Planning your summer activity bucket list? Before doing so, Stephanie Lareau, an assistant professor of emergency medicine at the Virginia Tech Carilion School of Medicine, said a little common sense and the right preparation will go a long way in keeping your summer plans safe and fun.

1. Wear sunscreen or sun-protective clothing.

While it’s important year-round, it’s very important during the summer to wear sunscreen or sun-protective clothing such as sun shirts and hats when outdoors. Not only is sunburn uncomfortable, but it can also increase risk of skin cancer and predispose you to heat-related illnesses. With sunscreen it’s important to re-apply every two hours, or more often if you're in the water. About 1 oz, which is a shot glass full, is recommended. 

2. Check for ticks.

Tick-borne illnesses are common in summer months. It is important to check for ticks after being outdoors, especially in tall grasses or wooded areas. To remove ticks, use tweezers and grasp as closely to the tick’s head as possible. Lyme disease is one of the more common tick-borne illnesses. It can present with flu-like symptoms including muscle aches, joint pain, fevers, and a bull’s-eye rash. We also see a lot of alpha gal allergy. This causes a red meat allergy where people often present with allergy or even anaphylaxis after eating red meat. This comes from the lone star tick, which is identifiable by a white spot on the tick's back.

3. Wear a bicycle helmet.

There is an uptick in trauma — especially pediatric — during the summer. Make sure children (and adults) wear helmets when biking or using scooters.

4. Take a boat safety course.

If you are spending time on the lake, consider a boat safety course. Also, watch the lake monitoring information for areas you shouldn't swim. With heavy rains, agriculture, lawn chemicals, and animal waste from farms can contaminate water, making it unsafe for swimming.  

5. Exercise early to avoid midday heat.

Heat-related illness is more common in summer months. Get outside early to avoid midday heat. Wear light-colored, breathable clothing and make sure to drink plenty of fluids. Exercise tolerance can decrease when it’s hot, so plan accordingly and slowly increase exercise to help your body become acclimatized to increasing temperatures. Adjust your activities accordingly on days with high heat index: consider going for a swim or running on a treadmill indoors instead of running outdoors.  

6. Stay hydrated while doing outdoor chores.

If you work outdoors during the summer, it’s important to stay well hydrated. A good rule of thumb is making sure your urine looks light yellow to clear. Make sure you have water available and are drinking it at regular intervals. Take frequent breaks and get out of the sun. If possible, try to get work done in the early morning or late evening, when the temperatures are lower. Look at the forecast and try to pick days with not only lower temperatures but lower heat index, which takes into account both temperature and humidity. When the humidity is high, sweating is less effective, making it harder for your body to regulate temperature.  

7. Take swim lessons; wear a life jacket when needed.

There is also an increase in drowning during the summer. Make sure to have a designated person to watch children around water. Ensure children have well-fitting life jackets on lakes and rivers. It’s also a great time to get children enrolled in swimming lessons. If you witness someone drowning, early CPR with rescue breaths is vital for improving chances of survival while waiting for help to arrive. Consider taking a CPR class.  

8. Check water levels before tubing.

If you’re planning to tube or float a river, make sure to check water levels before you go. Websites such as show levels. If you aren’t familiar with the levels, check with a local outfitter before you go. Many rivers that are fun for tubing at low levels can be very dangerous at high levels and have new hazards. Everyone should wear a life jacket while on moving water. Alcohol is also associated with an increased risk of drowning, even in good swimmers. It’s also important to know dangers in waterways like low-head dams to avoid boating accidents. Additional danger can come from down trees and debris in rivers after storms. Consider taking a water safety course if you enjoy recreating on rivers.  

9. Prepare for longer hikes and outdoor activities.

When taking longer trips in the summer, it’s important to have adequate access to water; remember in hot weather you make need more water than usual. If you are planning on obtaining water from streams or creeks, talk to those familiar with the area to make sure they aren’t dry. If you are doing strenuous activities, it also can be important to include electrolyte drinks as well to avoid exercise-induced hyponatremia: low sodium or salt levels, which can lead to confusion and even seizures.

If you are on medications for blood pressure, heart problems, or psychiatric conditions, it is worth talking to your doctor about these medications and your outdoor plans. Some medications can predispose individuals to heat illness or dehydration. As with any outdoor activity, it’s also helpful to get acclimated to the heat before embarking on ambitious adventures.  

Ensure you have a plan if you get stuck in bad weather. The Southeast region typically sees a lot of pop-up storms over the summer. Have a plan to seek shelter and stay dry. 

10. Prevent heatstroke.

The most serious medical problem related to summer heat is heatstroke. Any time someone is out in the heat and starts having altered mental status, this is heatstroke. Altered mental status could be confusion or not being able to walk correctly; this is a medical emergency and potentially life-threatening. You should call 911 and work on cooling the person down. Simple things such as spraying them with cool water, immersing them in water (if they are awake and able to help), and getting them out of direct sun can help while you are awaiting more aid. 

About Lareau

In addition to her work in the Carilion Clinic emergency department and teaching at Virginia Tech, Lareau is a board member of the Wilderness Medicine Society, which helps medical professionals get additional training in environmental emergencies such as hypothermia, hyperthermia, and other weather-related outdoor problems. More here.

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