Stay Outdoors This Summer!

My college required students to take four blocks of Physical Education, much like high school, except we chose the sports.  We also had to pass a swim test to graduate.  My roommate Brian, who'd never learned to swim, had to use his PE blocks to take swim lessons until he passed that test.  So while the rest of my buddies and me were horsing around in floor hockey or golf lessons, Brian was off to the campus pool in swim trunks, towel around his neck, trailed by jokes about playing in the "kiddie pool," and "don't forget your water wings." Learning to swim and playing in the pool are great ways to spend the hot summer. It's good exercise and though kids are outdoors, they stay cool.  And they have fun!  More importantly for we in Emergency services, knowing how to swim is good drowning prevention. Proper swim lessons, like in the Boy Scouts, don't only teach swimming.  They also teach water safety, because even good swimmers can get into trouble, like my buddy Walt. Walt is an ER doctor who had been in the Air Force Pararescue, or "PJs." This elite team's mission is to rescue downed pilots, particularly in water. Needless to say, Walt was as capable in water as any Navy Seal.  One day at the beach, however, he and his 8 year-old son got caught in a riptide and were taken out to sea. Hundreds of yards off shore, Walt saw a current that would sweep them back, but the stream he was in prevented him from swimming there.  After hours of trying to break through while holding up his son, growing exhausted, he resigned himself to throwing his son to the beach-bound current before he himself drowned.  Just then a rogue wave slapped them into that good current and they got home. After that, Walt never went to the beach without numerous flotation devices and a long rope.  Good swim lessons likewise teach about safety and rescue strategies like having flotation and other equipment handy.  They also teach the buddy system so everyone is accounted for in a crowd. Playing outdoors in the summer is great exercise too, though not as cooling as swimming.  Kids can get overheated, especially if they are in sports practices.  Several times in July and August we get football players in the Emergency Department with heat exhaustion.  The boys start to get muscle cramps, and then can become sleepy and sometimes confused.  When they are confused or difficult to arouse, we worry about heat stroke, a life-threatening emergency. Dr. James Andrews, a famed sports orthopedic surgeon, wrote a book called "Any Given Monday: Sports Injuries and How to Prevent Them."  In that book he advocates kids cutting back on organized sports when they are young, to avoid repetitive injuries that he used to see only in college and professional athletes.  This allows for more unstructured outdoor play for kids that's easier on their joints.  Kid-driven play also helps avoid heat injury. In regular play, there's no training agenda to drive kids past their comfort zone.  Kids can goof around outside all they want, and when they get hot and thirsty come in to get drinks and cool off.  They take breaks whenever they want.  In coach-driven sports, kids are pushed to the limits of their endurance to improve performance.  Sometimes they are pushed too far, and get over-heated. However, organized sports practice can be made safer. Coaches should allow unlimited water breaks.  Heat injury happens with temperature and dehydration working together to punish; plenty of fluids prevents that.  Breaks should be in the shade.  Teams should practice in cooler times of day, early morning and late afternoon or evening.  Football practice should start with shorts and tee-shirts, with endurance and equipment gradually added in following weeks.  Finally, coaches should watch players for signs of heat exhaustion, just like they watch for signs of concussion.  If players acts groggy, they should be rested and hydrated in the shade. So let your kids play freely outdoors. They should get swimming lessons and have lots of pool time to play and exercise.  If they are outdoors in the yard, be sure they take plenty of water and cooling-off breaks, and have sprinklers to play in.  Come to think of it, maybe football practices should have lots of running through the sprinklers too!