Summer is a time for being outdoors, grilling your favorite foods for various social gatherings. While your guests will be lining up for mouth-watering burgers and brats, medical experts say it’s important to play it safe before igniting that first flame.

The first thing is to make sure your gas grill is ready. If the grill is not primed correctly, it could lead up to a build up of gas that can explode. “Some people try to light them with matches or gasoline or try to do some crazy things,” says Stathis Poulakidas, MD, burn center medical director at OSF HealthCare Saint Anthony Medical Center in Rockford. “We want people to be safe and use common sense.” 

The bigger concern is when people use lighter fluid with charcoal. Some people like to pour too much lighter fluid for a good burn which can quickly create flash burns and cause significant burns.

According to the National Fire Protection Association (NFPA), nearly 20,000 people are treated every year in emergency departments due to injuries involving grills. More than 10,500 home fires are started by grills each year. July is the peak month for grill fires, followed by June, May and August.

Dr. Poulakidas treats many different injuries throughout the summer – from burns to eyelashes and eyebrows – to significant burns that require skin grafting. The Burn Center sees injuries from grilling, fireworks and burning leaves.

One practical tip is to become familiar with your grill – especially if it’s new. Not knowing how to use the grill is one of the biggest hazards, according to Dr. Poulakidas. For example, improper installation of gas tanks can cause them to explode. 

Also, keep the grill outdoors and away from potential hazards.

“Garages are a very dangerous place,” says Dr. Poulakidas. “You think ‘I'm going to get out of the rain, or I'll be able to grill year-round’ and it's going to be warm and safe. But you have turpentine, gasoline, all different types of gas products in the garage that you might use for your lawn mowers or weed eaters.”

If you get lighter fluid on your skin, move away from the grill, and wash your hands and arms to ensure that when you do light the flame it doesn't catch fire to your arms as well.

And get a fire extinguisher if you don’t already have one. “I really believe everybody should probably have a fire extinguisher in their home without question,” says Dr. Poulakidas. “Having a fire extinguisher close to a grill site is probably the best piece of advice that I can offer.” 

Remember those burgers and brats? They are loaded with fats, oils and grease that tend to cause any flame to intensify. “You should have good control and setup and instead of having them directly on the fire, maybe put them a level up if you have a two-tiered grill to minimize that grease falling on the pit and actually flaming up significantly,” says Dr. Poulakidas.

Dr. Poulakidas is looking forward to grilling this summer, too. He says the best way for everyone to enjoy the summer with family and friends is to play it smart around the grill and avoid being one of the thousands of people who end up in the hospital.

Grilling Safety tips

·         Propane and charcoal grills should only be used outdoors

·         The grills should be placed away from the home and never in the garage

·         Keep children and pets at least three feet away from the grill area

·         Avoid using wire brushes to clean the grill. Use nylon scrapers or wool brushes instead

·         Keep the grill clean by removing grease or fat build-up from the grills and trays below

·         Never leave the grill unattended

·         Always make sure the gas grill lid is open before lighting it

·         Avoid drugs and alcohol while grilling

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• YES: moles, blisters, bumps, acne, boils, peeling skin from a sunburn, rashes, poison ivy or similar skin reactions, warts, skin tags and bug bites
   
• YES, BUT: Dr. Kumar says freckles and birthmarks are lesions, but they are not harmful.

In other words: “A skin lesion is any type of abnormal growth. It can happen anywhere on the body. If it doesn’t look like normal skin, it’s considered a growth,” Dr. Kumar says.

Causes for each of these lesions vary. We know acne is due to bacteria, and warts are from a virus, for example. Medications, lifestyle choices (like eating certain food that doesn’t agree with you) and medical conditions (such as diabetes and liver failure) are other culprits. But when the cause is unexplained, health care providers might need to investigate.

“We look at the lesion. The majority of the time, we can tell if something is benign or malignant. If we have questions, we err on the side of caution and do a biopsy,” Dr. Kumar explains. That involves cutting out part of the lesion and sending it off to a lab for analysis. “Biopsies can be done in the office. If it’s a bigger procedure, we have to go to the operating room.”

If the biopsy confirms evidence of a problem, such as cancer, the doctor will remove the rest of the bad tissue. Or, Dr. Kumar says some people come to him with a cosmetic or practical reason. They have a large birthmark or cyst on their face, are self-conscious about their appearance and would like it removed, for example. Or, they wear a hard hat for work, and the hat rubs against a lesion on their forehead, causing discomfort.

Dr. Kumar outlines how he would remove a lesion: “Let’s say it’s on your arm. We clean up the arm. We inject some lidocaine, which is a numbing agent. Then with a knife or other instrument, I’m able to cut it all out. Depending on how deep it is and the size of the lesion, we can glue it back together or put stitches in.” Regardless of the method, Dr. Kumar says most of these procedures are routine for providers with minimal aftereffects for the patient. In complex cases, like if the lesion goes down into a muscle, a plastic surgeon might be consulted.

Prevention

We can’t control if we have things like freckles or moles. But there are plenty of things you can do to help prevent problematic lesions.

• Limit your exposure to ultraviolet rays from the sun or by tanning. In fact, Dr. Kumar would not recommend tanning at all. For outdoor activities, use waterproof sunscreen of 50 sun protection factor (SPF) or higher, and reapply every few hours. Wear long sleeves and a wide brimmed hat.
   
• Wear bug spray when doing outdoor activities, such as hiking, where insects are present.
   
• Wash your body regularly.
  
  “Don’t overclean,” Dr. Kumar warns. “If you scratch your skin, that allows bacteria and other things to get into your skin and cause infections.”
   
• Don’t smoke. Dr. Kumar says smoking changes your skin for the worse, such as developing wrinkles and lesions.
   
• Find the right skincare products. If you use a lotion and it causes a rash, for example, don’t use that product again. Dr. Kumar adds that Vaselines and petroleum jellies are good for moisturizing your skin. But they’re thick and can clog pores.
  
  “Keep it simple. The $100 face cream is going to work the same as the $10 one,” Dr. Kumar says.
   
• Know the ABCDEs of suspicious moles.

o    A is for asymmetry. One half of the spot is not like the other half.

o    B is for border. The mole has an irregular, scalloped or poorly defined border.

o    C is for color. The spot has varying colors, like tan, brown, black, white, red or blue.

o    D is for diameter. Dermatologists say melanoma skin cancers are usually greater than six millimeters, or about the width of a pencil eraser. But they can be smaller, so don’t consider diameter alone.

o    E is for evolving. The mole looks different from the rest or is changing in size, shape or color. Dr. Kumar says you can take pictures to show your provider how the mole has changed.

                           If your lesion has any of the ABCDE red flags or you just have a concern, see a provider.

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We all get thirsty from time to time. But it’s not just that feeling that can mean you’re dehydrated – when your body doesn’t have enough fluids. There are lesser known signs you should know to avoid a possibly life-threatening situation, says Awad Alyami, MD, an OSF HealthCare pediatrician.

“You get less perfusion to tissues and organs,” when you’re dehydrated, Dr. Alyami says. “That can cause organ damage.

“Perfusion refers to fluid, nutrients and energy your organs need to function,” he adds.

Unfamiliar signs

Take note of these things to keep an eye on for possible dehydration, especially if you are at high risk. For example, if you work an outdoor job in warm weather or if you look after someone who can’t fully care for themselves.

• You’ve suffered burns. This means there is less skin tissue doing its job of keeping you healthy.
   
• Peeing isn’t normal, such as expelling less urine.

“When you’re hydrated, your urine should look yellow, pale yellow or sometimes almost transparent like water,” Dr. Alyami explains. “When you become dehydrated, your urine will become less in volume, and the color will be darker. It goes into an orange color. It can have a smell, also.”

• Crying without tears
   
• Skin changes, such as eyes appearing sunken in
   
• Fast heart rate
   
• Deep, heavy breaths

“When you’re dehydrated, your blood can be more acidic. You’ll try to get rid of some of that acid in your breaths,” Dr. Alyami says.

• Bad breath
   
• Headaches
   
• Muscle cramps
   
• Food cravings
   
• Sudden weight loss. Dr. Alyami says one kilogram (or around 2.2 pounds) of weight loss means one liter of fluid loss. So if someone has lost two to four pounds quickly and unintentionally (for example, not because of a diet and exercise program), it’s cause for concern.

What to do

Dr. Alyami says while dehydration can be serious, recovering doesn’t have to be. Rest and drink fluids. Water or Pedialyte are go-tos.

“If the dehydration is because of decreased oral intake, the person might just need pain medicine so it’s less painful to swallow while eating and drinking. If they are losing fluids from vomiting, we can give them medicine to stop vomiting,” Dr. Alyami says.

If those steps don’t work, Dr. Alyami says the person would likely get intravenous (IV) fluids in a hospital emergency department.

“You’re probably going to be there for at least a couple hours. [Health care providers] want to make sure you can take fluids and keep them down before you go home,” Dr. Alyami says. “Sometimes the dehydration is severe enough that we need to replace those fluids over one to two days.”

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Don't sweat it

It’s the dead of winter, and you need to run to the mailbox or let your dog out. It’s just a minute, you think. A sweater and sandals will be fine.

Not so fast, says Maddy Draper, APRN, a health care provider at OSF OnCall who sees cold weather injuries often. She says exposure to frigid temperatures can have serious consequences.

Types of cold weather injuries

• Frostnip: Draper says this is a mild form of frostbite where exposure to cold temperatures turns the skin pink or red. Your skin may feel burning or numb.

“The numbness typically goes away with rewarming,” Draper says.

• Frostbite: This is a more severe case of cold exposure. Your skin may be numb and appear yellow, white, gray or black. It may feel waxy and have blisters.
   
• Hypothermia: This is when the body’s temperature drops below 95 degrees.

“There are different stages,” Draper explains. “The first is our natural response of shivering. It gets more severe. The person may get confused and have lethargy, memory loss and slurred speech. It can lead to a coma and death.”

Inside, too?

Yes, there’s a risk for these injuries inside, too, Draper says. Notably, there have been cases of infants getting hypothermia.

“The room may be too cold, and they’re not dressed appropriately,” Draper says. “If they’re in a bassinet or crib with just a onesie and it’s cold, that can lead to hypothermia.”

Signs of infant hypothermia are bright red skin and decreased energy. Sleep experts use a thermal overall grade scale (TOG) to suggest how much clothing a baby should wear to sleep depending on the temperature of the room.

Treatment

Draper says she usually sees cases of frostbite and hypothermia sent to the emergency department. Providers will rewarm you with warm water or blankets and may provide warm liquids to drink, warmed oxygen through a mask and nasal tube or heated fluids through an intravenous line (IV) or other methods. Medication can also help with pain and blood flow.

“The hospital has more imaging resources to see the impact of the tissue damage,” compared to urgent care, Draper says.

For frostnip, you can take steps to warm up at home.

“It’s not as fast as possible. It’s not as hot as possible. It’s just that gradual warming,” Draper says. “Get off your cool or wet clothes immediately. You don’t want to stick your hands or feet into hot, steaming water. Just warm water.”

That’s because hot water can burn your skin. And if your skin is numb, you may not feel the burn before the damage is done. If water is not available, you can place your hands in your armpits. And handle the sensitive skin gently. Don’t rub or massage it. If your feet are affected, get off your feet.

Prevention

Draper says older adults, people who work or do activities outside (like hunters or hikers), unhoused people and people with medical conditions (like peripheral artery disease, diabetes and Raynaud’s disease) are at a higher risk of cold weather injuries. Getting stranded in a vehicle without proper protection is also common in the winter. Drinking alcohol or using drugs may lead to you losing consciousness outside. And smoking impacts blood circulation, putting you at a higher risk, Draper says.

Some ways to beat the cold:

• Dress in layers. You can always take a layer off, but you can’t put one on if you leave it at home. Make a hat, scarf, gloves and winter boots part of your wardrobe. Make sure the clothes aren’t too tight to allow for blood circulation. And look for water-resistant garments when buying clothes.
   
• Have winter weather supplies, like blankets, flares, a first aid kit and food, in your vehicle.
   
• Be well fed and hydrated. Body fat, though unhealthy in excess, helps us stay warm. For drinks, avoid alcohol and caffeinated beverages.
   
• During outdoor activities, take breaks and go with a buddy. Keep a close eye on kids who may not realize how cold they are. Come inside to change from wet to dry clothes. Let others know your plans and when you’ll be back. If you’re not back in time, that’s a sign you may have fallen victim to the cold, and help should be sent.

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Running in the cold

With that comes an increased amount of burn hazards like hot ovens, stovetops, deep fryers and more that you need to look out for, even more so during the busy holiday season.

"If you're deep frying a turkey, I would not have my child anywhere near it, the splashing can get them. They're at a different level from the items," says Tinsley Anderson, MD, a pediatric surgeon with OSF HealthCare Children’s Hospital of Illinois. “So, things on the stove can get pulled down, we see a lot of scald burns on the face, chest and abdomen from kids pulling stuff down on themselves.”

The National Fire Protection Association (NFPA) recommends always staying in the kitchen while you’re cooking to keep a closer eye on the food. The NFPA says to always be alert while cooking and keep anything that can catch fire (oven mitts, wooden utensils, towels etc.) away from your stovetop.

Some burns are worse than others, that’s why they’re broken up into different degrees.

"There are three main degrees of burn, first being like a light sunburn. The second degree can have some blistering and be a little deeper. Third degree, the most severe type of burn, can look white and be hard and firm. Because the skin and tissue underneath it is completely burnt," Dr. Anderson says. 

The dressing of the wound stage is the most important part of treating a wound, Dr. Anderson adds.

"I would say no alcohols or any abrasive, hydrogen peroxide-type cleansing agents should be used to treat burns," Dr. Anderson says. “In the emergency department we use soap and water. Something very simple, regular hand soap.”

Burns from hot food and drinks aren’t solely for the outside of our bodies. Research shows drinking really hot drinks can increase your risk for esophageal and gastric cancers.

If there are severe burns, bring the person to the emergency department (ED) and the medical team will take care of it there. 

Dr. Anderson says most cases the ED sees in kids are first- and second-degree burns. Most burns get cleaned up in the ED so the patient is comfortable, and the medical team will then teach them dressing care when they go home.

Larger, deeper and more severe burns can become infected, because bacteria live on the skin, but this is pretty rare. Dr. Anderson says Neosporin is good to put on the wound for comfort and keep the burn from sticking to things like clothes.

To learn more about burn care, visit the OSF HealthCare website.

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This is part two of a two part story on hygiene myths. Click here for part one.

From health care providers to websites to advice passed down through generations, there are a lot of ways to get health care information, especially tips for minor ailments you can treat at home.

Awad Alyami, MD, a pediatrician at OSF HealthCare, breaks down some common myths.

• Myth: When I shower, bathe or wash my hands, really hot water is best to kill germs.

Fact: Really hot showers can feel good, but they may burn your skin. Dr. Alyami recommends setting your home’s water heater at 120 degrees or less. Then, when you use the shower or sink, warm, but not hot water is best.

Dr. Alyami adds that a cold shower after a sweaty summer activity is OK because it can reduce the chance of heat rash. But frequent cold showers can irritate your skin.

• Myth: Q-tips are meant for cleaning your ear.

Fact: “The ear is a self-cleaning oven. Most everything inside the ear will come out on its own,” Dr. Alyami says. “When we put anything inside the ear, we are pushing everything from the outside to the inside, especially earwax. It makes it harder for the ear to clean itself.”

Using Q-tips and similar devices can lead to injuries to the ear canal or eardrum, Dr. Alyami adds. Instead, during your shower or bath, gently clean and dry the outside of your ears. If your ears look or feel off (pain or itchiness, for example), see a provider.

“We can clean you safely in the office,” Dr. Alyami says.

• Myth: For cuts and scrapes, apply antibiotic ointment like Neosporin until it heals.

Fact: You can apply the ointment once after cleaning the wound and then again after the wound is healed. But doing so often can lead to contact dermatitis, a bad skin reaction.

• Myth: The “five second rule” is OK for eating food that’s fallen on the floor.

Fact: Dr. Alyami puts this one to rest once and for all: Don’t do it. Always eat off a sanitary surface.

He even says that research has shown that bacteria from the floor can attach to food in as little as less than one second. Eating dirty food can lead to vomiting and stomach illnesses.

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But they're completely harmless. 

We're talking about cicadas, the winged insects that may be swarming your trees and yards this summer. 

Dr. Brian Curtis with OSF HealthCare says to experience the rarity of nature while it's here.

“Enjoy them. It’s part of nature, right? They only come around every 15-16 years," Dr. Curtis says. 

While they are loud bugs, Dr. Curtis says it's only during the day. So don't lose any sleep over cicadas.

Summer's a time for being outdoors and grilling your favorite foods. But medical experts say it's important to play it safe before lighting that first flame. 

Make sure your gas grill is ready. If it's not primed correctly, that could lead up to a buildup of gas that can explode. 

Another concern is when people use lighter fluid with charcoal. Some people pour too much lighter fluid on which can quickly create flash burns.

“Garages are a very dangerous place. You think ‘I'm going to get out of the rain, or I'll be able to grill year-round’ and it's going to be warm and safe," says Dr. Stathis Poulakidas, the medical director of OSF Saint Anthony Medical Center's Burn Unit. "But you have turpentine, gasoline, all different types of gas products in the garage that you might use for your lawn mowers or weed eaters.”

If you get lighter fluid on your skin, move away from the grill and wash your hands and arms to ensure when you do light the flame, it doesn't catch your arms on fire.

Invest in a fire extinguisher and avoid drinking alcohol while grilling.

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The Fourth of July holiday usually brings plenty of opportunities for the 3 Fs: fun, food and fireworks. That’s why it’s even more important to remember your ABCs: always be careful.

According to the Consumer Product Safety Commission, on average, 250 people go to the emergency room every day with fireworks-related injuries around the July 4th holiday. Most fireworks are illegal in the state of Illinois, but even the legal ones are risky.

“About a quarter of all ER visits are due to legal fireworks in the state of Illinois,” said Dr. Ben Kemp, OSF HealthCare emergency room physician. “Sparklers, for instance, can be relatively dangerous if used inappropriately: given to children who are too young to handle them, or lit in a way that they shouldn’t be, which we see occasionally where people wrap a lot of fireworks together or light them in a way where they cause a larger fire and can be potentially harmful.”

Dr. Kemp continued, “Never light a firework in your hand, obviously that can explode unexpectedly, quickly and you can get blast injuries to the hand or burn injuries to the hand and be very harmful. And also burns to clothing – clothing lights on fire and you can get burns to other areas. Facial injuries too – so a firework goes off in somebody’s face and you get injuries to the eye, the face and can be rather harmful and something we have to deal with.”

Dr. Kemp reminds everyone when using sparklers or other legal fireworks to always have a hose or bucket of water nearby, do so in a wide, open area and to make sure young children are kept at a safe distance. He also says be careful when it comes to alcohol use during festivities.

“Anytime somebody is drinking too much in the heat there is the risk of heat illness,” he warned. “Obviously drinking and driving is a terrible thing that we don’t want to see on a holiday, something us and law enforcement are very concerned about. And certainly mixing alcohol is a recipe for injury as well.”

The July 4th holiday is also a time for picnics. The Illinois Department of Public Health says each year about 1 in 6 Americans get sick from food poisoning, so you want to make sure you prepare, cook and store any food properly.

“You want to make sure things are cooked appropriately. Food sitting out for hours at a time, so something that’s got mayonnaise on it that’s sitting out for 2 or 3 hours, those sort of things can be at risk to cause gastroenteritis or food borne illness,” said Dr. Kemp.

And what would a summer holiday be without water activities, whether in a pool, lake or river? Again, safety is key. Drowning is the third leading cause of unintentional injury death, with children most at risk. Water-related injuries are something emergency department physicians don’t like to see come through the door, because an ounce of prevention can go a long way.

“Always ensure that you’re in a safe environment to dive into the water or jump into the water. Making sure little ones are well supervised when they are swimming or have appropriate floatation gear on,” advised Dr. Kemp. “The tragic things are when a little one is unsupervised and gets into a pool or a young, healthy person dives into a shallow pool of water and injures their neck. Those are things we don’t want to see.”

Check out more tips on fireworks safety, water safety and food safety for a safe and happy 4^th of July.

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