From sunburns to water injuries, doctors at Duke see common ailments each summer. Here are some of their tips to keep your family healthy and ready for fun.

Saving your skin

Sunburn
The summer ailments that usually drive people to the family medicine clinic where Donna Tuccero, M.D., works are all associated with our skin: rashes, bites and sunburns.

To prevent sunburn, avoid the sun when it’s strongest, between 10 a.m. and 4 p.m., and if you are outside, wear a sunblock of at least SPF 30, reapplying every two hours or after swimming. Layering protective clothing and hats is also effective, especially on babies under 6 months, who are not yet old enough to wear sunscreen.

Call your doctor if… the sunburn is so severe it results in fever or blistering, which can also make your skin susceptible to infection.

Rashes
Plants such as poison ivy and oak and even some flowers can irritate your skin and cause severe itching and scabbing. Wear protective clothes when exploring woods or trails with unknown plants.

Rashes can also occur simply from sweating, especially in humid areas such as North Carolina, Tuccero said. To avoid skin irritation, don’t linger in sweaty or wet clothes after working in the yard or going swimming, she said. Children are also susceptible to prickly heat rash – prevent it by keeping them cool and dry, and avoiding oil-based skin products that can block sweat glands.

Call your doctor if… you have trouble managing an itchy rash with over-the-counter remedies, or if there are any other symptoms of illness, such as trouble breathing or infection due to scratching the rash. Also call if a rash won’t go away or is associated with any other symptoms of illness, such as fever.

Bug Bites
Bug bites can occur anywhere from the woods to a downtown cafe, Tuccero said. Often, families store summer toys or seating outdoors where they can house wasps, biting ants or hard-to-see mites like chiggers. Set items in the sun for a few days to encourage any lingering critters to find new homes.

Ticks can also be tiny and hard to see, but can be deterred with repellants and protective clothing such as long pants tucked into socks. Anyone over 2 months of age can wear repellent containing 10 to 15 percent DEET. Avoid the eyes and mouth and wash hands thoroughly after applying.

Remove and launder clothes as soon as possible and shower to wash away any hidden ticks before they have a chance to bite, being sure to also inspect your hair and scalp.

Call your doctor if… swelling from bites or stings doesn’t improve, or there’s pain around the bite area that could indicate infection, Tuccero said. Any signs of illness after an insect bite, such as fever, are important to report to your doctor. Families should call a doctor right away if a rash, particularly a bulls-eye pattern, develops after a tick bite.

Swimming safely

Every summer, Duke emergency department doctor Neel Kapadia, M.D., sees injuries related to swimming and playing in water.

Dry drowning
Kapadia reminds parents to closely monitor children who are playing in the water and to ensure they have flotation devices suitable for their size and ability.

Drowning can occur in any number of situations, he warns, and “dry drowning” can also be a risk. Dry drowning is exceedingly rare, but something people should be aware of, he said. It occurs when someone becomes unconscious underwater and their larynx spasms, not allowing water or oxygen into the lungs. Although water does not enter the lungs, the lack of oxygen can cause lung damage. Even if the person is pulled from the water and regains consciousness, they should be carefully monitored for several hours after the incident, Kapadia said.

Call your doctor if… you or your child experienced a near-drowning. Call 911 if even several hours after the incident, the person is coughing, having any trouble breathing or their face or skin appears pale or blue.

Hazards in natural areas
Summer activities can often take families to rivers and lakes, where the water can be dark and hide unseen currents. Be mindful that depths can vary widely in natural bodies of water, Kapadia said. Rocks, tree limbs and other objects can also be hidden hazards that can cause broken bones, spine injuries and even death if you strike them while jumping or diving.

Consuming alcohol during an outing at the lake or pool can not only impair a swimmer’s ability, but also their judgment of factors such as depth and distance, Kapadia said. It’s also important not to swim with any healing or open wounds and avoid swallowing water, as many rivers and lakes contain bacteria that could cause infection or illness.

Call your doctor if… you sustain even a cut or scrape in a body of water like a lake or river that isn’t healing or may be infected, or if you experience any other symptoms of illness, such as vomiting, diarrhea or fever.

Firework safety

Emergency departments also see injuries related to fireworks occurring around the July 4 holiday, Kapadia said.

Severe injuries include loss of fingers or limbs, and burns to skin, eyes and lungs, he said. Check local and state laws about what fireworks are legal.

Ensure that spectators, especially children, know to remain at a safe distance from where fireworks are being used, and always announce before lighting, giving yourself enough time and a clear path to get out of the way.

Call your doctor if… you sustain any injuries, even those that seem minor but are not resolving. Even breathing in soot or smoke from fireworks can cause irritation in the eyes or lungs for some people, and lingering symptoms should not be taken lightly, Kapadia said.