WEBVTT 00:00:00.040 --> 00:00:03.740 This week, we picked up a camper. What is it? 00:00:03.759 --> 00:00:05.339 What is it called? I don't know. I don't know 00:00:05.339 --> 00:00:07.299 what these are called. It's like a tent for your 00:00:07.299 --> 00:00:08.939 car. It's a tent that you put on the roof of 00:00:08.939 --> 00:00:12.240 your car. And it goes pop! Boom! And then you 00:00:12.240 --> 00:00:13.859 can sleep in it. And there's a little ladder. 00:00:14.140 --> 00:00:16.699 So the idea is that we are gonna go camping. 00:00:17.260 --> 00:00:20.679 The idea. The idea is that me and you and the 00:00:20.679 --> 00:00:22.940 dog and the baby, that we're outdoor people and 00:00:22.940 --> 00:00:24.399 we're gonna go camping. And that we're all gonna 00:00:24.399 --> 00:00:26.960 sleep in the same small little space with a dog 00:00:26.960 --> 00:00:29.879 and a baby. The main downfall of this plan is 00:00:29.879 --> 00:00:33.219 that the last time I took my dog hiking, I let 00:00:33.219 --> 00:00:36.000 him run through all the tall grass, he was chasing 00:00:36.000 --> 00:00:40.880 all the bugs, and he, despite being small, loved 00:00:40.880 --> 00:00:45.539 the hike. Uh oh. Is there like a part B to this? 00:00:45.939 --> 00:00:49.299 I was thinking, look how happy he is! And then 00:00:49.299 --> 00:00:51.960 an hour later, I was thinking, why is he covered 00:00:51.960 --> 00:00:54.579 in all these tiny little black dots that are 00:00:54.579 --> 00:00:57.679 moving? Oh god, I'm just ready. vomit in my mouth. 00:00:58.100 --> 00:01:00.719 And then I had to sit with tweezers and remove 00:01:00.719 --> 00:01:03.799 over 50 ticks from his tiny little body. I feel 00:01:03.799 --> 00:01:05.739 like this is an important lesson about hiking, 00:01:06.340 --> 00:01:08.920 but we're going to try car camping anyways, because 00:01:08.920 --> 00:01:11.719 the good news is most people are not removing 00:01:11.719 --> 00:01:14.200 50 ticks from their children after a hike. But 00:01:14.200 --> 00:01:16.200 every summer we see families worried about tick 00:01:16.200 --> 00:01:20.359 bites, giant mosquito bites, bee stings, poison 00:01:20.359 --> 00:01:23.069 ivy, and all sorts of mysterious rashes. The 00:01:23.069 --> 00:01:24.849 tricky part is knowing what's normal and what's 00:01:24.849 --> 00:01:26.909 not, and when it's time to seek professional 00:01:26.909 --> 00:01:29.950 help. Giant mosquitoes are not normal, but they 00:01:29.950 --> 00:01:31.689 are in Alaska. Do you remember how big those 00:01:31.689 --> 00:01:34.069 mosquitoes were? They were the size of bears, 00:01:34.290 --> 00:01:36.450 honestly. They were small bites, but giant mosquitoes. 00:01:36.629 --> 00:01:38.829 But here I think you mean... Big bites. Big bites 00:01:38.829 --> 00:01:48.000 from little mosquitoes. Well, welcome back to 00:01:48.000 --> 00:01:50.299 this week's episode of the Rolin Forward podcast. 00:01:50.599 --> 00:01:52.920 I'm Dr. Stephanie Rolin. I'm Dr. Alicia Rolin 00:01:53.060 --> 00:01:55.359 I'm a forensic psychiatrist. And I'm a pediatric 00:01:55.359 --> 00:01:58.700 emergency physician. And this podcast, we decided 00:01:58.700 --> 00:02:01.420 to do this because as physicians, as sisters, 00:02:01.599 --> 00:02:04.599 we know that parents are constantly just inundated 00:02:04.599 --> 00:02:07.140 with health information. Some of it's accurate. 00:02:07.439 --> 00:02:09.460 A lot of it is confusing. And sometimes just 00:02:09.460 --> 00:02:11.439 misleading. And then you're, you know, kind of 00:02:11.439 --> 00:02:13.080 sorting through all this trash, trying to find 00:02:13.080 --> 00:02:15.680 the truth. Our goal is to cut through the noise 00:02:15.680 --> 00:02:18.159 by bringing you practical, evidence -based information 00:02:18.159 --> 00:02:20.340 that helps you make informed decisions for your 00:02:20.340 --> 00:02:23.219 family without the fear, the hype, or the misinformation. 00:02:23.759 --> 00:02:25.120 In this summer, we're doing something a little 00:02:25.120 --> 00:02:27.620 different. It's our Summer School, our special 00:02:27.620 --> 00:02:29.979 summer series where we share lessons from the 00:02:29.979 --> 00:02:33.360 pediatric ER with one goal. We want to help your 00:02:33.360 --> 00:02:36.039 family enjoy everything summer has to offer while 00:02:36.039 --> 00:02:38.659 avoiding unnecessary trips to the emergency department. 00:02:39.289 --> 00:02:43.569 Today's class is Bugs, Bites, and Backyard Adventures. 00:02:45.169 --> 00:02:48.110 We'll cover tick bites and Lyme disease, mosquito 00:02:48.110 --> 00:02:51.050 bites, skeeter syndromes, bee and wasp stings, 00:02:51.289 --> 00:02:53.669 poison ivy, and how to tell what's a normal part 00:02:53.669 --> 00:02:56.349 of summer and what deserves a call to your pediatrician's 00:02:56.349 --> 00:03:04.009 office. So let's start with the bug that probably 00:03:04.009 --> 00:03:06.909 worries parents the most. It certainly worries 00:03:06.909 --> 00:03:11.000 me a lot. Ticks. Ticks. Now I'm convinced that 00:03:11.000 --> 00:03:13.379 every freckle on my dog is a tick, from now until 00:03:13.379 --> 00:03:15.939 forever. Yeah, once you find one, then you just 00:03:15.939 --> 00:03:18.620 see them everywhere. The good news is that while 00:03:18.620 --> 00:03:20.979 tick bites are common, most tick bites don't 00:03:20.979 --> 00:03:23.719 result in diseases like Lyme disease. And knowing 00:03:23.719 --> 00:03:26.460 what to do after you find a tick on your body 00:03:26.460 --> 00:03:29.780 can make a big difference. So let's start with 00:03:29.780 --> 00:03:32.860 the basics. I'm a parent, my child goes to play 00:03:32.860 --> 00:03:35.240 outside, they come home, and there's a tick. 00:03:35.860 --> 00:03:38.740 Do I burn the house down? The reality would be 00:03:38.740 --> 00:03:41.360 that you would scream and call me. I would probably 00:03:41.360 --> 00:03:44.199 just send her to you. I'd be like, go see your 00:03:44.199 --> 00:03:47.120 Tati. Just like leave. Put her in a bubble. Bring 00:03:47.120 --> 00:03:53.819 her house down. No, but really. In this hypothetical 00:03:53.819 --> 00:03:57.460 situation, what should a parent do? In this hypothetical 00:03:57.460 --> 00:03:59.139 about -to -be -real situation in car camping. 00:03:59.759 --> 00:04:02.360 The first step is simple. Remove the tick as 00:04:02.360 --> 00:04:05.650 soon as you notice it. Send to me and I'll remove 00:04:05.650 --> 00:04:08.289 the tick as soon as you notice it. Either you 00:04:08.289 --> 00:04:11.569 or another adult who is nearby should remove 00:04:11.569 --> 00:04:14.150 the tick as soon as you notice it. The Center 00:04:14.150 --> 00:04:15.990 for Disease Control and Prevention recommends 00:04:15.990 --> 00:04:19.430 using a pair of fine tipped tweezers. You grasp 00:04:19.430 --> 00:04:22.089 the tick as closely to the skin surface as possible 00:04:22.089 --> 00:04:24.889 and pull upwards with a slow and steady pressure. 00:04:25.529 --> 00:04:27.769 The goal is not to twist or jerk it because you 00:04:27.769 --> 00:04:29.670 don't want it to break off into different pieces 00:04:29.670 --> 00:04:32.980 or to leave the mouth part in the skin. Mouthpart 00:04:32.980 --> 00:04:35.839 is a word that I did not need to know. Mouthparts? 00:04:35.839 --> 00:04:40.579 Both. With an S? Worse, worse. Once the tick 00:04:40.579 --> 00:04:43.500 is out, wash the bite area and your hands with 00:04:43.500 --> 00:04:46.399 soap and water or rubbing alcohol. I remember 00:04:46.399 --> 00:04:48.259 growing up, there was all kinds of things people 00:04:48.259 --> 00:04:50.959 wanted to do, like burn the tick with a match, 00:04:51.040 --> 00:04:52.560 which how do you do that without burning the 00:04:52.560 --> 00:04:54.959 skin? Honestly, I don't know. Or just put lots 00:04:54.959 --> 00:04:58.279 of petroleum jelly or aquaphor on it, or nail 00:04:58.279 --> 00:05:01.500 polish. Those are all things that the CDC specifically 00:05:01.500 --> 00:05:06.399 recommends not doing. They don't help remove 00:05:06.399 --> 00:05:08.139 the tick, and they actually might increase the 00:05:08.139 --> 00:05:10.959 chance that the tick releases more saliva into 00:05:10.959 --> 00:05:14.000 the bite before it lets go. Tweezers are really 00:05:14.000 --> 00:05:16.939 the safest and most effective method. So once 00:05:16.939 --> 00:05:19.660 the tick is removed, do I need to run to the 00:05:19.660 --> 00:05:22.079 emergency department? And chop off their arm? 00:05:22.860 --> 00:05:27.319 These are the only choices. Essentially never. 00:05:28.579 --> 00:05:30.980 Most tick bites can be managed at home. And in 00:05:30.980 --> 00:05:33.100 fact, most tick bites never lead to Lyme diseases 00:05:33.100 --> 00:05:36.040 or other diseases. Not every tick carries the 00:05:36.040 --> 00:05:38.600 bacteria that causes Lyme disease. And even when 00:05:38.600 --> 00:05:41.639 an infected tick is involved, the risk of transmission 00:05:41.639 --> 00:05:44.579 depends on how long it's been attached. In general, 00:05:44.839 --> 00:05:47.660 the bacteria that causes Lyme disease isn't transmitted 00:05:47.660 --> 00:05:50.300 immediately. The risk increases when the tick 00:05:50.300 --> 00:05:53.040 has been attached for 36 to 48 hours or longer, 00:05:53.220 --> 00:05:55.720 and it looks engorged. and you can look up photos 00:05:55.720 --> 00:05:57.620 on the internet and have nightmares forever. 00:05:57.899 --> 00:06:00.620 I'm just going to call you. I'm not going to 00:06:00.620 --> 00:06:02.920 look that up. It sounds like finding a tick doesn't 00:06:02.920 --> 00:06:05.259 automatically mean that you need antibiotics. 00:06:06.019 --> 00:06:08.680 Exactly. For most children, antibiotics are actually 00:06:08.680 --> 00:06:11.620 not recommended after a simple tick bite. There 00:06:11.620 --> 00:06:14.639 are very few specific situations where a single 00:06:14.639 --> 00:06:17.319 preventative dose of doxycycline may be appropriate, 00:06:17.819 --> 00:06:20.199 such as a high -risk bite in an area where Lyme 00:06:20.199 --> 00:06:22.100 disease is common. but that's something to discuss 00:06:22.100 --> 00:06:23.620 with your pediatrician or another healthcare 00:06:23.620 --> 00:06:25.879 professional if you've noticed a tick bite. So 00:06:25.879 --> 00:06:27.519 let's say that there's a tick bite, the tick's 00:06:27.519 --> 00:06:29.819 removed, you speak to your pediatrician, antibiotics 00:06:29.819 --> 00:06:32.720 aren't recommended. Should parents watch for 00:06:32.720 --> 00:06:35.279 anything over the next few weeks? The biggest 00:06:35.279 --> 00:06:37.300 concern with tick bites is Lyme disease, and 00:06:37.300 --> 00:06:39.519 the classic symptom is an expanding rash called 00:06:39.519 --> 00:06:42.480 erythema migrans. Despite the pictures that people 00:06:42.480 --> 00:06:44.439 see online, it doesn't always look like a perfect 00:06:44.439 --> 00:06:47.139 bullseye. It usually starts several days after 00:06:47.139 --> 00:06:49.720 the bite, and it gradually gets larger. Parents 00:06:49.720 --> 00:06:52.439 should also watch for fever, fatigue, headaches, 00:06:52.740 --> 00:06:55.100 muscle aches, facial weakness, and swelling in 00:06:55.100 --> 00:06:57.540 a large joint, typically a knee. And if these 00:06:57.540 --> 00:06:59.560 symptoms develop ever tick bite, it's time to 00:06:59.560 --> 00:07:02.459 call your pediatrician. So, I just don't want 00:07:02.459 --> 00:07:05.180 anything to do with ticks, ever. Is there a way 00:07:05.180 --> 00:07:07.959 to just avoid any of this in the first place? 00:07:08.480 --> 00:07:10.939 Prevention is key. You don't have to avoid hiking 00:07:10.939 --> 00:07:13.540 or spending time in wooded grassy areas. But 00:07:13.540 --> 00:07:16.899 if you're in spaces where ticks live, You can 00:07:16.899 --> 00:07:20.319 use an EPA -registered insect repellent or long 00:07:20.319 --> 00:07:23.120 sleeves and long pants when practical and consider 00:07:23.120 --> 00:07:24.819 clothing that's been treated with permethrin. 00:07:25.819 --> 00:07:27.600 When you come inside or right before you come 00:07:27.600 --> 00:07:30.600 inside, do a quick tick check on yourself, your 00:07:30.600 --> 00:07:33.759 kids, and your pets. Showering soon after outdoor 00:07:33.759 --> 00:07:35.800 activities can help wash away ticks before they 00:07:35.800 --> 00:07:38.920 have a chance to attach. Adding permethrin to 00:07:38.920 --> 00:07:42.189 my online cart right now. The goal isn't to avoid 00:07:42.189 --> 00:07:44.470 being outside, it's to enjoy the outdoors while 00:07:44.470 --> 00:07:46.589 making tick checks part of your routine, just 00:07:46.589 --> 00:07:48.649 like putting in sunscreen. You put on sunscreen 00:07:48.649 --> 00:07:50.990 before you go out, you check for ticks before 00:07:50.990 --> 00:07:55.689 you go in. Alright, so moving on from the bug 00:07:55.689 --> 00:07:59.269 that scares parents the most to the bug that 00:07:59.269 --> 00:08:04.170 simply annoys everyone the most. Mosquitoes. 00:08:06.279 --> 00:08:09.959 Why do mosquitoes love kids so much, particularly 00:08:09.959 --> 00:08:12.699 my child? The truth is that mosquitoes are attracted 00:08:12.699 --> 00:08:15.180 to things like body heat, carbon dioxide, and 00:08:15.180 --> 00:08:18.240 certain chemicals on our skin. And children certainly 00:08:18.240 --> 00:08:20.259 get bitten a lot, especially because they're 00:08:20.259 --> 00:08:22.779 outside a lot, playing in the summer, probably 00:08:22.779 --> 00:08:25.980 more than adults. And while most mosquito bites 00:08:25.980 --> 00:08:28.620 are just itchy and annoying, some children have 00:08:28.620 --> 00:08:30.939 much bigger reactions. I remember I got a mosquito 00:08:30.939 --> 00:08:33.779 bite on your face and it made one of your eyes 00:08:33.779 --> 00:08:37.429 swell so much. You looked. Terrible. Thank you. 00:08:37.690 --> 00:08:39.990 Yes, you did. It was terrible. That's actually 00:08:39.990 --> 00:08:42.590 a great example. Children can have what's called 00:08:42.590 --> 00:08:45.070 a large local reaction, sometimes referred to 00:08:45.070 --> 00:08:47.929 as Skeeter syndrome. It's an allergic reaction 00:08:47.929 --> 00:08:50.590 to the protein in the mosquito's saliva. And 00:08:50.590 --> 00:08:52.950 the bite can very quickly become swollen, red, 00:08:53.149 --> 00:08:56.590 warm, and super, super itchy. It can look incredibly 00:08:56.590 --> 00:08:59.750 dramatic, especially if it's on the face. But 00:08:59.750 --> 00:09:02.730 that doesn't mean that it's infected. So how 00:09:02.730 --> 00:09:05.350 can parents tell the difference between a big 00:09:05.350 --> 00:09:08.350 allergic reaction to a disgusting annoying mosquito 00:09:08.350 --> 00:09:11.669 bite versus a bacterial skin infection, something 00:09:11.669 --> 00:09:14.850 like a cellulitis? That's a great question because 00:09:14.850 --> 00:09:18.929 they can look very similar. A large local reaction 00:09:18.929 --> 00:09:21.769 usually develops within hours of the bite. It's 00:09:21.769 --> 00:09:23.950 usually very itchy and the swelling may continue 00:09:23.950 --> 00:09:26.009 to increase over the first day or two before 00:09:26.009 --> 00:09:29.690 it gradually improves. A bacterial skin infection, 00:09:29.690 --> 00:09:31.929 on the other hand, it tends to become progressively 00:09:31.929 --> 00:09:35.230 more painful rather than itchy. The redness continues 00:09:35.230 --> 00:09:38.529 to spread, the skin may become tender, and totally 00:09:38.529 --> 00:09:41.570 may develop fever or drainage and pus from the 00:09:41.570 --> 00:09:44.590 area. If you're ever unsure, it's always reasonable 00:09:44.590 --> 00:09:47.289 to check with your pediatrician. So what should 00:09:47.289 --> 00:09:49.789 parents do for a typical mosquito bite or even 00:09:49.789 --> 00:09:52.559 one of these bigger reactions? I'm itching my 00:09:52.559 --> 00:09:55.120 whole body. I know, this episode is making me 00:09:55.120 --> 00:09:57.480 itch. Are we all so, so itchy? Are you itchy 00:09:57.480 --> 00:09:59.679 listening to this? So itchy. And now you're making 00:09:59.679 --> 00:10:03.799 me itch. The goal is to control the itching and 00:10:03.799 --> 00:10:07.039 the swelling. A cool compress can help. For children 00:10:07.039 --> 00:10:09.700 with bothersome itching, a low -potency topical 00:10:09.700 --> 00:10:13.039 corticosteroid, like the over -the -counter hydrocortisone 00:10:13.039 --> 00:10:14.940 cream that you can find at any local pharmacy, 00:10:15.299 --> 00:10:17.820 might provide some more relief. An oral antihistamine 00:10:17.820 --> 00:10:20.009 like Zyrtec can be helpful for itching. And if 00:10:20.009 --> 00:10:21.950 it's keeping your child awake, consider using 00:10:21.950 --> 00:10:25.710 Benadryl. Which can treat the itch and make people 00:10:25.710 --> 00:10:29.570 sleepy. Perfect. Win, win. And as hard as it 00:10:29.570 --> 00:10:32.570 is, try to keep kids from scratching. Scratching 00:10:32.570 --> 00:10:35.289 breaks the skin and increases the risk of developing 00:10:35.289 --> 00:10:38.169 a bacterial infection. All right, so now my favorite 00:10:38.169 --> 00:10:40.909 question. Let's just go back to prevention. And 00:10:40.909 --> 00:10:43.809 I want to keep mosquitoes from existing in the 00:10:43.809 --> 00:10:47.019 first place. Or biting me, at least. I think 00:10:47.019 --> 00:10:49.259 that's particularly important. We live in an 00:10:49.259 --> 00:10:51.960 area where there is West Nile virus. I'm sorry. 00:10:52.480 --> 00:10:55.519 I'm sorry, Dr. Fauci, who canceled his grand 00:10:55.519 --> 00:10:57.740 rounds at my hospital because he was actively 00:10:57.740 --> 00:11:01.200 sick with West Nile virus. The CDC and American 00:11:01.200 --> 00:11:04.620 Academy of Pediatrics recommends using an EPA 00:11:04.620 --> 00:11:07.220 -registered insect repellent where you're spending 00:11:07.220 --> 00:11:10.340 time outdoors where mosquitoes are active. Products 00:11:10.340 --> 00:11:14.639 containing DEET or Picardin? are both safe and 00:11:14.639 --> 00:11:16.419 effective while used according to the label. 00:11:17.000 --> 00:11:19.659 For children, insect repellent should be applied 00:11:19.659 --> 00:11:22.559 by an adult, avoiding the hands, eyes, and mouth, 00:11:22.879 --> 00:11:24.600 and it shouldn't be used on infants younger than 00:11:24.600 --> 00:11:28.080 two months. Long sleeves and pants can also be 00:11:28.080 --> 00:11:31.139 helpful when practical, and one of the easiest 00:11:31.139 --> 00:11:32.820 things that families can do around the house 00:11:32.820 --> 00:11:36.320 is eliminate standing water. Things like buckets, 00:11:36.779 --> 00:11:40.220 flower pots, bird baths, kiddie pools, tires 00:11:40.220 --> 00:11:44.440 can become mosquito breeding sites. More words 00:11:44.440 --> 00:11:47.820 that I did not need to hear, but it sounds like 00:11:47.820 --> 00:11:51.279 overall these giant mosquito bites, whether from 00:11:51.279 --> 00:11:55.379 a giant mosquito or a giant bite, can look alarming, 00:11:55.379 --> 00:11:58.179 but it's not automatically an infection. It's 00:11:58.179 --> 00:12:01.320 not automatically an emergency. Exactly. Most 00:12:01.320 --> 00:12:04.059 mosquito bites are more uncomfortable than dangerous. 00:12:04.500 --> 00:12:06.539 The biggest challenge is knowing when it's simply 00:12:06.539 --> 00:12:09.000 an exaggerated allergic reaction and when it's 00:12:09.000 --> 00:12:10.779 something that could deserve a closer look by 00:12:10.779 --> 00:12:13.399 your pediatrician. So now we're moving, this 00:12:13.399 --> 00:12:16.480 is like a tale of horrors here. We're moving 00:12:16.480 --> 00:12:18.980 from mosquitoes to another summer classic, bee 00:12:18.980 --> 00:12:22.899 and wasp stings. And I don't know about you, 00:12:22.919 --> 00:12:26.899 but I'm always thinking, is this normal or is 00:12:26.899 --> 00:12:29.720 my child allergic? That's actually one of the 00:12:29.720 --> 00:12:32.500 most common questions I hear. The reassuring 00:12:32.500 --> 00:12:36.059 news is that most bee and wasp stings can cause 00:12:36.059 --> 00:12:39.460 a normal local reaction. It hurts right away. 00:12:39.759 --> 00:12:42.100 and then it looks red and swollen and it's tender, 00:12:42.620 --> 00:12:44.460 and the swelling might even increase the first 00:12:44.460 --> 00:12:48.899 24 to 48 hours before it starts to improve. So, 00:12:49.059 --> 00:12:52.080 speaking of someone who navigated this last week 00:12:52.080 --> 00:12:54.779 with one of the children in our home, a swollen 00:12:54.779 --> 00:12:56.879 hand after a sting doesn't automatically mean 00:12:56.879 --> 00:12:58.799 that something is wrong? It does not mean that 00:12:58.799 --> 00:13:00.600 something is wrong. It means that they were stunned 00:13:00.600 --> 00:13:04.179 by a bee. A large local reaction can look dramatic, 00:13:04.480 --> 00:13:07.059 especially if the sting is on the fingers, foot, 00:13:07.100 --> 00:13:09.450 or face. but that doesn't necessarily mean that 00:13:09.450 --> 00:13:12.950 your child has a severe allergy. Similar to the 00:13:12.950 --> 00:13:15.129 other bug bites, the first step is to wash the 00:13:15.129 --> 00:13:18.129 area with soap or water, apply ice or cold -back 00:13:18.129 --> 00:13:21.169 to help with pain and swelling, and you can use 00:13:21.169 --> 00:13:23.149 age -appropriate medications if needed, things 00:13:23.149 --> 00:13:27.950 like NSAIDs, Advil Motrin, things like antihistamines, 00:13:28.230 --> 00:13:30.570 Benadryl, and Zyrtec. If your child is stunned 00:13:30.570 --> 00:13:33.289 by a honeybee and you can see the stinger, you 00:13:33.289 --> 00:13:35.700 want to remove it as soon as possible. How you 00:13:35.700 --> 00:13:37.659 remove it doesn't really matter. You just want 00:13:37.659 --> 00:13:40.200 to take it out of the body so it stops releasing 00:13:40.200 --> 00:13:44.080 venom. So some kids are allergic and when should 00:13:44.080 --> 00:13:46.820 parents start worrying about that? The concerns 00:13:46.820 --> 00:13:49.360 about allergy is something called anaphylaxis. 00:13:50.240 --> 00:13:53.299 Anaphylaxis are when symptoms extend beyond the 00:13:53.299 --> 00:13:56.179 sting itself. You should call 911 immediately 00:13:56.179 --> 00:13:59.480 if a child develops difficulty breathing, wheezing, 00:14:00.039 --> 00:14:02.720 swelling of the lips, tongue or throat, repeated 00:14:02.720 --> 00:14:06.539 vomiting, dizziness, fainting, along with widespread 00:14:06.539 --> 00:14:09.440 hives along the body. These are all signs of 00:14:09.440 --> 00:14:11.919 a severe allergic reaction that require immediate 00:14:11.919 --> 00:14:15.000 treatment with an EpiPen. And so that's different 00:14:15.000 --> 00:14:17.379 than having a swollen finger or a swollen arm. 00:14:17.779 --> 00:14:21.159 Exactly. It's a whole body involvement. It typically 00:14:21.159 --> 00:14:24.539 involves multiple systems. So your skin, your 00:14:24.539 --> 00:14:27.080 GI tract, your respiratory system, your heart, 00:14:27.620 --> 00:14:30.919 and so it's a full body reaction. So it sounds 00:14:30.919 --> 00:14:32.720 like the good news is that these severe allergic 00:14:32.720 --> 00:14:35.879 reactions are uncommon and most kids can recover 00:14:35.879 --> 00:14:38.879 with simple supportive care. But now let's finish 00:14:38.879 --> 00:14:42.600 with one of the itchiest parts of summer as people 00:14:42.600 --> 00:14:45.120 who are about to go car camping. We haven't talked 00:14:45.120 --> 00:14:49.200 ourselves out of it yet. And that is poison ivy. 00:14:49.320 --> 00:14:51.779 I feel like every family has a poison ivy story. 00:14:52.480 --> 00:14:54.940 Absolutely. Every summer we see kids who have 00:14:54.940 --> 00:14:57.399 somehow managed to find one patch of poison ivy 00:14:57.399 --> 00:14:59.539 on the entire hiking trail and decided to use 00:14:59.539 --> 00:15:02.820 that. as toilet paper, and also rub it all over 00:15:02.820 --> 00:15:06.820 their body. I mean, the memories. I don't know 00:15:06.820 --> 00:15:09.659 who did that. I think one of the biggest misconceptions 00:15:09.659 --> 00:15:12.740 about poison ivy is that it spreads because you 00:15:12.740 --> 00:15:15.820 scratch it. The rash itself isn't once contagious, 00:15:16.159 --> 00:15:18.899 and so scratching doesn't spread it. Poison ivy 00:15:18.899 --> 00:15:22.759 is caused by an oily resin called urushal that's 00:15:22.759 --> 00:15:25.399 found on poison ivy, poison oak, and poison sumac 00:15:25.399 --> 00:15:28.039 plants. Once the oil is washed off your skin, 00:15:28.179 --> 00:15:30.639 you can't spread the rash to someone else. But 00:15:30.639 --> 00:15:32.620 what can happen, though, is that the oil stays 00:15:32.620 --> 00:15:34.500 on your clothing, your shoes, your backpack, 00:15:34.659 --> 00:15:36.659 your gardening tools, or even your pet's fur. 00:15:37.139 --> 00:15:39.000 And if someone touches the oil later, they can 00:15:39.000 --> 00:15:41.879 develop their own rash. So if your child is coming 00:15:41.879 --> 00:15:44.399 from the woods, or perhaps your backyard, and 00:15:44.399 --> 00:15:46.419 you think that they have touched or brushed against 00:15:46.419 --> 00:15:50.539 poison ivy, what should you do? You want to wash 00:15:50.539 --> 00:15:52.379 the exposed skin with soap and water as soon 00:15:52.379 --> 00:15:55.480 as possible. It's also super important to wash 00:15:55.480 --> 00:15:57.559 clothing, shoes, any gear that might have come 00:15:57.559 --> 00:16:00.620 in contact with the plant. And your dog, if it's 00:16:00.620 --> 00:16:02.740 been running through the woods, might need a 00:16:02.740 --> 00:16:07.120 bath too. Oh, it's a family horror story. Removing 00:16:07.120 --> 00:16:10.820 the oil early may reduce how much of a reaction 00:16:10.820 --> 00:16:13.879 develops. But what if the rash does appear? Most 00:16:13.879 --> 00:16:16.639 cases can be treated at home. Cool compresses 00:16:16.639 --> 00:16:18.600 can help with itching, and over -the -counter 00:16:18.600 --> 00:16:21.039 topical corticosteroids may be helpful for mild 00:16:21.039 --> 00:16:24.220 localized reactions. Try to keep kids from scratching 00:16:24.220 --> 00:16:26.740 too much because scratching breaks the skin and 00:16:26.740 --> 00:16:28.460 increases the risk of a bacterial infection. 00:16:28.919 --> 00:16:31.340 For more extensive rashes, especially those involving 00:16:31.340 --> 00:16:33.940 the face, eyes, or genitals, or if the itching 00:16:33.940 --> 00:16:36.659 is severe, that's usually when it's time to call 00:16:36.659 --> 00:16:39.419 your pediatrician. Some children might need prescription 00:16:39.419 --> 00:16:43.000 medications, including oral steroids. So to wrap 00:16:43.000 --> 00:16:46.080 up, it sounds like we should go car camping. 00:16:46.240 --> 00:16:48.779 We should not avoid the outdoors, but we should 00:16:48.779 --> 00:16:51.990 be aware of what poison ivy looks like. We should 00:16:51.990 --> 00:16:54.950 wash up after any possible exposure and then 00:16:54.950 --> 00:16:57.169 realize that most cases can be managed at home. 00:16:57.669 --> 00:17:00.110 Exactly. We want kids outside exploring, hiking, 00:17:00.350 --> 00:17:02.529 camping, and playing. But a little preparation 00:17:02.529 --> 00:17:04.730 goes a long way towards making sure these adventures 00:17:04.730 --> 00:17:07.049 end with great memories and not a week of itching. 00:17:07.950 --> 00:17:10.529 So before we wrap up, what is the biggest takeaway 00:17:10.529 --> 00:17:13.529 from today's lesson? I'd leave parents with three 00:17:13.529 --> 00:17:17.150 things. First, prevention goes a long way. Whether 00:17:17.150 --> 00:17:20.039 it's an EPA -registered insect propellant, checking 00:17:20.039 --> 00:17:22.680 for ticks after a hike, or learning to recognize 00:17:22.680 --> 00:17:26.299 poison ivy, poison oak, poison sumac, a few simple 00:17:26.299 --> 00:17:29.839 habits can prevent a lot of summer misery. Noted. 00:17:30.259 --> 00:17:33.299 Second, most bites, stings, and rashes are more 00:17:33.299 --> 00:17:35.700 uncomfortable than dangerous. They can look dramatic, 00:17:35.700 --> 00:17:37.940 but they're often a normal part of spending time 00:17:37.940 --> 00:17:41.259 outdoors. Check. And finally, know the warning 00:17:41.259 --> 00:17:44.519 signs. Difficulty breathing after a sting, expanding 00:17:44.519 --> 00:17:47.599 rash or fever after a tick bite, poison ivy rash 00:17:47.599 --> 00:17:50.720 involving the eyes or face, are all good reasons 00:17:50.720 --> 00:17:53.960 to call your pediatrician. So let's plan not 00:17:53.960 --> 00:17:56.960 to keep kids inside. Let's get outside, let's 00:17:56.960 --> 00:17:59.660 explore, hike, catch bugs, maybe even car camp, 00:17:59.799 --> 00:18:02.420 make some memories. But let's do it feeling a 00:18:02.420 --> 00:18:05.579 little bit more confident that we know what we're 00:18:05.579 --> 00:18:08.299 handling when everyone's just got a few extra 00:18:08.299 --> 00:18:10.799 bug bites coming home. And that's our episode 00:18:10.799 --> 00:18:19.180 for today. Thank you for joining us for another 00:18:19.180 --> 00:18:21.859 episode of the Rolin Forward podcast on our 00:18:21.859 --> 00:18:24.380 summer school series. And if you enjoyed today's 00:18:24.380 --> 00:18:27.400 episode or it just made you itch, we'd love it 00:18:27.400 --> 00:18:29.220 if you subscribed. We usually don't talk about 00:18:29.220 --> 00:18:31.539 bugs. It's usually not an itchy podcast. You 00:18:31.539 --> 00:18:33.559 can leave us a five -star review and then share 00:18:33.559 --> 00:18:35.660 it with someone else in your life. You can find 00:18:35.660 --> 00:18:38.559 us on social media, send us an email at rolinforwardshow 00:18:38.559 --> 00:18:44.200 .com. And then we'll see you next week for another 00:18:44.200 --> 00:18:46.220 lesson from the pediatric emergency department. 00:18:46.519 --> 00:18:50.099 Until then, stay safe, itch free, and enjoy the 00:18:50.099 --> 00:18:50.380 summer.