With the onset of summer, pharmacy teams need to up their first aid knowledge in order to treat a range of ‘fun in the sun’ injuries. We point out some of the hazards you should be aware of

 

Summer is nearly upon us. And if we’re lucky, the longer days and balmy nights will no doubt leave many of us raring to catch some long awaited rays. However, this is not without its risks. “As people are more active in the summer, incidents are more likely to happen,” explains Clive James, training officer at St John Ambulance. So where are such injuries most likely to occur and what can be done to prevent and treat them?

At the beach

Sunburn occurs due to skin damage caused by ultraviolet (UV) rays, which makes skin red, sore, warm, tender and, in some cases, itchy. These symptoms usually heal fully within seven days, but the damage to the skin unfortunately lasts much longer. Sun exposure is easily underestimated, as redness takes several hours to develop. Anyone exposed to UV light is susceptible to sunburn.

However, vulnerable individuals include those with:

• Pale skin
• Freckles
• Fair hair
• Occasional intense exposure, e.g. on holiday.

Babies and young children are also more sensitive to UV rays. The sun is at its most intense between 11am and 3pm, although sunburn can occur outside of these hours, particularly in peak summer months. Customers can protect their skin by:

• Staying in the shade
• Covering up with loose clothing and a wide-brimmed hat
• Wearing a broad-spectrum sunscreen of at least SPF 25
• Applying a generous amount of sunscreen at least 15 minutes before sun exposure and reapplying at least every two hours
• Wearing CE marked, British Standard sunglasses with a UV400 label and 100 per cent UV protection.

To treat sunburn, it’s important to ensure the skin has no further sun exposure, so advise customers to stay indoors or in a shady area. Sufferers can also apply a cold compress to cool the skin and drink plenty of water to avoid dehydration. Basic analgesics such as ibuprofen or paracetamol can relieve pain and a cooling moisturiser or sunburn treatment can soothe skin.

At the park

Cuts and grazes are minor injuries that don’t normally pose any health risk. “Cuts and grazes will happen and are hard to prevent, unless you cover everyone in bubble wrap, but if you know how to treat these then they are not an issue,” says Clive. Cuts and grazes can usually be treated at home and should heal within a few days. If bleeding is heavy or on a particularly delicate area (e.g. the palm of the hand), the person should apply pressure to the wound using a bandage or towel and raise the area above the level of the heart, before applying any dressing.

Once bleeding has ceased, the wound can be treated by:

• Washing and drying hands thoroughly
• Cleaning the wound under running tap water
• Patting the area dry using a clean towel
• Applying a sterile adhesive dressing, which should be changed as often as required. Antiseptic should not be applied as this can damage tissue and slow healing
• Taking OTC painkillers if needed.

On the pitch

“Sprains affect ligaments and joints, strains affect muscles and tendons,” explains Clive. “Apart from that they’re very hard to differentiate.” Sprains and strains occur if an individual changes direction or speed suddenly, over-reaches, lands awkwardly or collides with something – or someone! Such injuries are common during sport due to the physical contact and acceleration involved.

Sprains

Sprains occur when ligaments (bands of tissue that join bones together) stretch, twist or tear due to excessive force being applied to a joint. Symptoms include pain, swelling, bruising and an inability to apply weight to the joint. Swelling can occur almost immediately, while bruising often appears later, away from the joint, as blood seeps along the muscles and close to the skin.

Mild sprains heal quicker if the joint is moved as soon as possible without experiencing significant pain. Generally, people can use the joint fully after six to eight weeks. However, it may be eight to 12 weeks before they are able to exercise.

Strains

Strains occur when muscle fibres stretch or tear, usually when stretched beyond their limit or forced to contract too quickly. Symptoms including pain, swelling, bruising, spasms and loss of function. Recovery times vary – some return to normal activity within a few weeks; others may take several months. Strains are often best kept still for a few days to avoid worsening the injury.

To prevent injuries such as sprains and strains, customers should wear shoes that support their feet and ankles. Regular exercise can help to prevent sprains by making muscles stronger and more flexible. Warming up before exercise also helps to loosen muscles and increase joint movement. Rest is also important, as fatigued muscles provide less support and reduce body movement control.

Treat mild sprains and strains at home with PRICE therapy:

• Protection: protect the injured area from any further damage
• Rest: avoid activity for 48-72 hours
• Ice: apply ice wrapped in a damp towel to the injured area for 15-20 minutes every two to three hours for the first 48-72 hours. Don’t apply ice while sleeping or allow ice to directly touch the skin
• Compression: bandage the area to limit swelling and movement. Ensure this does not restrict blood flow, and remove before sleep
• Elevation: raise the injured area to reduce swelling.

In addition, for the first 72 hours, avoid HARM:

• Heat: e.g. hot baths
• Alcohol: as this increases bleeding and swelling
• Running: or any exercise
• Massage: as this may increase bleeding and swelling.

Painkillers can help to ease pain. However, oral non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided for the first 48 hours as they can delay healing. After this time, NSAIDs (oral or topical) can be beneficial in reducing pain and inflammation.

 

 

At a picnic

“Insects are more active during the summer, so the likelihood of bites and stings increases,” explains Clive. These usually only cause minor irritation, although they can trigger potentially serious allergic reactions (anaphylaxis) in hypersensitive individuals.

Biters

During the British summer, common biting insects include midges and mosquitoes, as well as ticks. While feeding, insects release saliva, which initiates the development of very itchy papules. Although irritating, mosquitoes do not transmit malaria in the UK. Ticks are not usually painful. However, they can cause swelling, itchiness, blistering or bruising. When in tick habitats (e.g. woodlands), customers should:

• Wear appropriate clothing (long-sleeved shirts and trousers tucked into socks) in light coloured fabrics
• Apply a DEET-containing repellent
• If with pets, inspect their fur.

After being in a tick habitat, customers should examine skin and remove ticks immediately by:

• Wearing gloves
• Grabbing the tick as close to the skin as possible using a pair of fine-tipped tweezers or a tick removal tool
• Gently but firmly pulling straight up to remove all of the tick’s mouthparts. Don’t use a twisting or jerking motion
• Cleaning the bite with soap and water or an antiseptic
• Not scratching to avoid swelling and infection.

Ticks can transmit a bacterial infection that causes Lyme disease, which can be serious if untreated. Refer to the pharmacist anyone who has:

• A tick that cannot be removed
• A pink-red rash
• A temperature over 38°C
• Flu-like symptoms.
• Swollen lymph nodes.

Stingers

UK stinging insects include bees, wasps and hornets. These sting as a defence, injecting venom into the skin to create a swollen, red, itchy weal. Although painful, they are usually harmless. However, the surrounding area may be uncomfortable for several days. Bees differ from other stinging insects as they deposit their sting and venomous sac in the wound.

This should be scraped out immediately using a hard edge (e.g. a clean bank card) to avoid puncturing the sac. To avoid stings, advise customers to:

• Apply a DEET-containing repellent and keep skin covered while outdoors
• Slowly back away from stinging insects
• Avoid wearing fragrance (e.g. perfume)
• Keep food and drink covered while outdoors
• Never disturb insect nests.

Most stings can be treated at home by:

• Washing the wound with soap and water
• Placing a cold compress over the area to reduce swelling
• Applying a local anaesthetic, antihistamine or mild hydrocortisone 1% formulation to ease symptoms
• Not scratching the wound.

 

Cuts and grazes will happen and are hard to prevent, unless you cover everyone in bubble wrap