Search for tag: "safety"

Dr. Gellner: Playground politics, how to help your child build social and emotional skills to help solve their own issues when things get out of control is today's topic on The Scope. I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering the Healthy Kids Zone with Dr. Cindy Gellner on The Scope.

Dr. Gellner: Face it, kids love playgrounds, and we as parents love them to play on playgrounds because it makes them expend energy and get tired. What happens when kids meet other kids on the playground and it turns into a battlefield? The good news is, you as parents can help your child learn skills to help with just these situations. Say your child comes to you and tells you the other kids won't let them play, or that another child is calling them names. You get mad, but you can't let your child see that you're doing that because you, as the adult, need to be the voice of reason.

The first thing to do is to teach your child empathy. Empathy helps children understand, or feel, what another person is feeling by putting themselves in the other person's shoes. Empathy can help create self-awareness that allows children to differentiate their feelings from the feelings of others. The most powerful way to encourage empathy is to show them how to do it. If your child is hurt or disappointed, you could say, "You sound very sad about that," or, "Please tell me more about what happened."

Next comes the emotional management, which is basically temper control. Teach your child to talk to themselves in a quiet voice. If they're mad, that voice can say, "I need to take three deep breaths before I do something I shouldn't." If they're sad, that voice can say, "I'm not going to let what that child said or did get to me."

The last part is problem solving. Once something happens and your child comes to you, let them tell their story so that they're heard. Ask them how that made them feel, ask them what they want to happen, and ask them to give you two or three ideas on how to get what they want. Finally, ask them what they're going to actually do about the situation, and have them also think, what would they do next time? So they're prepared, and can address the situation themselves if it happens again, which you know it will.

Managing social dynamics when there are several children other than your own involved can be very stressful for both children and their parents. Teaching your child these social-emotional skills can help children de-escalate a conflict, advocate for themselves, and find more acceptable, safe and socially appropriate ways of getting their needs met when they may be feeling bullied or dismissed.

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Interviewer: Are you struggling with the decision whether or not you should let your kids play sports because of the danger of concussion? Dr. Greg Hawryluk is a concussion expert and neurosurgeon. Give us your perspective.

Dr. Hawryluk: The first point is that we don't want people to be overly concerned about concussion. There are so many benefits to sporting activities. We're seeing very high rates of childhood obesity. Sports are good for you. We don't want people being pulled out because of fear of concussion.

The second point is that we really want to encourage players to respect their own bodies and the bodies of their competitors. We don't want them using their heads as a battering ram. They need to be using proper tackling technique.

The third point is we really want the coaching staff to have the proper training and experience where they can recognize concussion, they understand the importance of it, and so they know how to take the right steps if concussion happens to one of their athletes.

updated: June 10, 2021
originally published: April 18, 2019

Interviewer: You step outside for 30 seconds, you come in and your body is covered with mosquito bites. Is this normal? We'll find out next on The Scope.

Announcer: Questions every woman wonders about her health, body, and mind. This is "Am I Normal?" on The Scope.

Interviewer: We're talking to Dr. Kirtly Parker Jones. She is the expert in all things woman, and she is going to tell me why my mom, when she steps outside, is a mosquito magnet, but I'm totally fine. I'm assuming it has to do with blood type.

Dr. Jones: Well, it's a complicated question, but let's get to the normal part.

Interviewer: Yes, is this normal?

Dr. Jones: Remember, we've decided in medicine that something that happens to less than 5% of the population is not normal so if it's something that happens to more than 5% of the population is normal. Twenty percent of people, one out of five, are mosquito magnets so we're normal.

Interviewer: So we're normal people. So I'm not normal, then.

Dr. Jones: No, you're part of the 80% so it's normal to be a mosquito magnet and to not be a mosquito magnet. Now, I am a mosquito magnet and it ticks me off. Here are some of the things that mosquitos like. First of all, mosquitos can find you from 160 feet away. They can find you by the carbon dioxide that you emit. People who emit more carbon dioxide, people who are exercising and pregnant women, those are the triggers for mosquitos to come and find you. So more carbon dioxide can attract mosquitos.

Now, people who are mosquito magnets can just be sitting there and not breathing too much, drinking beer . . . guys drink beer, they sit outside, they get mosquito bites. It turns out that mosquitos would prefer somebody who drank beer because they must be smelling the beer.

Interviewer: That's so interesting to me.

Dr. Jones: You know how you can smell beer on a guy.

Interviewer: Yeah, okay.

Dr. Jones: Also, we do know that people who are O blood type. So, how mosquitos can tell O blood types from other blood types, but O blood types are more likely to get mosquito bites. There are some other things too that people are looking into. Now, this is big business. You can bet that the Off people, the people who make mosquito repellant, are very interested in trying to figure out why some people get bitten and some people don't and coming up with some answers with what we might put on ourselves.

It's important to know that mosquitos like some colors too. They are more attracted to dark colors or bright colors.

Interviewer: Oh, like skin? Are you talking about skin color?

Dr. Jones: Well, skin color, but colors that you wear. Remember, they're seeing you from 100 feet away. They say, "There's red," or, "There's black," or, "There's blue; let's go over there." If you're covered in white, they're less likely to bite you. So we don't know all the answers that make people into mosquito magnets, and there probably are hormones or steroids or scents that we don't know about yet, but one in five people get more bites than others.

Now, getting a bite is also a function of how you respond to it. Some people get a bite and it's a tiny, little round thing, and some people get a bite and it's a great, big welt. It could be that the people with the little, tiny round thing are getting as many bites, but they don't have the same kind of immune response to the bite.

Interviewer: So it's not so much the mosquito bite, it's how you react to it.

Dr. Jones: Right. Remember, the mosquito is doing this really cool thing. First of all, there are only girl mosquitos. Only girl mosquitos do the biting because they need a blood meal for their eggs. Mosquitos insert a little chemical that makes blood flow more easily, but that chemical causes a little irritation. They want to put in a little anticoagulant so they can suck your blood, but sometimes there's an immune response to that. Some people have a bigger response than others.

So yes, you are normal if you're a mosquito magnet. I'm glad to say, as a mosquito magnet that I'm normal, but I'm ticked off. Is it my blood type? No, I'm type A. Is it my exercise? No, I don't exercise that much, just enough, and it's usually inside. Is it my beer? I don't drink beer. Is it my perfume? It could be, but I get it when I'm coming out of the lake. So I'm not exactly sure why, but I do know what to do about it. And that is I cover up in light clothing. If I'm in an area where West Nile fever is a big deal, I might use DEET, but normally I usually just cover up. There are many new products on the market to help people, which aren't DEET, decrease the chance of getting bitten. So, for the one in five of you listening who is a mosquito magnet, so sorry for you. Wear white and cover up.

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Interviewer: Dehydration. When should you really worry? We'll talk about that next with Dr. Scott Youngquist on The Scope.

Announcer: Medical news and research from University Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: In the summer months you hear a lot about dehydration, and I've actually even heard that when you're thirsty it's too late. You're already dehydrated. So we're going to talk about that and other things about dehydration with Dr. Scott Youngquist. He's an emergency room physician at University of Utah Health Care. First of all, is there any truth to that, "When you're thirsty it's too late?" I'm already dehydrated?

Dr. Youngquist: There's some truth to that. That's not way too late, but it's a sign that you are dehydrated. That cotton-mouth, thirsty feeling is your body telling you it's time to get some more water.

Interviewer: I remember when I was younger nobody carried water bottles anywhere. You'd go out on hikes. My dad was a rancher. He'd go out and work all day and never take any water with him. Nowadays, you can't go anywhere without somebody having water. Is that silly or is that actually good?

Dr. Youngquist: That's a good question. One recent study suggested that children, at least, get not enough water during the day. So they're not drinking enough water for their regular needs and probably are going around in a state of constant dehydration.

Interviewer: I think I saw that study. They get a lot of juices and stuff like that but not actual water. Like a lot of kids don't ever drink pure water.

Dr. Youngquist: Yeah, absolutely. And some of those juices that are high in sugar actually cause you to be more dehydrated. So they will cause what's called a diuresis or cause you to urinate more fluids than you actually took in. So they can actually be a negative in terms of overall hydration status. And I think that some of the mild symptoms in kids, that are probably true for adults as well, are feeling tired, lethargic, not able to concentrate. Those may be signs that you are dehydrated.

And most adults like to start their day with a drink of coffee or several coffees during the course of the morning, which is also diuretic. Caffeine is something that causes you to urinate and it's also sort of a negative fluid. In other words, you'll pee out more than you took in with coffee alone.

Interviewer: So on a day-to-day basis, if I'm not necessarily super active or out in the sun working, am I probably not getting enough fluid and dehydrated? And is that a problem?

Dr. Youngquist: Yeah. It's only a problem if it causes impaired function for your day. So if you're feeling, like I said, excessively tired, trouble concentrating, and things like that, you may try drinking water.

Interviewer: So that's interesting. That seems like something I would never consider. I think, "Well, maybe I had too big of a lunch, or I didn't get enough sleep." But it could actually be water.

Dr. Youngquist: Yeah. Water could be a part of it. And a lot of people will get into a cycle of treating that with additional doses of coffee or Diet Coke or something like that. They're actually making their hydration status worse rather than better. So consider taking more water as one possible solution to that feeling you get in the afternoon.

Interviewer: All right, let's go outside for a second. On a 90 degree day, for example, I like to cycle or hike or do something like that. When should I start worrying if I don't have water? Like if I'm doing a ten-mile bike ride and I don't take water with me, is that a problem?

Dr. Youngquist: That's going to vary depending on how much water you had beforehand. So when you start out in the morning, actually, you haven't had anything to drink all night long. If you think about it, even fasted. You haven't had anything to drink. And most of your hydration status is actually come from mobilizing that's in your soft tissues. It's kind of accumulated in your feet and legs during the day through gravity. And that gets reabsorbed back into the vascular space while you're sleeping. But you can quickly become dehydrated in the morning without having enough hydration because of that, and you're actually have just urinated, not taken in any fluids at all.

Interviewer: So on a hike, say a couple miles, if for the most part I'm drinking water and I don't take water on that hike, and it's a hot day and I'm out in the sun for a couple hours, I'm probably going to be fine. It's just getting back to everybody's got water with them at all times.

Dr. Youngquist: Yeah absolutely. So it's going to depend on the duration of exercise, the amount of heat that you're exposed to, and your pre-exercise hydration status.

Interviewer: At what point should I start being concerned as a general rule, if I'm relatively well-hydrated most of the time?

Dr. Youngquist: Well, I'll give you just a general rule of thumb. I would say anything more than a couple of miles, you should probably bring some water.

Interviewer: Okay. And how much water should I be drinking every day? It tends to vary a lot. Like I've heard ten cups. I've heard as much as a gallon. Is there a general rule on that?

Dr. Youngquist: Yeah there is, and I don't know off the top of my head unfortunately, but there is.

Interviewer: Maybe ten cups is a gallon.

Dr. Youngquist: There is a calculation you could do, and you could look this up online, but there are various numbers given for the amount of appropriate fluids. We tend to calculate people's fluids on a maintenance basis when they come into the hospital and have to go without food or water because they're preparing for surgery or something like that. And for an adult we tend to go around 125 to 200 milliliters per hour as a maintenance fluid.

Interviewer: So what does that translate into in ounces then?

Dr. Youngquist: That's somewhere between four to eight ounces. So one half to a whole cup of water per hour is about what your maintenance requirement is.

Interviewer: While I'm awake?

Dr. Youngquist: Yes.

Interviewer: Wow, really? And how much should that increase when I'm exercising?

Dr. Youngquist: So you could probably at least double that when you're exercising. People tend to, instead of maintaining that fluid status, tend to get behind and catch up with a lot of water, and then get behind and catch up. So we don't consume that evenly throughout the course of the day, and it's probably impossible to do so. But that's why we have kidneys. Kidneys are good about conserving water when we need it and getting rid of it when we've got excess.

Interviewer: Can you drink too much?

Dr. Youngquist: You can, certainly. Yeah there's a phenomenon known as "water intoxication." You can get very sick from it. In fact, there have been some high-profile deaths from water consumption contests. There was a famous one, I think in California, where a radio station sponsored a water consumption contest, and I believe it was a female participant died shortly thereafter from water intoxication. So yes, you can drink too much.

Interviewer: But beyond that, I've heard that you could wash out all the good vitamins and minerals if you're drinking too much water. You could flush too much of the good stuff out of your body. Is there any validity to that?

Dr. Youngquist: I don't know about vitamins. It depends on if they're water soluble or not, but yes most of the time if you take supplemental vitamins most of it ends up in your urine anyway, regardless of how much water you take. And that's why you take some B12 vitamins and you'll notice that your urine becomes distinctly kind of dark yellow-orange in color, and it's not because you're suddenly dehydrated. It's because of the concentration of those vitamins.

Interviewer: So as long as you're doing about four to eight ounces, you're good.

Dr. Youngquist: Yeah. On average per hour.

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Interviewer: So the question is, can you build up a tolerance to heat exhaustion or even getting heat stroke as the summer progresses.

We're with Dr. Scott Youngquist. He's an emergency room doctor at University of Utah Health Care. So the question is, can you build up that tolerance or is it just always the same.

Dr. Youngquist: The short answer, Scot, is yes, you can build up tolerance to heat exposure, and this has been shown for some time now, experimentally, with human volunteer subjects, that you can take them and, typically, under conditions of exercise. So you put one group into an area where they're going to exercise under heat conditions, around 37 degrees Celsius or 98.6 degrees Fahrenheit. You have them exercise for 20 minutes and then have a 10-minute cool-down period, and you do this for 6 days, and they will tolerate passive heat exposure much better than somebody who exercises in the cold. So you can develop this.

When you're exposed to heat, a couple of things happen to try to cool your body and adjust to the heat stress. One of those is, you start to hyperventilate and that will reduce blood flow to your brain. So you start to lose the amount of blood going to your brain. That's why people can get altered mental status with heat stroke. We call it heat stroke, not because they're actually having a stroke, but because, sort of like a stroke, their brain is deprived of essential nutrients and oxygen. So that occurs.

You also have a diversion of blood flow toward the skin, so you sweat and also your skin heats up so you can radiate heat from the body and try to lose heat that way. But that also reduces your circulating blood volume and so you get a drop in your blood pressure, and that can be, in cases of severe heat stroke, that drop in blood pressure can lead to cardiovascular collapse.

And so you have a couple of compensatory mechanisms when you're exposed to heat, and at a cellular level, there are these proteins called heat shock proteins. The heat shock proteins are produced in response to this, and give you this tolerance. So people who are exposed to exercise under conditions of heat build up this tolerance by producing these heat shock proteins. And what you find is that they hyperventilate less, there's increased blood flow to the brain compared to the group that hasn't developed tolerance, and so they're able to compensate much better. They also increase their plasma volume, so they hold onto water a little bit more, anticipating they're going to be sweating and things like that.

Interviewer: So at the beginning of the summer when I feel like, "Oh man, I'm just having a hard time handling the heat," versus the end of the summer, where I'm running and cycling, and it doesn't bother me at all, all those things are happening inside my body.

Dr. Youngquist: Exactly. That's why you feel better as the summer goes along in the same amount of heat.

Interviewer: And I would imagine that everybody's a little bit different. Some people probably have a natural higher tolerance, right?

Dr. Youngquist: Yeah, absolutely. So if you are obese or overweight, it's going to make it harder for you to develop heat tolerance because you've got that extra layer of insulation.

Interviewer: If I'm interested in building up heat tolerance because I want to compete in some sort of an athletic event, is there a systematic way I should go about it, or is it just about getting out for longer and longer periods of time?

Dr. Youngquist: There are several protocols you can look at online. So if you do a Google search, you'll find several proposed heat tolerance regimens that you can adopt. But experimentally it's usually just a small amount of exercise, about 20 minutes a day for 6 days straight, in the heat, being careful to hydrate yourself well and to stop if you're feeling dizzy or excessively tired, and that should do it.

Interviewer: All right. Well, thank you very much. Indeed, you can build up a tolerance to heat exhaustion.

updated: July 16, 2021
originally published: August 6, 2015

Interviewer: Did you know that fireworks injuries are actually worse on the 24th of July here in Utah than the 4th of July? We'll explore why and give you some safety tips coming up next on The Scope.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.

Interviewer: Brad Wiggins is a nurse manager at University of Utah Healthcare Brun Center. And Brad was telling me that the 24th of July is your worst day of the year for fireworks burns. I find that interesting. Why do you think the 24th?

Brad: I just think here in Utah, the population of people that we have, they celebrate the 24th a lot more readily than they do the 4th of July. The celebrations around both of those, I think people are celebrating the fact that they live in Utah and that they're a part of the history of Utah being in the United States. So I think they take it a little bit more to the extreme sometimes.

Interviewer: Yeah. And what kind of injuries do you see in the Burn Center? Would that surprise people?

Brad: The types of injuries we see and the type of problems we see, number one, in small children, is related to sparklers. Sparklers are very, very dangerous. And probably the most common thing people don't know is that a sparkler burns close to 2,000 degrees. That's as hot as a blown torch. Would you give your two or three or four or five-year-old a blow torch and have them run around with the blow torch?

Interviewer: Like one of those ones you do a copper pipe repair on, would you light that thing up and let them run around waving it in the air?

Brad: And the answer is no. Nobody does that.

Interviewer: No, of course, you wouldn't. But a sparkler is the same thing essentially.

Brad: Yeah, and I think that's the extreme of people thinking about, "Oh, this is just fireworks fun," and it is fireworks fun. And if you ask me if I held this sparkler when I was a kid, absolutely. But now in my profession, I'm a burn professional and I understand the dangers and the risk and I think they really get associated with some very life-changing types of injuries that people just don't take the time to recognize when it comes to sparkler injuries.

Interviewer: When a child comes in with the sparkler injury, what kinds of injuries do you see and how does that affect the rest of their life?

Brad: Sure. A very simple type of injury we see from a sparkler is the fact that they held this sparkler, not on the handle part, that they actually held it where the chemical is that's burning. And the child doesn't know that. They haven't been educated and taught where to hold the sparklers. And it burns down into their tissue of their hand. When it's burning to 2000 degrees, it gives you a third-degree burn in less than a second.

Interviewer: So it's a guaranteed third-degree burn.

Brad: It's a third-degree burn and the only option for third-degree burn is surgical intervention. And the problem is this when a third-degree burn hits the finger or joint, which is where you're holding it because it's your fingers. So wherever you hit on a joint like that, it can actually lend itself to the possibility of amputation of fingers, partial amputation of fingers, skin grafting procedures on those areas and a lifetime of disability of movement of the joints in that area.

Interviewer: So you see sparklers and what are some of the other usual suspects when people come in like, "Oh yup, now there's another one of those."

Brad: Sure, someone trying to hold a firework like a firecracker, that's obviously going to have big ramifications. You can lose fingers from that, things blown right off.

Interviewer: And you've seen this stuff?

Brad: Absolutely, we see that every Summer. Yeah, absolutely.

Interviewer: It must be heartbreaking.

Brad: It is heartbreaking because it's such an easy thing to prevent. I think that in the burn world, we'd like to say about 75% of all the injuries we see in the burn center are preventable injuries. We're starting to see a lot of aerial types of injuries where someone will point in aerial firework at someone goofing around, having fun, maybe they've had some alcoholic beverage and they're enjoying themselves. Or maybe they have one and they're just being goofy and having fun with their friends. But they point them at each other, they're shooting them at each other and they don't know the ramifications. Most clothing catches on fire incredibly easily. You're pointing fireworks at people, you're sitting too close. Sparks can get you, embers can get you and the same goes back to the sparkler thing. Most catastrophic type of injuries we see from sparklers are that you have a child who's holding one and it catches their clothes in fire and no one is with the child when that happened and extinguish them close enough.

Interviewer: Some of these things that you are saying seemed incredible. People's clothes, catching on fire, that sort of thing, but that happens. You see that.

Brad: We see that every week. It's a common occurrence for us. Yeah, flame injury from clothes catching on fire is a huge deal and those are the types of injuries that are catastrophic on a much larger scale. And that's where people forget that your skin is the largest organ of your body. You damage the largest organ of your body significantly with flame and it's dead, the skin is dead, it impacts every other body system. It's the kind of thing that puts you in intensive care unit. It puts you on a breathing machine. It puts you having most likely to have that have some type of skin grafting and surgical intervention. There's a really huge cascade here from the simple concept of buying a sparkler pack at the booth and letting your child run around and play with it.

Interviewer: You're kind of bombing me out. This festive time now all of a sudden sounds like this is a very dangerous time. So let's talk about safety. It sounds like your number one suggestion is to leave it up to the professionals. But people are going to want to do this sort of thing. So what are your big safety tips other than what we've discussed?

Brad: Actually having a conversation about the safety risk. Promote the idea of letting an adult light the firework or have a supervised teaching moment with your child of, "This is how you do it and these are the risks." Not a scare tactic, but really direct communication about, "This is how you light a firework. This is what you want to do. You never want to hold it in your hand. You never want to try to keep it on some part of your body part. You don't want to throw it at someone because it can cause a life-changing injury for them." Let's just watch it and have some fun. We're going to do it the safe way.

Interviewer: Thank you very much. Hopefully, this conversation will reduce your workload on the 24th.

Brad: Yeah, I certainly hope so. And just as another reminder, if you do need our attention and you do need our care here at the Burn Center, we are available for that. And burns is incredibly unique and there are a lot of specialties to be able to do that. We recommend not using a lot of home remedies out there. There are a lot of myths. There are a lot of things you can find out there on the worldwide web that guide you with different directions. So why not. You have an incredible resource here in the State of Utah. We will take care of you. Let us do it for you.

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Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: When it comes to things that could be a threat to your eyes, a lot of people don't think of things around the home as a possibility, like construction sites, sure; and maybe athletic events, yes. But around the home there are a lot of dangers to your eyes, and we're going to find out how you can make sure you and your family are safe. We're with Dr. Bill Barlow. He's an ophthalmologist at the Moran Eye Center.
The home is an unlikely place, at least that people think eye injuries can happen, and nothing could be further from the truth. Tell me about that.

Dr. Barlow: When people were surveyed, just a general survey about where they were likely to have an eye injury, less than half of them mentioned the home as a possible place for an eye injury to occur.

Interviewer: Where are the places people think they are happening then?

Dr. Barlow: Well they think they're happening; I'm a construction worker at my worksite, and specific places like that, or paintball.

Interviewer: Sure, yeah.

Dr. Barlow: Gun ranges, things like that, things when they're thinking about risk of injury, and not just eye injury, but other types of injuries.

Interviewer: But home doesn't really cross people's minds, so they get a little lax I'd imagine?

Dr. Barlow: Yeah, home is a place where you take your shoes off, kick your feet up, and you're there to relax, it's safe, it's a comfortable place. You're not thinking of a place that you're comfortable in as a place with potential dangers lurking, so to speak.

Interviewer: Yeah. So what has been your experience with the types of eye injuries that happen around the home?

Dr. Barlow: Eye injuries that happen around the home include exposure to chemicals, cleaning chemicals, making sure that people have good ventilation or eye protection to avoid being exposed to those. People who like to cook, especially with grease or oil that can sometimes splatter and splash up into the eye causing significant burns.

Interviewer: Really? Wow.

Dr. Barlow: People who use curling irons, or other types of heated devices to do their hair or other things that they get around their eyes and their faces, inadvertently will strike the eye and that can cause a burn or a serious injury to the eye.

Interviewer: I guess I never thought about that; that things hot. How hot are those things, 400 or 500 degrees, probably, huh?

Dr. Barlow: I don't know the exact temperature, but yeah, high enough to create a significant burn in a very short period of time.

Interviewer: Yeah, if you make one misstep.

Dr. Barlow: Exactly.

Interviewer: Wow.

Dr. Barlow: So it's important to be thinking of these different things, for children, different toys can become projectile objects very easily if they throw them or things like Nerf Guns where they shoot these soft bullets. But when they're shot at a very high velocity they can cause significant blunt trauma injury to the eyes. So it's important that you're thinking about these things and making sure that your kids are aware of that.
Outdoor activities, such as mowing the lawn, trimming the lawn, anything that's loose debris can become a high projectile, essentially a missile if you will if it's picked up and flipped up towards either the person who's doing the activity, or an innocent observer. So it's important to wear eye protection when you're doing those higher risk activities at home.

Interviewer: I wear glasses; does that qualify as eye protection, or should I have something else?

Dr. Barlow: It's important to have something that wraps around and doesn't leave a lot of open space. So if you wear glasses, getting something that would go over them that wraps around that is ANSI certified. That's A-N, as in Nancy, S-I; that's an acronym for the American National Standards Institute. They have set specific standards based on testing to provide adequate protection in these situations.

Interviewer: All right, so out in the yard, that was one thing that came to mind. Another is I do some woodworking, and I generally wear eye protection, and then I'd imagine you'd really recommend that?

Dr. Barlow: Absolutely, you're hammering on things, especially on hard objects, something happens and you didn't recognize something underneath that wood. You hammer on that nail and it can flip up and become a high velocity missile and again, can strike the eye and cause significant injury, or obviously soft tissue injury to other parts. So it's important to be wearing protection.

Interviewer: What are some of the less common threats around the home that somebody should be aware of that they might not have considered?

Dr. Barlow: Things to think about in terms of less common threats are loose rugs, or sharp edges to furniture, especially if you have children or elderly individuals in the home. They are more likely to become unbalanced, slip and fall. If they hit their face or their eye on one of those objects it can cause a serious injury to the eye. So either creating some way to soften the blow with soft padding on those sharp edges, or tacking down loose rugs so they are not easily tripped over; that can be very important, and it's not something that many people think about.

Interviewer: We talked about some precautions wearing proper eye protection that's certified. Inside, if I'm using cleaners and I'm cleaning the bathroom mirror, do I need to be wearing goggles?

Dr. Barlow: You may not need to wear goggles, but make sure you read the label and know how you're supposed to use that substance and in some cases they may want good ventilation. And some people like to mix chemicals or mix cleansers, and make sure you're not mixing those.

Interviewer: More than just getting it in your eye, the fumes...

Dr. Barlow: Yeah, the fumes can be toxic to any mucous membranes, and the surface of the eyes is a mucous membrane.

Interviewer: Oh, I never think of that.

Dr. Barlow: Also the mouth, and the lungs.

Interviewer: Right.

Dr. Barlow: So if you're inhaling those substances it can be very damaging to those mucous membranes as well. Really avoiding getting them in the eye by wearing eye protection is important. But reading the label and making sure that you're being safe in the way that you're using it and following the directions that they've provided to make it safe.

Interviewer: What should I do if something does happen; say I do get something in my eye? You mentioned a bunch of different scenarios; chemicals, or something that hits the eye. Is it all kind of the same, or are there different procedures?

Dr. Barlow: If you're getting chemicals in the eye, the first and foremost thing to do is to flush the eye, and then you think you're done, to flush it some more. And that's to neutralize any acidic or non-neutral ph substance as quickly as possible to minimize the extent of injury.

Interviewer: Okay.

Dr. Barlow: With other things, of course, if you're struck by a high velocity object it's getting in to be seen by a trained ophthalmologist as soon as possible to have that evaluated and look for any significant injury and have that treated as appropriate based on the injury. Those things require medical attention and evaluation. Obviously the exposure to chemicals does as well, but rinsing and flushing the eye is the first thing you want to do and have somebody else call to make the appointment or make arrangements to get you seen on an emergency basis. But flush the eye and flush it some more to neutralize any non-neutral ph substance that has gotten into the eye.

Interviewer: What about, like you said, trauma or a scratch to the eye? Is there anything I should do other than just call somebody and get in?

Dr. Barlow: In those cases if it's significant trauma, we recommend you take something like a paper cup, cut out the edge and just tape it over the eye to protect it from getting bumped by anything else. That would be the only other thing that I would recommend, and again, it's getting in to be seen to evaluate the eye for injury and determine if it's a blunt injury or a sharp injury and what treatment is needed to try and recover the injury.

Interviewer: What's the threshold though; say I get whacked by something in the eye and it hurts, but I can open my eye, and I can still see. Do I still need to come in?

Dr. Barlow: I would recommend it. If you've been hit by something that's high velocity, you have an irritation, even just a corneal abrasion, there is the risk of developing an infection or other problem associated with that; making sure, particularly if it's vegetable matter, like something that came out of the lawn, there's a little bit higher risk of infection, making sure there are no signs of that, and making sure treatment is instituted to avoid or prevent injury and infection.

Interviewer: So when it comes to your eyes, better safe than sorry.

Dr. Barlow: Better safe than sorry, exactly.

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Announcer: Is it bad enough to go to the emergency room, or isn't it? Find out now. This is ER or Not on, The Scope.

Interviewer: All right, it is time for another episode of ER or Not, a game where we ask Dr. Troy Madsen of the University of Utah Hospital emergency department physician whether or not we should go to the ER if something happens. Play along at home. Dr. Madsen, I slipped on the ice. A lot of that going on right now.

Dr. Troy Madsen: A lot of it.

Interviewer: You get the melt and freeze things going on here in Utah. I slipped on the ice and I fell. ER or Not?

Dr. Troy Madsen: So it's really going to depend what happened to you. So there are a lot of different things that can get injured when you slip and fall. There's your head, there's your back, there's your hip, there's your legs, there's your arms. So all of these things. . .

Interviewer: You forgot about your wrists. . .

Dr. Troy Madsen: And your wrists.

Interviewer: And your elbows.

Dr. Troy Madsen: And elbows, exactly. So there are lots of different things that can be a problem. So with your head, if you hit your head, and you don't get knocked out, you're probably okay. The exception being, if you are older. If you are older than 65, you need to come to the ER because you are higher risk for bleeding in the brain. Or, if you are on blood thinners. If you're on Warfarin, Clopidogrel, aspirin, these kinds of medications that thin the blood out, you are at higher risk for bleeding and should come to the ER to potentially get a scan of your head.

Interviewer: So any sort of head contact with the ground, even if you felt it was minor.

Dr. Troy Madsen: Yeah, if you came down and if you're an older person coming down from a standing position, they are at risk for those sort of things, but the average person, if you don't get knocked out, you're probably okay. If you do get knocked out, come to the ER.

Interviewer: Okay.

Dr. Troy Madsen: The next thing we think about is the back, and that is the big thing we see with these slips and falls. We see a lot of back injuries and a lot of hip injuries, because most people come down and land straight on their buttocks. Come down really hard, they could hit their hip and break it or dislocate it, or they create what's called a compression fracture in the back, where basically you take all this force, you push down on the back and it's usually where we see it is in the low back where all that force is coming right down, and it basically just compresses down that vertebrae. So if you fall down, you hit your back, or just land straight on your buttocks and have back pain, great reason to come to the ER, get an x-ray of either your back or your hip.

Interviewer: All right. What are some of the other concerns?

Dr. Troy Madsen: So the other concerns are forearms and wrists, like you said. That's a big thing we see too, because people are coming down, they reach out to stop themselves, you've got all that force, all your body weight potentially coming down on your forearm, and so usually if you've got a forearm fracture, you're going to at least have an idea because it hurts.

Interviewer: Okay.

Dr. Troy Madsen: You may look deformed to you, but if you do come down on your forearm, you're having a lot of tenderness and pain there; again, worth getting an x-ray of that.

Interviewer: What about, like, elbows?

Dr. Troy Madsen: So elbows potentially, we don't see that so often. I think most people try and get their hand out first. But yeah, if you're having tenderness in your elbow, any bony tenderness and these kind of things is usually a reason to get an x-ray.

Interviewer: So have we hit all the areas?

Dr. Troy Madsen: Well, you know, potentially you could hit your knee or twist your ankle. Those are things we don't see quite as often. Usually after an injury, if you are able to stand up and walk and put weight on it and you're pushing around on the bones on your knee or your ankle and it is not really that tender, you should be okay.

Interviewer: Okay. Is there a correct way to fall? First of all, falls are scary.

Dr. Troy Madsen: They are.

Interviewer: Of all the things we talked about, you went through this laundry list of. . .

Dr. Troy Madsen: Exactly.

Interviewer: . . .parts of your body that could suffer.

Dr. Troy Madsen: Yeah. You're exactly right. So there are a lot of different things that can suffer. If it were me going down and I tried to think, okay if I'm going to hurt anything, I would want that thing to be my forearm.

Interviewer: Okay.

Dr. Troy Madsen: I would not want it to be my back because of the potential issues there with the back fracture. I would not want to hit my head, because of the very serious issues there. So if I'm going down I'm going to put an arm out, try and catch myself, if I break my forearm, okay, I'm going to have to wear a cast for four to six weeks. If I break my back, it's often a lot worse.

Interviewer: So I've often heard that skiers or snowboarders, when you fall, you should try to have the whole forearm hit the ground.

Dr. Troy Madsen: Oh yeah.

Interviewer: Because that spreads out the. . .

Dr. Troy Madsen: Yeah. If you can do that.

Interviewer: Sure.

Dr. Troy Madsen: Yeah. And that's a reasonable approach if you can do that or even kind of quickly ease yourself into it where you come down, your forearm or your hand takes the first part of it and then you bring it down at least some of the force, and kind of bring yourself down more on your elbow. I don't know. It's hard to really think through that if you're. . .

Interviewer: Sure.

Dr. Troy Madsen: . . .if you're slipping.

Interviewer: Yeah.

Dr. Troy Madsen: But if you can at least think through that, whatever you can do to distribute that force a little bit so it's not all on one part.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there’s a pretty good chance you’ll find what you want to know. Check it out at TheScopeRadio.com.

updated: January 11, 2019
originally published: December 19, 2013