Get summer safety tips from Dr. Daniel Weinstein, Medical Director of Urgent Care and Family Medicine Physician at the UVM Medical Center. He tells us about some precautions we can take to stay safe while enjoying the beautiful summer weather in Vermont.

Listen to the interview at the link below or read the transcript that follows.

Learn more about Urgent Care at the University of Vermont Medical Center.

UVM Medical Center:     Summer in Vermont is a great time for enjoying the outdoors, and we’re lucky to have so many beautiful areas to explore and enjoy. But whether you’re out hiking the trails, swimming in the lake, or even doing yard work, there are certain precautions everyone should take to make the most of the weather without serious consequences.

To give us all some tips on how we can stay safe this summer, we’re joined by Dr. Daniel Weinstein, Medical Director of Urgent Care and Family Medicine Physician at the University of Vermont Medical Center, and Assistant Professor at the Larner College of Medicine. Thanks for joining us today, Dr. Weinstein.

Dr. Daniel W.: Glad to be here.

UVM Medical Center: Let’s start with something that shines on everybody. What’s the best way to protect yourself from the sun?

Dr. Daniel W.: That beautiful sun out there does come with some risks in terms of UVA and UVB light leading to the potential for skin cancers and premature aging. One of the things you can help do is limit your overall exposure to the sun, particularly at peak times. The sun is strongest in the middle of the day, and if you can avoid 10 AM to 4 PM direct sunlight, or even the more concentrated period in the middle of the day, that’s helpful. If you can stay out of the sun and in some shade, that’s helpful as well. Sunscreen that helps protect against both UVA and UVB light can be helpful, and is an important part of protecting yourself against the sun.

UVM Medical Center: What should I be looking for in a sunscreen?

Dr. Daniel W.: SPF is a big factor in sunscreen ratings. SPF stands for sun protection factor. Generally speaking, an SPF somewhere between 30 and 50 is recommended. Some of the issues with the SPF ratings are that they’re developed with a fairly heavy application of sunscreen on your skin, and most people tend to put a much thinner layer of sunscreen on, so the higher SPF factors can help compensate for that a little bit. It’s also important to put an adequate amount on your skin, so it shouldn’t be just a really thin film. You should put a healthy amount on there.

UVM Medical Center: I could see that being easy to under-apply with a spray sunscreen.

Dr. Daniel W.: Yeah. A spray sunscreen, I think, in particular, can go on pretty thin, so you need to be cautious about that. The other thing about sunscreen is that, eventually, it loses its effectiveness, so the recommendations are, in general, that you apply the sunscreen 15 to 30 minutes before you’re going to have sun exposure, and that you reapply the sunscreen every two hours. If you are going to be sweating heavily or if you’re swimming, then, of course, you need to reapply sunscreen more frequently.

UVM Medical Center: Does that even go for waterproof sunscreen?

Dr. Daniel W.: It does. Even waterproof or water resistant sunscreen will wash off if you’re in the water long enough, so reapplying that after you swim is a good idea.

UVM Medical Center: Speaking of swimming, how do we stay safe while we cool off?

Dr. Daniel W.: I love to go to swimming holes, and they can be a lot of fun, but those currents can harbor some dangers that we have to be aware of. The currents are greatest when the water volumes are highest, and a lot of times people get into trouble on a nice sunny day that follows a period of time where there’s been some heavy rainfall. So, in the proceeding day or two if there’ve been some heavy rainfall, that rainfall takes a little bit of time to make its way down the watershed into the swimming holes, so often a day or two after those heavy rain falls you’ll still see heavy water volumes in the rivers, and you need to be cautious about strong currents in that scenario.

You can help mitigate that risk by picking areas of the river that are a little bit flatter with a little bit less current, and you can help avoid some of the risks by avoiding areas that are really known to be dangerous. Around here, Huntington Gorge is pretty well known as a swimming hole that has, unfortunately, seen a number of deaths over the years. Much less publicized in terms of danger would be Bolton Potholes. There have been a handful of deaths there over the years as well, and I think the other area with the greatest number of deaths over the years has been Jamaica Falls, though that’s a little bit further from here.

UVM Medical Center: What else should we keep in mind when we go to a swimming hole, or go to the lake where there might be some cliffs?

Dr. Daniel W.: Yeah, so swimming holes and those nice rock ledges that we have along Lake Champlain can tempt people to take some plunges from heights, some cliff jumping and that kind of thing, and from reasonable levels that can be fun, but you have to be cautious about what lurks underneath the water. A lot of times you can’t see down very far, and especially if you’re jumping from a height you’re going to plunge into the water some distance, and there may be a big boulder down there that you can’t see, or that rock ledge that you’re jumping off may jut out into the water at some point, and you can impact that with some force, and that can be dangerous to you, so you have to be cautious about that.

Even if there isn’t anything in the water underneath you, if you’re jumping from a high enough height and you land in the water in any sort of awkward way, you’re putting yourself at some risk for spinal column injuries, internal organ damage, fractures. There was an unfortunate incident a couple of summers ago where somebody jumped off of a high ledge at Red Rocks Park and died from damage from the impact from the water.

UVM Medical Center: We’re talking with Dr. Daniel Weinstein, Medical Director of Urgent Care and Family Medicine Physician at the University of Vermont Medical Center about how to stay safe this summer. Let’s talk about hiking. Trails around the state are already crowded with people, especially on the weekends. Do you have any tips for first-time summer hikers, or even experienced hikers who might be listening?

Dr. Daniel W.: Yeah. I think it’s great that people enjoy the outdoors and want to hike. It’s great exercise. It’s great to get outside and get some fresh air, but you have to be aware that if you’re going into the woods, particularly if you’re climbing a mountain, you’re going in potentially to some backcountry area, and you need to be prepared for changes. The first thing that I would mention to people is having good footwear, so hiking in your flip-flops isn’t necessarily a great idea. You should have some footwear ideally that would provide some support around your ankles, and has a nice, good, beefy sole that will help prevent you from slipping. It’s good to anticipate slippery surfaces, so you can help avoid a fall.

You should be aware that when you get out of the car and it’s nice and hot out there, the mountain top if you’re climbing a mountain, is going to be a lot different than that parking area. Chances are the temperatures are going to be much cooler on top, and chances are there’s going to be a lot more wind up there, so you should be prepared for that, and you should be prepared for the eventuality of rain even though the skies may be sunny and blue when you leave. If you’re going on a multi-hour hike, weather can change, and it can change quickly, and the combination of getting wet, windy conditions and dropping temperatures can lead to hypothermia. So wearing fabrics that can keep you warm even when you get wet is important, and a lot of the synthetic polypropylene fabrics, that kind of thing, can be good at that. Cotton is notoriously bad. It doesn’t provide any insulation once it’s wet, so that’s not a great choice for hiking.

The other things that you want to have with you are some good rain gear and something that is windproof. Other things that can be important are being prepared – especially if you’re going for a longer hike – for darkness. If you take a wrong turn, and you end up on a trail in the dark, a headlamp can be a lifesaver for you. If you’re really going on a long hike into a remote area, even if you’re intending it to just be a day hike, you might want to consider having some insulation for nighttime – a sleeping bag. Again, you want a sleeping bag that will provide some warmth if it gets wet, so down, just similar to cotton, does not hold its insulating value once it gets wet.

UVM Medical Center: What about bugs? Should I be more worried about ticks, mosquitoes?

Dr. Daniel W.: Both. Ticks are getting a lot of attention these days because of the diseases that they carry potentially. Bug spray can be helpful in repelling both insects including mosquitoes and ticks. DEET, some people feel is unsafe, but it is effective. You don’t need to use bug spray that has 100% DEET. DEET beyond 30% concentration doesn’t really provide increased repellency against insects though it may last longer. Bug spray that has 30% or lower of DEET might be effective. You can use permethrin-treated clothing which can help repel ticks and mosquitoes, so those are helpful also.

A lot of times people feel that they have an added level of safety from their smartphones, and that can be true if you’re lucky enough to have a signal when you’re off on a trail. There are two things there: number one, your smartphone needs to have a good charge because you’ll burn through battery much more quickly if you’re out and it’s searching for a cell phone signal continuously, and the other thing is really be aware that you may not have that signal when you really need it. You cannot rely totally on your cell phone for safety.

UVM Medical Center: How about for those of us who stay home on the weekend to work in our gardens or mow the lawn? Is heat stroke something we should be concerned about?

Dr. Daniel W.: Yeah, so heat, particularly on really humid days, can be dangerous especially in those really midday hours where there’s strong sunlight, and the heat is often the greatest. That can pertain both to doing work around the house and in the yard, but also for people that like to exercise, and run, and bike ride, and that kind of thing. Things that you can do: Avoid the midday sun and heat if you can. Wear loose, breathable clothing that helps wick away moisture and allows for evaporation. You can help yourself by staying well hydrated. You can take some breaks in the shade in a cooler space to try and cool off periodically.

Signs of heatstroke can include headaches, nausea, vomiting, dizziness, and as things progress, people can develop mental status changes and neurologic symptoms. If people start to become irrational, or confused, or have seizures, those are times when people really need some medical attention in an emergency room. You can help yourself by, as soon as those symptoms develop, taking yourself out of the heat if you can into a cool environment. You can use water and fans to help with evaporative cooling. For people that are healthy and have exertional heat stroke, ice baths can be helpful. You have to be cautious if you’re elderly and have non-exertional heat stroke, particularly if you have underlying medical comorbidities including things like cardiac and lung disease. Ice baths actually have been shown in those scenarios with non-exertional heat stroke, particularly in the elderly, to be dangerous.

UVM Medical Center: It’s probably best to err on the safe side and go to a hospital?

Dr. Daniel W.: Yes. Particularly if you’re really showing signs of heatstroke that has advanced to some of those more worrisome symptoms.

UVM Medical Center: Okay, so talking about people who are exercising outside, in the summer we see a lot of people biking to work, even going on bike races. What are some good ways to stay safe while on a bike?

Dr. Daniel W.: There’s a lot of bike safety things that are important to keep in mind. Number one is wear a helmet consistently every time you ride a bike. Whether you’re a child or an adult that’s an important factor. Most of the trauma that occurs from bikes, the serious trauma, the traumatic brain injuries, happen from impact of your head, so those bike helmets are important. You want to look for a helmet that fits really well. It should fit just above the eyebrows. It should be fairly snug and not wiggle back and forth. The chinstrap underneath, if you open your mouth widely, that should make your helmet move a little bit from the tension on the chinstrap. The helmets often will have a sticker on the inside saying that they’re CPSC certified, so that’s an important thing to look for. If you’ve been in an accident where your bike helmet hits the ground, if it’s got scrapes on it or a crack, you need to replace that helmet.

You want to make sure that your bike’s in good shape. Most importantly, you want to make sure that your tires are in good shape, and that your brakes function well. When you’re riding, you want to make sure that you apply pressure to your brakes evenly in the front and back. If you apply too much pressure to the front brake and none to the back, that’s a recipe to go flying over your handlebars.

If you’re riding on the road, you want to make sure that you’re riding with traffic not against it, and you are legally obligated when you’re riding on a road to be following the traffic laws – the same traffic laws that the cars are following. It’s helpful to learn the hand signals, though I wouldn’t rely on those 100% because drivers that are around you may not understand those hand signals, so you need to be aware of cars that are around you. A mirror on your handlebars or on your helmet can help with that. It can help you see what’s coming up from behind.

Bright, reflective clothing can be helpful. There’s a recent study that showed that bright, reflective clothing not only on your upper body but actually on your lower body, can be important, and it makes sense. If you think about it your legs are moving constantly when you’re biking, and there’s a lot of motion there, and bright, reflective clothing, or reflectors on the back of your legs, or even the light, particularly if your legs are moving, can help people see you.

UVM Medical Center: Any other advice for warm weather safety that we might not have talked about?

Dr. Daniel W.: I think there was a lot of doom and gloom in there, but the truth is summertime’s a great time to get out of doors. It’s good for us to get out there. It helps reduce stress. Exercise is good for us, and there’s a lot of fun, enjoyable things to do out in Vermont in the summer, and it’s great to get out there and do that. You just have to be cautious, and keep safety in mind.

UVM Medical Center: Well, our guest today on HealthSource has been Dr. Daniel Weinstein, Medical Director of Urgent Care and Family Medicine Physician at the UVM Medical Center, and Assistant Professor at the Larner College of Medicine. Thanks very much for joining us, and talking about how to stay safe this summer while we enjoy the beautiful weather.

Dr. Daniel W.: My pleasure.

 

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