Author's note: this is part one of a two part story on outdoor water safety. Click here for part two.


Warmer weather means people flocking to lakes and rivers in droves to enjoy some fishing or time on the boat. But something as simple as the wrong type of footwear can lead to an injury that ruins your day and maybe even your life.

In 2023, the United States Coast Guard reported 3,844 instances of something going wrong on a boat and 564 boating deaths. The numbers were down from 2022 and don’t capture what’s happening on every waterway in America. But they’re still worth paying attention to.

Bethany Huelskoetter, APRN, a family medicine provider at OSF HealthCare, knows a thing or two in this area of medicine, having treated patients for outdoor injuries for years, plus spending leisure time on the water.

• Entanglements in boat engines: Contacting the parts under the boat can lead to traumatic injuries and even limb loss. Huelskoetter has heard of instances where a boat driver unknowingly backs up into a swimmer’s midsection.
  
  “Make people aware of where the motor is, and tell them not to swim there,” Huelskoetter says. “Don’t put your feet on the boat’s propellor. It can be sharp and injure you. And if the driver is going to move the boat, they should know where everyone is.”
   
• Head injuries: Diving into water where you don’t know the depth is a big no. There can also be objects like logs, Huelskoetter says.
  
  “People can go down and not come back up,” Huelskoetter warns. “They hit their head, and it knocks them unconscious. And maybe there’s a current underwater that they’re unable to fight.”
   
• Slip and falls: Wet surfaces, like a dock or the back of a boat, make you prone to falls. First, Huelskoetter says to enter the boat in the right spot. That’s usually the back or the side. Don’t try to hop over a tall railing, for example. Second, find a good non-slip footwear that works for you. That could be a sandal or a specialized boat shoe. Huelskoetter says going barefoot can be OK, too, if you watch where you walk. Look for sharp objects, and avoid long contact with hot surfaces.

• The buddy system: Try to boat or fish with someone. They can help you if you have an emergency. If you’re alone, let people know your plans. Then if you’re not back when you planned to be, they can alert law enforcement to look for you.
   
• Fish hook impalements: It’s a tiny object. How bad can it be?
  
  Bad, Huelskoetter says. The hooks are dirty, so infections are possible.
  
  “If you can cut the [fishing line] string and come to an urgent care or your primary care provider, that’s fantastic,” Huelskoetter says. “But if you’re unable, push the hook the rest of the way through [the wound]. Then cut the barb on the end of the hook off. If you go fishing, have wire cutters with you in case this happens. Then you can slide the hook out.
  
  “Wash with soap and water, then keep the wound dry and covered. Antibiotic ointment is good to use,” Huelskoetter adds. “Follow up with your primary care provider in the following few days if it develops redness, soreness or anything else irregular. We expect it to be tender, but if you have redness, swelling, drainage or if you’re just unsure, contact your primary care provider.”
  
  Huelskoetter points out that you can usually send a photo to your provider via your online patient portal. Then the provider can advise what to do.

Getting help

If someone suffers a minor injury on the water, you can treat it with a first aid kit until you return home. If it’s a major injury like a concussion, gently move the person out of the water and onto a flat surface. Gentle movements are critical to prevent further injury like paralysis. Call 9-1-1 and meet first responders on land. A charged phone is crucial for a day outdoors, but signal can lack in rural areas. So it never hurts to have a global positioning system (GPS) device, too.

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Author's note: this is part two of a story on outdoor water safety. Click here for part one.


More sun and rising mercury mean people will head outdoors to lakes and forests. But something as simple as drinking river water can lead to an illness that derails your spring.

Bethany Huelskoetter, APRN, a family medicine provider at OSF HealthCare, hits the major safety points about leisure time on the water.

• Bug bites: Coat yourself with bug spray to start the day, and avoid hanging out in tall grass where pests can hide. If your bug bite comes with skin tissue damage, chest pain, muscle cramps, sweating or nausea, see a provider right away. Also, watch for a rash in the shape of a bullseye, which is common with tick bites. To remove a tick, use tweezers to get close to the skin, and gently pull the insect out. Avoid twisting and yanking.
   
• Life jackets: Illinois and Michigan outline their life jacket laws. And some additional suggestions from Huelskoetter: for young kids, use a life jacket that straps on like a diaper. Life jackets that go over the chest could come up over the child’s head, and they could slip out or have trouble breathing. And read the life jacket label to make sure it’s right for you based on your chest size and weight.
  
  Huelskoetter also says a life jacket or any wet object has a risk of mold. So, dry the life jackets by hanging them in the sun.
   
• Fire extinguishers: Like life jackets, Illinois and Michigan laws require a United States Coast Guard-approved fire extinguisher on board most watercraft. Boat fires do happen, Huelskoetter says, and a fire extinguisher can mean the difference between a small fire and an explosion.
   
• Dirty water: It’s tough for kids who want to explore, but Huelskoetter says you should keep lake water out of your eyes and mouth. For kids, that could mean wearing goggles.
  
  “There are bacteria, parasites and other microorganisms that can get in your eyes. Also, don’t open your mouth underwater. You don’t want to drink that water,” Huelskoetter says. “If you swim in a lake and your eyes get red or itchy, that’s a sign you might have an infection from an organism in the water. So we want to put you on the proper antibiotic or whatever medication we feel is best.
  
  If you drink the water, gastrointestinal upset can occur. If you have nausea, vomiting or diarrhea, you definitely want to be seen by a provider. We’ll do testing to determine what bacteria or parasite you came in contact with so we can treat appropriately,” Huelskoetter adds.
   
• Alcohol: Drinking responsibly can be a part of your day on the water. But Huelskoetter says the rules are just like on land: A blood alcohol concentration (BAC) of .08% is the legal limit, so be aware if you’re the boat captain.
   
• Fumes: My group is in the open air. How much should we worry about boat exhaust?
  
  Huelskoetter says you should be fine, but make sure your watercraft has good ventilation. You can also buy carbon monoxide detectors made to clip on boats or life jackets. This can be extra helpful if your boat has an enclosed cabin, Huelskoetter points out.
   
• Spoiled food: Of course, you’ll want to eat on your boating or fishing trip. That could include perishable items like a sandwich.
  
  Putting the food and drink in an ice-filled cooler isn’t enough, Huelskoetter says.
  
  “Keeping your cooler covered and out of the sun is going to do wonders. It’ll keep that ice nice and cool,” she says.
  
  “Never eat anything that’s been sitting out, and now it’s hot,” Huelskoetter adds. “Once food reaches room temperature, you want to be careful. You can go by smell, too. If it doesn’t smell right, don’t eat it.”

Getting help

Have a first aid kit for minor injuries. For major injuries like a head or limb wound, gently move the person to land and call 9-1-1. The word “gently” is important to avoid further injury like paralysis.

Experts also point out that cell phone service can be spotty in the wilderness. So you should also have a global positioning system (GPS) device.

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Year-round sun safety
Heat exhaustion vs. heat stroke: Know the difference
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But don't let lake life wash away your safety habits or good judgment. 

In 2023, the U.S. Coast Guard counted over 3,800 recreational boating accidents, resulting in 564 deaths. The Centers for Disease Control and Prevention (CDC) reports drowning deaths are on the rise for the first time in decades, with over 4,500 people drowning each year from 2020 to 2022. 

Jon Gehlbach, MD, is the medical director for the Pediatric Critical Care Unit at the OSF Children's Hospital of Illinois. He says there are many unknown factors in natural bodies of water like lakes and rivers that make them more dangerous than pools.

“They tend to be darker, so it’s harder to see what’s going on below the surface. They could have hidden obstacles," Dr. Gehlbach says.  "Currents play a factor as well. Kids might be great swimmers in the pool, but currents make it a lot more challenging to swim safely.”

Another harmful thing to keep in mind is the spread of waterborne pathogens and bacteria like E. Coli. 

The Illinois Environmental Protection Agency (IEPA) says to not transport water, animals, fish or plants from one body of water to another. 

Also, wash yourself, your boats and equipment with hot water as soon as possible once you're out of the water.

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