Monday, July 18, 2011

Extreme Heat Injury Prevention

When sustained heat waves hit a region, heat related injury and health ramifications can be serious, including sunstroke and even major organ damage due to heat.
According to the Center for Disease Control, extreme heat is blamed for 700 deaths each year in the U.S. They tend to happen in small epidemics when we are confronted with heat waves as we are experiencing this time of year. Some experts predict this may be more commonplace due to overall global climate changes. Heat exhaustion is a relatively common reaction to severe heat and includes symptoms such as dizziness, headache and fainting. If left untreated, it can progress to Heat stroke. When severe, it requires medical attention. The severe form manifests when someone can no longer cool their body after profuse sweating leading to dry skin, a body temperature above 103 degrees Fahrenheit, heat rash, muscle cramps, confusion and sometimes unconsciousness. Profoundly dangerous effects to the central nervous system and circulation can happen quickly when warning signs are ignored.

Humans cope with heat by expelling some heat through their breath and perspiring. The evaporation of moisture off the surface of our skin dissipates the internal heat. High humidity makes this very difficult. The cooling effect is seriously impaired. The published Heat Index estimates how it feels and how much the humidity can increase the effect of a given temperature, which can be 15 degrees or more when humidity is high. Urban areas are known to be “islands of heat”. The vast amount of concrete and asphalt absorbs and radiates the heat to a great extent. The increase density of people and heat producing machinery put urban dwellers at much greater risk than their rural counterparts. This is particularly dangerous when a heat wave lasts more than two days. The nights do not cool down due to the stored heat and people do not get a break from the prolonged heat. More urban heat related deaths occur at night.

Who is affected most? Elderly, the very young, people with chronic illness are most vulnerable. Some medications may make people more sensitive to the heat (diuretics, beta blockers, mental health meds) Discuss your concerns with your physician to see if any special precautions are recommended. But even healthy people who have to work or exercise in extreme heat are subject to dangerous effects.

The single most helpful thing you can do in extreme heat is spend several hours a day in air conditioning. If you do not have air conditioning, plan to spend time with someone who does. Many public buildings are available that have climate control such as libraries, schools, shopping malls, coffee shops. Fans do help with the evaporation/cooling process. They can also be more detrimental when simply blowing more hot air around. It can be comparable to a convection oven, magnifying the bad effects of the heat. During periods of extreme heat stay indoors and avoid direct sun. Slow down and avoid strenuous activities.

Even healthy well conditioned athletes are vulnerable to dangerous effects of heat. If you have to work outside you need a plan. Wear loose fitting, lightweight, light colored clothing. Use a wide brimmed hat to protect the head and face. Drink plenty of fluids. Water is the best. Alcohol and caffeinated beverages should be avoided as they can make things worse. Eat light food in smaller amounts but more often. Take frequent breaks to get out of the direct sun and catch up on fluids. A buddy system is a great idea. If you work alone you may not notice the beginning effects that can cloud your judgment. Partners can help keep an eye on each other. A buddy system is also a great idea for elderly or those who live alone and may need assistance. Water consumption is top of the list. Two liters a day is a good start for a normal healthy person. In extreme heat the need goes up dramatically. Use of salt tablets is discouraged and potentially dangerous. Some sports drinks without caffeine can be suitable but should not be the sole source of fluid replacement. Water is the best.

Never leave children or pets in a closed vehicle. Temperatures can increase rapidly to 140 degrees which is seriously dangerous after only a few minutes.

With only a small bit of planning and common sense you can survive the heat wave comfortably and safely without becoming a statistic.

Friday, July 8, 2011

Sibling Rivalry or Support?


We usually spend more time with our siblings than any other family member. We potentially spend more time on earth with them than any other human. If you think of it that way, you probably want to be nicer to your brother or sister. Seriously, the relationship with our siblings along with the interaction of parents is the basis for all relationships and how we make our way in the world. The social skills learned here provide a foundation for all other relationships.

Sibling rivalry has been the subject of a great deal of research. It happens and is normal. How the parents handle those interactions dictates a lot of the future. Children are testing and exploring the limits of social behavior. They are learning what to do when confronted with certain challenges and frustrating situations. Each child needs to be acknowledged as a valued individual and not compared to another. Try to reward or acknowledge appropriate behavior. When a child is quiet and occupied, it may be hard to take time out of a hectic schedule to provide praise for the child's quiet behavior. If a child shows initiative by being considerate, let them know how much that is appreciated. Modeling good behavior for children is important, particularly how parents handle the difficult moments. It is still normal for some disagreement when sharing; feeling slighted by the attention or advantages provided to another sibling. Never tolerate physical harm, verbal abuse or intimidation. This can and should be interrupted. Time outs are very useful. They are not punitive, but serve as an immediate way to interrupt the bad behavior and provide a couple minutes of cooling off. Then appropriate behavior and an alternative can be discussed. Do not be concerned about assigning blame. Learning how to compromise, negotiate, and control aggressive impulses are important lessons. It is how these simple moments are resolved that will determine how they resolve conflicts and disagreements in the future and as adults. They will begin to gain perspective of another person and learn how to compromise. They acquire important life long skills when realizing consideration is actually easier and more beneficial. Family meetings serve as a reminder, when review of issues and rules takes place. Encourage the children's input for rules, expectations and consequences if expectations are not met. Validating their opinion encourages self-esteem and cooperation. If possible, give the kids opportunity to settle their differences in a reasonable fashion without a parent always intervening or defending one of the combatants. On the other hand, inappropriate behavior should be interrupted by a time out, followed by discussion when cooler heads can prevail.

Children need to be safe, know their basic needs will be met, understood as individuals, and loved. This sounds simple but is a bit of a challenge to do consistently in some families. Good communication based on mutual trust and respect for each family member is mission critical. Studies in the last few years in Britain and the U.S. have indicated that families were happier if there was at least one girl. The suggestion was that there was more discussion of feelings, expression of affection and perhaps caretaking done by a sister of other siblings. Certainly, there is a cultural pattern repeated here but it is not gender specific. A pattern of sisters in a family promotes this favorable communication. Studies indicated growing up with at least one girl or more in the family lowered the chance of depression, violent behavior, or feelings of guilt. However, the fundamental difference is part cultural when females are considered more emotional and nurturing. Experts agree that emotional expression is fundamental to good psychological health. That is not to say both genders with proper modeling of behavior and communication skills can learn the importance of respectful meaningful communication skills. Research has also found that single children who found strong social support inside or outside the family did just as well. Therefore, the important element is quality of communication within the family that addresses truly important issues. Parental behavior that models loving expression and nurturing behavior resulted in children who were more confident and effective adults.

Bruce Kaler M.D. is a practicing physician for over thirty years and has authored the medical mystery novel Turnabout as well as the non-fiction Owners Manual for Injury Prevention. Visit his website at http://www.seattledoc.com/ . Health related articles at Ezine expert articles