Sports drinks and other non-caffeinated drinks can help to prevent dehydration. But, these drinks may not replace important nutrients and minerals. Oral rehydration fluids that you can get over the counter are most helpful for mild dehydration. Antibiotics will not help you recuperate from a virus.

 

When to see a doctor:

See a doctor when you suspect severe dehydration. Young children, older adults, and people with other illnesses are the most susceptible. Signs of dehydration are a decrease in urination, dry mouth and throat, and feeling dizzy when standing up. Children may cry with few or no tears, be unusually sleepy or fussy, and have fewer wet diapers than usual.

https://www.cdc.gov/norovirus/about/index.html

 

 

By Diane M. Bowman, CMA, CCRC

Is Compassion on Your Christmas To-Do List?

Compassion could be the most valuable gift you give this Christmas, even though it doesn’t need to cost a penny.

Each month, Family Health Care’s nursing staff focuses on developing a different character trait. This December, we are concentrating on becoming more compassionate, not simply feeling sorry for the circumstances of others from a distance but sharing in their suffering and taking action to alleviate it. While genuine compassion for our patients is always a priority, in the midst of the busyness of our days, it is easy to forget to show the same care for our colleagues.

One group of people in need of compassion during the holiday season is especially close to all our hearts this year–those who are facing their first holiday season without a loved one.

While most of us thoroughly enjoy the ringing bells, Christmas carols, and greetings of Merry Christmas and Happy New Year, grief can make it a season of changes and new challenges, even for those who know and rejoice over the true meaning of Christmas.

 

But how can we share in their suffering?

 

Be aware of their pain. If we have a heart to see grief, God will send people who need compassion into our lives. Watch for anger, frustration, and personal neglect as well as tears. Grief can come out at the most unexpected times and in many different ways.

Realize that the pain of the people around you matters to you. Whether at work, home, church, or in the community, we depend on each other and when one person is hurting, we all suffer.

Be willing to feel concern. It sounds simple, but our impulse is to protect ourselves from hurt, rather than wading into it to help someone else.

Take action to help relieve their grief. Listen when they are ready to talk. Cry with them. Tears are not weak. On the contrary, in grief, tears speak of strong love.

 

Ultimately, be patient. Grief doesn’t have a timeline.

 

 

Diane M. Bowman, CMA, CCRC

Are You Protected Against Flu?

You wear a seat belt, buckle in your children, and drive carefully. You buy traction tires and carry tire chains in your trunk. You don’t text or do anything else that may distract you while driving but…

Have you had a flu vaccine this fall?

Influenza can cause more deaths per year than motor vehicle accidents.

 

You watch your budget carefully, clip coupons, and watch for sales. You have staycations instead of vacations. You drive past your favorite coffee shop without stopping, at least most mornings but….

Have you had a flu vaccine this fall?

Influenza drains over $87 billion from the US economy each year.

 

You cover your mouth when you cough, take your vitamins, and use hand sanitizer. You wash your hands and try not to touch your eyes, nose, and mouth. You avoid close contact with people who are sick and stay home when you aren’t feeling well, but…

Have you had a flu vaccine this fall?

Vaccination is the first step to prevent influenza.

 

Family Health Care recommends that everyone 6 months of age and older get an influenza vaccination each flu season. We’ve followed our patients over the last few years, gathering our own data on the flu vaccine. As the table below shows, you are far more likely to spend a “staycation” coughing, wheezing, and sneezing if you skip your annual flu vaccine.

 

References and further reading:

https://www.cdcfoundation.org/businesspulse/flu-prevention-infographic

https://www.cdc.gov/flu/consumer/prevention.htm

 

 

By Diane Bowman, CMA, CCRC

A Perfect Activity for December

It appears that Ellensburg has once again missed the memo that most of December is technically still fall. This month’s weather forecast includes rather alarming things like snow, wintry mix, ice, and absurdly low temperatures of 15 degrees. (Shudder, shiver, shake!) Such frightful weather leaves us with no alternative but to sneak away, turn off our phones and find a comfy recliner, a soft throw, a steaming hot drink, and a warm, crackling fire. And of course, the perfect addition to that is a good book.

Quite fittingly, December is ‘Read a New Book Month.’ If you’re like me, you have plenty of unread or partially read books waiting for you to take time to read them but, just in case you don’t and you need suggestions, we have asked some of your Family Health Care providers to list books they and their families have enjoyed. (Links are for your convenience only.)

 

Dr. Haney enjoys reading books that challenge, inspire, and change him. These are several of the books that have been a blessing in his life:

King Jesus Claims His Church by Finny Kuruvilla

Will the Real Heretic Please Stand Up by David W. Bercot

The Kingdom That Turned the World Upside Down by David W. Bercot

Gifted Hands by Ben Carson

America the Beautiful by Ben Carson

Best Loved Poems of the American People by Hazel Felleman

And to read to his grandchildren: Uncle Arthur’s Bedtime Stories by Harry Baerg Arthur S. Maxwell

 

If Dr. Walters isn’t occupied by building his latest Star Wars Lego creation, you may find him reading Les Miserables.

 

When Dr. Mongrain can squeeze out a bit of time amid the activity of his busy family, he enjoys books like these:

Family Driven Faith by Vodie Baucham

Same Kind of Different as Me by Denver Moore

Celebration of Discipline by Richard Foster

Unbroken by Laura Hillebrand

The Boys in the Boat by Daniel James Brown

Hold On To Your Kids By Drs Gabor Matte (MD) and Gordon Neufield (PhD)

Mere Christianity by CS Lewis

 

Dr. Druschel likes to readYou Are Special by Max Lucadoto his two darling little girls and recommendsThe Case for Christ by Lee StrobelandOverdiagnosed by H. Gilbert Welchfor adults.

 

When it’s too cold for Ryan Beachy to be out hiking the Manastash ridge and the ground is frozen so he can’t be in the middle of a mud run, he may be spending his time reading one of these books:

Destiny of the Republic: A Tale of Madness, Medicine, & the Murder of a President by Candice Millard

Into Thin Air by Jon Krakauer

Mark of the Lion series by  Francine Rivers

Sons of Encouragement series by Francine Rivers

He recommends The Call of the Wild by Jack London and My Side of the Mountain by Jean Craighead for young adults. Also, Ryan’s 11 year old daughter, Emma, really liked Wonder by R.J. Palacio.

 

Enjoy your reading and check back later for additional suggestions from the rest of our providers.

 

By Diane Bowman, CMA, CCRC

The Invisible Invaders of Your Festivities

It’s December and Christmas is fast approaching, bringing with it plans for family time and gift exchanges, but gifts aren’t the only thing we tend to exchange. Amid the hugs and kisses and travel, the holiday season is the perfect storm for passing along many varieties of germs.

After several consecutive years of our entire extended family being subjected to the dreaded gastrointestinal bug during or directly after Christmas, I began threatening to dip my dear little nieces and nephews in vats of hand sanitizer prior to and after any gatherings. However, my sisters-in-law didn’t seem to appreciate the idea so I’ve refrained, at least so far.

Unless you are one of the rare people who enjoy conversing with relatives while lying on the floor near the restroom or while sitting around with a Costco-size case of tissues and a bag of cough drops in your lap, you would like to find a way to remain healthy before, during, and after the Christmas season. Aside from dipping small children in hand sanitizer (Please don’t.) or wearing a complete bio-hazard suit, what can you do to avoid those microscopic invaders that steal your vacations and eat up your sick days?

One simple thing you can do to avoid drinking your Christmas dinner from a Pepto-Bismol bottle is doing what your mother taught you before you were old enough to talk – wash your hands. Yes, I did just suggest that it is healthy to listen to your mother.

Believe it or not, hand washing is important enough that we spent one entire college class attempting to perfect the art. I say attempting because it’s not as easy to remove all the germs from your hands as you might think. To reveal our inadequacies in the technique, we were given a special gel that turns florescent under a black light to rub into our hands like lotion and then we washed our hands per the directions of our instructor. After everyone’s hands were ‘clean’, our instructor turned off the light and proceeded to expose the areas soap and water didn’t reach effectively. We’ll just say there was a considerable amount of florescent orange in the room and leave it at that.

It really doesn’t take a college course or special gel to learn the best technique to wash your hands. One of the most important things you need to do is simply take your time.

See below for detailed hand washing instructions from the Centers for Disease Control and Prevention (CDC).

When should you wash your hands?

  • Before, during, and after preparing food
  • Before eating food
  • Before and after caring for someone who is sick
  • Before and after treating a cut or wound
  • After using the toilet
  • After changing diapers or cleaning up a child who has used the toilet
  • After blowing your nose, coughing, or sneezing
  • After touching an animal, animal feed, or animal waste
  • After handling pet food or pet treats
  • After touching garbage

How should you wash your hands?

  • Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
  • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  • Rinse your hands well under clean, running water.
  • Dry your hands using a clean towel or air dry them.

Why? Read the science behind the recommendations.

What should you do if you don’t have soap and clean, running water?

Washing hands with soap and water is the best way to reduce the number of germs on them in most situations. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs and might not remove harmful chemicals.

Hand sanitizers are not as effective when hands are visibly dirty or greasy.

How do you use hand sanitizers?

  • Apply the product to the palm of one hand (read the label to learn the correct amount).
  • Rub your hands together.
  • Rub the product over all surfaces of your hands and fingers until your hands are dry.

Why? Read the science behind the recommendations.

 

References and further reading:

https://www.cdc.gov/handwashing/index.html

 

 

 

By Diane Bowman, CMA, CCRC

Sun and Water Safety Tips

FUN IN THE SUN 

Babies under 6 months:

  • The two main recommendations from the AAP to prevent sunburn are to avoid sun exposure, and to dress infants in lightweight long pants, long-sleeved shirts, and brimmed hats that shade the neck to prevent sunburn. However, when adequate clothing and shade are not available, parents can apply a minimal amount of sunscreen with at least 15 SPF (sun protection factor) to small areas, such as the infant’s face. If an infant gets sunburn, apply cool compresses to the affected area.

For All Other Children:

  • The first, and best, line of defense against harmful ultraviolet radiation (UVR) exposure is covering up. Wear a hat with a three-inch brim or a bill facing forward, sunglasses (look for sunglasses that provide 97% -100% protection against both UVA and UVB rays), and clothing with a tight weave.
  • Stay in the shade whenever possible, and limit sun exposure during the peak intensity hours – between 10 a.m. and 4 p.m.
  • On both sunny and cloudy days use a sunscreen with an SPF 15 or greater that protects against UVA and UVB rays.
  • Be sure to apply enough sunscreen — about one ounce per sitting for a young adult.
  • Reapply sunscreen every two hours, or after swimming or sweating.
  • Use extra caution near water and sand (and even snow!) as they reflect UV rays and may result in sunburn more quickly.

HEAT STRESS IN EXERCISING CHILDREN

  • The intensity of activities that last 15 minutes or more should be reduced whenever high heat or humidity reach critical levels.
  • At the beginning of a strenuous exercise program or after traveling to a warmer climate, the intensity and duration of outdoor activities should start low and then gradually increase over 7 to 14 days to acclimatize to the heat, particularly if it is very humid.
  • Before outdoor physical activities, children should drink freely and should not feel thirsty. During activities less than one hour, water alone is fine. Kids should always have water or a sports drink available and take a break to drink every 20 minutes while active in the heat.
  • Clothing should be light-colored and lightweight and limited to one layer of absorbent material to facilitate evaporation of sweat. Sweat-saturated shirts should be replaced by dry clothing.
  • Practices and games played in the heat should be shortened and there should be more frequent water/hydration breaks. Children should promptly move to cooler environments if they feel dizzy, lightheaded or nauseous.

POOL SAFETY

  • Never leave children alone in or near the pool or spa, even for a moment.
  • Whenever infants or toddlers are in or around water, an adult – preferably one who knows how to swim and perform CPR – should be within arm’s length, providing “touch supervision.”
  • Install a fence at least 4 feet high around all four sides of the pool. The fence should not have openings or protrusions that a young child could use to get over, under, or through.
  • Make sure pool gates open out from the pool, and self-close and self-latch at a height children can’t reach. Consider alarms on the gate to alert you when someone opens the gate. Consider surface wave or underwater alarms as an added layer of protection.
  • If the house serves as the fourth side of a fence surrounding a pool, install an alarm on the exit door to the yard and the pool. For additional protection, install window guards on windows facing the pool. Drowning victims have also used pet doors to gain access to pools. Keep all of your barriers and alarms in good repair with fresh batteries.
  • Keep rescue equipment (a shepherd’s hook ­– a long pole with a hook on the end — and life preserver) and a portable telephone near the pool. Choose a shepherd’s hook and other rescue equipment made of fiberglass or other materials that do not conduct electricity.
  • Avoid inflatable swimming aids such as “floaties.” They are not a substitute for approved life vests and can give children and parents a false sense of security.
  • Children ages 1 to 4 may be at a lower risk of drowning if they have had some formal swimming instruction. However, there is no evidence that swimming lessons or water survival skills courses can prevent drowning in babies younger than 1 year of age.
  • The decision to enroll a 1- to 4-year-old child in swimming lessons should be made by the parent and based on the child’s developmental readiness, but swim programs should never be seen as “drown proofing” a child of any age.
  • Avoid entrapment: Suction from pool and spa drains can trap a swimmer underwater. Do not use a pool or spa if there are broken or missing drain covers.  Ask your pool operator if your pool or spa’s drains are compliant with the Pool and Spa Safety Act. If you have a swimming pool or spa, ask your pool service representative to update your drains and other suction fitting with anti-entrapment drain covers and other devices or systems. See PoolSafely.gov for more information on the Virginia Graeme Baker Pool and Spa Safety Act.
  • Large, inflatable, above-ground pools have become increasingly popular for backyard use. Children may fall in if they lean against the soft side of an inflatable pool. Although such pools are often exempt from local pool fencing requirements, it is essential that they be surrounded by an appropriate fence just as a permanent pool would be so that children cannot gain unsupervised access.
  • If a child is missing, look for him or her in the pool or spa first.
  • Share safety instructions with family, friends and neighbors.

BOATING SAFETY

  • Children should wear life jackets at all times when on boats or near bodies of water.
  • Make sure the life jacket is the right size for your child. The jacket should not be loose. It should always be worn as instructed with all straps belted.
  • Blow-up water wings, toys, rafts and air mattresses should not be used as life jackets or personal flotation devices. Adults should wear life jackets for their own protection, and to set a good example.
  • Adolescents and adults should be warned of the dangers of boating when under the influence of alcohol, drugs, and even some prescription medications.

OPEN WATER SWIMMING

  • Never swim alone. Even good swimmers need buddies!
  • A lifeguard (or another adult who knows about water rescue) needs to be watching children whenever they are in or near the water. Younger children should be closely supervised while in or near the water – use “touch supervision,” keeping no more than an arm’s length away.
  • Make sure your child knows never to dive into water except when permitted by an adult who knows the depth of the water and who has checked for underwater objects.
  • Never let your child swim in canals or any fast moving water.
  • Ocean swimming should only be allowed when a lifeguard is on duty.
  • Teach children about rip currents. If you are caught in a rip current, swim parallel to shore until you escape the current, and then swim back to shore.

For more tips on sun and water safety, visit www.healthychildren.org

Copyright © 2013 American Academy of Pediatrics. Please feel free to use tips in any print or broadcast story with appropriate attribution of source.