Keep safe this holiday: tips from an emergency centre doctor

Posted on 10 December 2013

We chatted to Dr Rudy Bosch, head of the emergency centre at Mediclinic Louis Leipoldt, about some of the more common reasons for needing emergency medical care during the holidays, and what preventative measures you can take.

You mentioned that you attend to many people with severe sunburn, especially children. Why is this?
People forget that kids have a very sensitive skin and often simply neglect to put on sunscreen. As a rule of thumb your skin starts burning within 15 to 20 minutes. The scale of SPF will then multiply this by 15 minutes. So, an SPF5 will protect against sunburn 5 x 15 minutes (75 minutes). Also remember that after swimming or playing in water you’ll need to reapply sunblock.

Sunburnt arms are what we see most frequently. We also attend to people visiting the coast who try to get a suntan in one day. And then there are those who fall asleep in the sun – especially after having a few drinks.

What about the choking hazard presented by decorations and presents?
As far as small objects go, we don’t see too many more choking incidents, but it’s a good time to emphasise to parents shouldn’t let their guard down if they have small kids. And to make sure your holiday accommodation is also safe for your children.

What alcohol-related injuries or medical problems do you see?
Alcohol per se is a major issue for us, and our admissions reflect that. People are drinking and driving more, and therefore have more accidents. They fall asleep in the sun, as already mentioned. People also shouldn’t go near the water – whether it’s for skiing, swimming, kayaking or surfing – when they’ve been drinking.

Also, make sure you don’t suddenly increase your physical activity on holiday if you have risk factors for heart disease, We often start the year with New Year’s resolutions to get fit or lose weight, and then suffer heart problems as a result. Make sure you start any exercise programme with moderate intensity.

When it comes to insect and spider bites – how do you know it’s serious enough to come to the emergency centre and when do you just let the bite go away by itself?
Luckily in South Africa we don’t have many deadly poisonous animals – unlike Australia. Because these holidays fall in the hot months, we do see more snake and scorpion bites. If bitten by a snake, try to take a photo with your phone (it helps with making the choice of anti-venom) and get to the hospital as soon as possible. Scorpions are seldom as dangerous, but if you’re out in the woods and you have tingling around the bite, get to emergency centre.

Spider bites are normally not fatal. We rarely need to use anti-venom, and only do so if symptoms are severe and life threatening. There are really only two spiders in the Western Cape we see bites of and those are the violin spider and the button (or black widow) spider.

We see an increase in stings from blue bottles and jellyfish, though. Make sure your first-aid kit has a good antihistamine cream or gel. And if this cream or gel doesn’t work, go to hospital.

Also, if any bite gets worse after two or three days and more red swollen, then it probably is infected and needs care from a GP or an emergency centre.

You worked as an emergency doctor on cruise ships in the past. What advice do you have for people travelling outside our borders?
Insurance, insurance, insurance. I cannot stress this enough when you travel abroad: you must have travel insurance. Make sure you activate your credit-card insurance before leaving South African shores.

And do let the insurance company know about any pre-existing conditions. I have seen many people get major bills that the insurance company didn’t pay, as one of the fine-print clauses is that pre-existing medical conditions are not covered. In America, in particular, you won’t receive treatment (or will have to sell your house) without insurance.

Also, keep a document listing your allergies, current medications, immunisation history and blood group in your travel pouch, so that people can find it in the event of you being unable to speak.

Then, of course, if you have chronic illness to make sure you take your medication despite the disruption of your usual routine. Diabetics, always check the hotel fridge before you check out – people forget their insulin in the fridges and sometimes it can be a nightmare to try and get the right medication in another country.

Then, inside the emergency centre, what is triage and would that be that the reason someone who came in after me is treated first?
Triage is a system we use to treat the most severe illness first. We code everyone red/orange/yellow/green in order of severity, and have a very well-documented system to decide who is seen first. In smaller units, life-threatening emergencies can take all our resources away from other patients and people can wait a bit longer if they have less serious issues, like a common cold. With the triage system, someone experiencing a heart attack or seizure will be seen before someone with a fractured arm, and the person with a common cold will be seen last.

 

 

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.