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Interviewer: You got into some poison ivy. Should you worry and what should you do? That's next on The Scope.

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Interviewer: Dr. Scott Youngquist is an emergency room physician at University of Utah Health. As a kid, I was terrified of getting into poison ivy and personally, I never have, but I know that it does happen. Should somebody be terrified about getting into it first of all?

Dr. Youngquist: Well, I was terrified of it too, Scott, and I never got into it either. But you shouldn't be too terrified. It just causes a very annoying, itchy rash when you contact it on your skin.

Interviewer: All right. And is poison ivy and poison oak, are they kind of similar?

Dr. Youngquist: Yeah. There are three main problems in North America, poison ivy, poison oak, and poison sumac, which all cause the same type of reaction.

Interviewer: All right. And what does that look like on your skin?

Dr. Youngquist: Well, it starts out itchy and turns into a red rash that can become blisters as well and as people scratch at it, as they're prone to do because it's so itchy, can turn into scabs.

Interviewer: All right. And once you kind of get into it, how long until you start seeing some of those symptoms. Is it immediate or . . . ?

Dr. Youngquist: No. It's a delayed hypersensitivity reaction is what we call it in medicine, meaning the symptoms show up minutes to hours later and maybe half a day later before somebody notices that they came in contact with the poison ivy.

Interviewer: Okay. And are there other kinds of variables as to how severe it might be? Like I've heard that if it's wet that it might be worse. Is that true?

Dr. Youngquist: I don't know about wetness per se. Any part of the plant can cause a hypersensitivity reaction. But only 85% of people are sensitive to it. So there's 15% of the population that will not react, and that's sort of like their super power.

Interviewer: Okay. And then if it's scratches you, you know, because sometimes you might go through there with your bare legs. Could it be more dangerous if it gets into your bloodstream? Is that something that can happen, or is it really just a skin thing for the most part?

Dr. Youngquist: It's mostly a skin thing. The main problem with scratches is that they can become infected with other organisms. So it's a portal of entry for bacteria, usually can't get a large enough dose of the poison and poison ivy to cause a problem just from a scratch.

Interviewer: All right. And what are the treatments? If I get into it what should I start doing?

Dr. Youngquist: First thing you want to do is wash with cold water any parts of your body that have come in contact with the plant or the oak and remove any clothing that's come in contact with it as well. You can get the material on clothing or on anything else that's touched it, and then it will sit there for a while. It doesn't degrade. So you could pick up a rake from last season when you're raking up some of that stuff and touch it and get an exposure that way as well.

Interviewer: So if it gets on your clothes and you touched your clothes or your dog?

Dr. Youngquist: Yeah. That's been reported to come in . . . the dog can come in from the forest and bring the poison ivy with him or her.

Interviewer: All right. So wash it off with some cold water, some mild soap?

Dr. Youngquist: Yep, mild soap.

Interviewer: Okay.

Dr. Youngquist: And then the waiting begins to see if you react. If you do react, most of the problem is due to itching, and some people it drives nuts. You can try over-the-counter Benadryl and some calamine lotion, some oatmeal baths. That usually helps with the itchiness.

Interviewer: But otherwise not a major danger where you get into the trouble as if you really start scratching and damaging your skin.

Dr. Youngquist: Yeah. That's the main problem. Although I did have a friend who was camping with his family and they picked out poison oak as the branches they would use to roast their marshmallows, so they all ended up with swollen lips and tongues and had to go to the emergency department.

Interviewer: Wow.

Dr. Youngquist: So don't eat the stuff.

Interviewer: Okay. Some good advice. All right. And probably don't rub your eyes.

Dr. Youngquist: Right. Don't rub your eyes.

Interviewer: It could be pretty bad. So is there a point where you would need to see a doctor?

Dr. Youngquist: Well, doctors can prescribe steroids, of course. So if the Benadryl and the calamine and other treatments aren't cutting it for your itchiness, then, of course, steroids may help with that subjective sense of itchiness. Otherwise, there's not much that can be done.

Interviewer: All right. And how long does it take to run its course?

Dr. Youngquist: Well, it can take a few days to a week.

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Today we are talking about first aid kits. You may think of a first aid kit, you go online you buy something and it has all kinds of different things ranging from band-aids to Benadryl, to different creams and all these sorts of things. Tell you what, when I travel I don't carry any of those things. I figure a lot of things I can just buy in a pharmacy. If I need cold medicine I can go buy it. If I need Tylenol or Benadryl I can go buy it.

There are three things that I found as an emergency physician are potentially essential to keep you out of the ER. There are some reports out there, and I've talked to some people, who talk about ten hour waits in the waiting room. That is the absolute last thing you want to do over the holidays. So there are three things I carry. I'm going to tell you what those are. These may be a little surprising for you.
Item #1 to Include in Your Travel First Aid Kit: Antibiotic

The first I carry is ciprofloxacin. This is an antibiotic. You're going to need a prescription for it. You're going to need to talk to your doctor. But I will tell you why this can keep you out of the ER. If you have family members, and it's particularly females who may be more prone to urinary tract infections. That's just a horrible thing for a person to go through. You feel miserable and you need treatment.

I find when someone comes to the ER, particularly females, and they tell me, hey I feel like I have a urinary tract infection, they are right 89% of the time. The only reason they are in the E.R. is because they know they need an antibiotic. If you can just get a prescription and have a few pills of ciprofloxacin, just a simple antibiotic or if there is another antibiotic that has worked for you in the past. As long as you have a few of those pills available you can save your self an incredible amount of headache and a trip to the ER.
Item #2 to Include in Your Travel First Aid Kit: Anti-nausea Medication

The second thing I carry is an anti-nausea medication called Ondansetron. The generic name is Zofran. It's a generic medication now. It's very cheap. Again, you have to have a prescription for it. The absolute last thing you want to do, let's say you are traveling, you are in a hotel, you're feeling miserable you're vomiting, just imagine trying to get everything together, get a cab, get down to an ER, sit in a waiting room for six hours just to get back in a room, get and IV in, get some fluids and then get that same medication in an IV. That is what you're going to get. If you can just have a tablet or two of Ondansetron, again the brand name is Zofran. It is a generic. It's very cheap. If you can just have that in your travel kit, you can save yourself and incredible amount of headache. A lot of studies out there have shone that if you can just keep the pill down and drink some fluids you don't need an IV.
Item #3 to Include in Your Travel First Aid Kit: Superglue

The last thing I carry is going to sound a little bit strange but this will save you a whole lot of trouble and that is superglue. I actually take the medical form of superglue that we use for lacerations is almost the same thing as over the counter superglue. The medical form of superglue has a little bit of a chemical mixture that makes it so it burns less and irritates the skin a little less. You can even buy that online. You can find it under the brand name Derma Bond. The reason I carry this is because the third reason you don't want to have to go to the ER is for a laceration. Say you have a glass in your hand or something. It falls and breaks. You go to pick it up and a piece of glass cuts your hand. It's a simple thing that otherwise you would just put a band aid on.

You're thinking okay my tendons are all working fine. This isn't a dirty wound. I don't have a lot of stuff in there where I am concerned about tetanus or anything like that. You try to put a band-aid on or bring it together and it's just not going to work. You also want to make sure it's not a cosmetic concern. There is nothing on your face or anything like that. You are just thinking I need something to hold this wound together. Superglue will do the trick. The way you put it on is just hold the wound together, put a little bit across it, that's going to hold it in place. Then you can add a little bit more to hold that wound together. You don't want to get a lot of it in the wound. The biggest risk here is a little bit of skin irritation. It may burn a little bit. It's going to do the trick. It's going to fall off after about a week. The wound is going to heal up under that and should do just fine.

Anyway, these are my tips. I'll be honest here I am going a little bit rogue. You are not going to hear every doctor talk about these sorts of things. From my experience as an emergency physician I find pretty much everything else I can go out and by at a pharmacy if I need it. These are the things that are going to keep me out of the ER. Help me to avoid that ten hour wait or whatever I might be facing wherever I am and make life a little bit easier while I am traveling.

updated: December 9, 2022
originally published: December 23, 2013