So you have a cut.  What do you do now?

The first sight of blood likely sends you running to the medicine cabinet to grab the hydrogen peroxide or rubbing alcohol, Neosporin®, and a Band-Aid®.  These products may actually do more harm than good and can result in slower healing, more tissue damage and potentially a bigger scar.

Summer outdoor activities bring greater opportunities for cuts and scrapes.

Cleaning the Wound
Medical professionals are now recommending against using hydrogen peroxide or rubbing alcohol to clean open wounds.  Instead, wash the area with warm soap and water and pat dry with a clean towel.  Try to avoid further traumatizing the wound.

Antibiotic Cream
Using an antibiotic cream will keep the wound from drying out, which may promote healing and kill some harmful bacteria in the wound, helping to prevent infection.  When selecting an antibiotic cream, choose Polysporin® over Neosporin.  Neosporin includes an ingredient that is an allergen for about 20 percent of the population.  An allergic reaction can slow wound healing and cause inflammation of the wound site.  For clean wounds, such as those that result from surgery, Vaseline is often the best choice.

Covering the Wound
Covering the wound with a Band-Aid is a good idea until the bleeding stops or if you are doing something that may reintroduce dirt or germs into the wound.  Otherwise, going Band-Aid free can promote faster healing.

1. Wash the impacted area with warm soap and water to remove dirt
2. Pat the area dry with a clean towel
3. Apply antibiotic cream – Polysporin preferably
4. Cover with a bandage until the bleeding and oozing stops, then leave open when there is little chance of dirt getting in the wound.

What NOT TO DO When Treating a Cut:

1. Do not use hydrogen peroxide or rubbing alcohol
2. Do not rub the wound aggressively
3. Do not choose Neosporin to keep the wound moist

Dr. Michael Soboeiro is an internal medicine physician with WakeMed Physician Practices – Garner Primary Care.  He is currently accepting new patients.

In the summer 2014 issue of WakeMed’s Families First magazine, Michele Casey, MD, executive medical director for Primary Care and Urgent Care at WakeMed Physician Practices and Fellow of the Academy of Wilderness Medicine, shared tips to prevent health problems and what to do when you encounter some of the more common pesky problems that come up frequently in the summer. Here’s what she had to say about the pesky little tick.

Some ticks carry pathogens that cause disease in humans. It’s tough to know if a tick you find poses a problem. Even experts have difficulty identifying a specific tick species within a group. “The most important thing about ticks is knowing how to properly remove them and when you need to come in to be seen,” said Dr. Casey. “We started seeing tick bites this spring.”

If you find a tick, don’t panic. If it is loosely attached or is flat, it has probably only been on someone for a short amount of time. After removing the tick (see removal tips on page 7), Dr. Casey recommends monitoring the site and watching for symptoms for approximately 1-2 weeks. If nothing appears or symptoms do not develop, there is probably nothing to worry about.

“Remember, a small amount of redness without rash can be a body’s initial, normal inflammatory response to the tick bite,” said Dr. Casey. “However, if you develop a rash, significant redness or the area looks worse over time, get it assessed by a doctor.”

Other symptoms of concern include headache, joint aches, muscle aches and fatigue. If any of these occur and are new, get checked by a doctor. A trip to the emergency room is only necessary if symptoms progress rapidly, which is rare.

“If you do need to see the doctor and are able to bring in the tick at the time of your visit, it might be helpful for identifying the type,” said Dr. Casey. “However, keep in mind that the tick won’t necessarily be identifiable nor analyzed for specific diseases.”

Tips for Tick Removal
Avoid trying removal techniques that involve matches, nail polish remover, gasoline, etc. “Burns and other risks outweigh the benefits for most of these methods,” said Dr. Casey. They might even irritate the tick more, which could cause them to regurgitate pathogens into the wound.”

• DO use fine-tipped tweezers.
• DO wear gloves if available.
• DON’T use your fingers.
• DO grab the tick at the part that is stuck in your skin.
• DON’T grab the tick around its bloated belly.
• DO gently pull the tick straight out until it lets go of your skin.
• DON’T twist and turn the tick.
• DON’T crush it because you are expelling its pathogens.
• DO consider putting the tick in a jar or sealed bag and place it in a freezer for possible identification later.

Note: Try to remove the entire tick. If most of it is removed, you generally do not need to have it checked unless other symptoms develop.

“It is normal to see a small crater or indention in the skin after tick removal,” said Dr. Casey. “Clean the area with basic soap and water. You can use peroxide initially to clean the area and add antibiotic ointment. If the area itches a lot, use a topical or oral Benadryl® (diphenhydramine). Make sure the dosage is appropriate for children.”

Learn more
CDC.gov – Ticks – Removing a Tick

Summer is the season for fresh, delicious produce. From traditional fruits and vegetables, like corn-on-the-cob and watermelon, to the not-so-common ones, such as the tomatillo and the passion fruit, everything seems to be ripe and abundant. To help you figure out what you can do with all of these seasonal goodies, here are some healthy summer recipes from WakeMed chef Jennifer Leamons. Enjoy! 

Passion Fruit Salsa
(For fish, chicken or pork)
Yield: 20 servings

Ingredients

• 5 tomatillos
• 2 ripe passion fruits
• 1 large ripe tomato 
• ½ a green pepper
• ½ a small onion
• ½ a jalapeño
• 2 tbsp. olive oil
• ¼  cup cilantro
• ½ a lime
• ¼ tsp. ground cumin
• Salt & pepper to taste

Method of Preparation:
1. Wash all vegetables, toss in olive oil and roast in oven on 400 degrees for 10 mins.
2. While hot, transfer vegetables from pan to food processor and pulse five times.
3. Add cilantro and pulse until you reach consistency you like (chunky vs. smooth).
4. Season with salt & pepper and top your favorite protein or taco .

Grilled Spicy Corn on Cob
Yield: 8 servings

Ingredients

• 8 ears corn-on-the-cob
• 2 sticks of butter, softened
• 1 lime, juiced
• 1 tbsp. chipotle powder
• 1 tsp. onion powder
• 1 tsp garlic powder
• Salt and pepper to taste
• 1 tbsp. ground cumin
• 1 cup mayonaise
• ½ cup grated Cotija cheese or Parmesan cheese
• 8 tsp. hot sauce (Cholula is good!)
• Lime wedges

Method of Preparation:
1. Combine well in a bowl: butter, lime juice, chipotle, onion and garlic powder, salt & pepper and cumin.
2. Corn: Peel back husk but don’t take off cob; remove all silk.
3. Using a pastry brush, brush the butter mixture all over the corn. Pull the husk back up over the kernels again.
4. Wrap each corn cob in aluminum foil individually and place on a hot grill, turning over after 5 minutes. Cook on other side for 5 minutes.
5. Peel back the husk and grill kernels directly on grill grates for a minute or until you reach a nice char.
6. Remove from heat and slather with mayo. Sprinkle cheese generously all over mayo; top with hot sauce and lime juice, if desired.

Watermelon & Basil Salad
Yield: 1 Salad

Ingredients

• 1 cup pea shoots
• ¾ cup watermelon, cubed
• 1 oz feta cheese
• 5 grape tomatoes, halved
• 5 large basil leaves, torn 
• 3 mint leaves, torn
• 2 scallions, tops only, thin sliced
• ¼ of a yellow pepper, medium dice
• 2 radishes, thin sliced
• 1 tbsp. balsamic vinegar
• 3 tbsp. olive oil
• ¼ tsp. Dijon mustard
• ¼ tsp. honey

Method of Preparation:
1. Wash all vegetables and cut as suggested above. Toss pea shoots, basil and mint together, and put on plate.
2. Scatter watermelon cubes, grape tomatoes, yellow peppers and radishes in appealing presentation.
3. Sprinkle feta cheese and scallions on top.
4. In a bowl, combine balsamic vinegar, Dijon and honey, whisk together. Slowly drizzle in oil until vinaigrette forms.
5. Lightly drizzle over entire salad and enjoy!

In the summer 2014 issue of WakeMed’s Heart to Heart magazine, four women shared stories about supporting a loved one through heart attack recovery, surviving heart disease and managing high blood pressure. Here’s a peek at the stories and advice they shared and click for the full article.  

Supporting Role 

Jennifer and Chris Petty

Jennifer Petty’s husband Chris suffered a heart attack after complaining about indigestion for a few days, then experiencing excruciating pain. After receiveing stents in one artery, Chris returned home, and Petty realized what he needed most was reassurance and support. Chris also participated in WakeMed’s Cardiac Rehab program, which offered supervised exercise sessions, educational lectures and cooking classes. 

“Many patients find peace of mind in learning all they can about their condition as well as healthy habits. That’s where patient education and cardiac rehab come into play,” said Dr. Islam Othman, a cardiologist with WakeMed Physician Practices – Raleigh Cardiology. 

“[Cardiac Rehab] was empowering for Chris,” said Petty, who also changed her family’s diet to organic and significantly reduced the amount of fats, sugar and processed foods they were eating. She offered some additional advice to the family members of loved ones who experience a heart attack. 

“Let them talk and really listen to what they’re saying,” said Petty. “…Work to keep the balance, knowing that family and health should come first. It is [also] important to ask questions about your loved one’s clinical well-being. … Knowledge about the process can reduce stress for the patient as well as the caregiver. Finally, encourage your loved one to fully embrace the Cardiac Rehab program from beginning to end.” 

Advice from Survivors 

Bev Stanion

Bev Stanion and Gerry Campbell-Days each experienced a heart attack and offered advice to other women about the importance of caring for yourself. 

“Talk about your risk factors with your primary care physician. And if you don’t feel well, don’t try to rationalize it or brush off your symptoms,” said Stanion. “Women are in tune with their bodies, so it’s up to us to be proactive and take our health seriously. We owe it to ourselves and to the people who love us.” 

Since experiencing a heart attack and a second heart catheterization, Campbell-Days said it is better to adopt healthy behavious sooner rather than later. A 30-year smoker who quit in 2000, Campbell-Days knows that smoking contributed to her poor heart health. 

Gerry Campbell-Days

“I encourage women to never start smoking, and if you do, quit now. Trust me when I say that the choice you make, good or bad, will eventually catch up with you.” 

Campbell-Days also participates in the WakeMed Cardiac Rehab program, which is available at WakeMed Cary Hospital Outpatient Rehabilitation at the Kraft Family YMCA (919-350-1875) and Healthworks on the WakeMed Raleigh Campus (919-350-8602).    

Fighting the ‘Silent Killer’ 

Felecia Williams

Felecia Williams was diagnosed with hypertension (high blood pressure of 140/90 or higher) at age 29. Complications of hypertension include heart failure, renal disease, stroke and coronary artery disease. At first, Williams was frustrated and depressed, and she felt helpless over her condition. She also experienced a rollercoaster of medication side effects and a change in physician care providers, which was unsettling. 

But through it all, Williams has remained proactive about her health by finding the right physician partners to help her manage her condition and making lifestyle changes. Specifically, the DASH diet has worked well for Williams and her family. DASH, or Dietary Approaches to Stop Hypertension, is proven to help reduce high blood pressure. It includes whole grains, lots of fruits and vegetables, low-fat milk; lean meats, poultry and fish, and a decrease in fats, oils, sweets and added sugars. Between 2,300 and 1,500 mg of sodium are recommended daily. 

Dr. Sahar Amery, a cardiologist with WakeMed Physician Practices – Raleigh Cardiology, highly reccomends the DASH diet and also advises to get your blood pressure checked regularly, get regular exercise, reduce stress and quit smoking. 

Said Williams, “The inside of the body is much more important than the outside. … Health can be taken for granted until is it jeopardized. It’s a better scenario to be proactive than reactive.”

Kids learn more about sugar at Healthy Communities Day 2014.

On Thursday, July 10, WakeMed was proud to partner with the YMCA of the Triangle and Saint Augustine’s University in Raleigh to host Healthy Communities Day for the sixth year in a row. Annually, this event aims to help build a healthier community by giving free medical screenings to children who participate in Camp High Hopes, a fully subsidized YMCA day camp. The camp is made up of 800 children, kindergarten through tenth grade.

This year, WakeMed, Eye Care Associates, Wake Human Services and the Wake County Healthy Smiles program offered the children comprehensive physicals, which included a body mass index check, dental and eye screenings, a blood pressure screening and a scoliosis check.

Children at the event are also educated about living a healthy lifestyle, including advice on nutrition and physical activity. A fun-filled afternoon of fitness activities always rounds out the day.

Learn more about Healthy Communities Day here.

Hand, Foot & Mouth Disease (HFMD) is more prominent in the summer and fall, which is why many cases are popping up in Wake County right now. HFMD is a common childhood illness but can also be found in adults. The disease is wrought with uncomfortable symptoms and has no medicinal treatment; however several types of supportive therapy are recommended. Dr. Joanne Fruth of WakeMed Physician Practices – Accent Urgent Care in Cary shares more about this illness.

Signs & Symptoms
HFMD is a virus that typically begins with a mild sore throat and high fever, 101 to 103 degrees. One to two days later, sores will appear in the mouth as well as blisters on the hands and/or feet, and sometimes on the buttocks as well. Blisters can also appear around the mouth or on the arms and legs. Symptoms last for about one week. When the sores and blisters disappear, a person is no longer contagious. Dehydration can also be a concern for infants who find it difficult to drink breast milk or formula with painful sores in the mouth.

Transmission
Because it is a coxsackievirus, HFMD is transmitted via saliva or droplets created by coughing and sneezing. It is also transmitted via the stool, which makes it common within daycare centers due to diaper changes.

The blisters that come from HFMD are also teeming with virus. They are not contagious through skin-to-skin contact, but liquid from within the blisters are infectious via the mouth, nose and eyes.

Supportive Treatment
While there is no medicinal treatment for HFMD, supportive treatment is recommended, such as:

• Tylenol® and Motrin® (never give a child aspirin for a viral illness)
• Cool foods such as pudding and Jell-O®.  Sometimes cold foods like popsicles can irritate the sores in the mouth.
• Gum-numbing gels for infants
• Adults can even swish with Maalox® or Mylanta®.

When to See the Doctor

• If you wish to receive a definitive diagnosis
• If your child is exhibiting signs of lethargy and seems unengaged or is not interacting as he or she usually does (i.e. not smiling back at you)
• If you have concerns that your child is dehydrated.  This can be detected when there is a decrease in oral intake of fluids, dry mouth, sunken eyes and lethargy.  Additionally, if a baby has less than three wet diapers per day, he or she very likely could be dehydrated and may require IV fluids.
• If you have other concerns that need medical attention, never hesitate to see your doctor.

Prevention
Hand washing with warm, soapy water is always key to prevention of illness. Scrub hands together while singing “Happy Birthday” twice for effective cleaning. Additionally, avoid as much contact as possible with other children or adults who are sick with the virus, and keep sick children out of daycare or school.

While HFMD can be extremely uncomfortable, people experience different degrees of symptoms. Some can have very mild symptoms, some more extreme. Unfortunately, you can get HFMD more than once since there is more than one virus that causes it.  However, you won’t get sick with the same strain twice. Hang in there – it should be gone in a week.

Located in Raleigh and Cary, WakeMed Physician Practices – Accent Urgent Care sees adults and children of all ages and is open seven days a week. Learn more here.

This blog has been adapted from an article out of the Summer 2014 issue of WakeMed’s Heart to Heart magazine.

In hospital-speak, a Code STEMI (or STsegment elevation myocardial infarction) signifies a serious type of heart attack in which a major artery leading to the heart is blocked. For a patient experiencing this kind of blockage, time is of the essence, or as cardiologists put it, “Time is muscle.”

WakeMed cardiologist Brian Go, MD, reviews images of a patient's arteries to expedite diagnosis and treatment.

“A heart attack happens because the artery has closed down and the muscle is deprived of blood flow and thereby deprived of oxygen,” said Pratik Desai, MD, cardiologist with WakeMed Physician Practices – Cary Cardiology. “Every second counts. Every second, the myocardial cells are dying, and once the cells die, they’re replaced by scar tissue and the heart loses function. So the goal is to minimize the damage, and the way to do that is to reestablish the flow to the blocked artery as quickly as possible.”

For emergency technicians, emergency room physicians, cardiologists, the staff in WakeMed’s 24/7 Cath Lab – the only one in North Carolina – and the rest of the Code STEMI response team at WakeMed, reestablishing blood flow as quickly as possible means making a coordinated effort to ensure the amount of time between a patient’s arrival at the Emergency Department and his treatment, called “door-to-balloon time,” is as short as possible.

“The coordinated chain of care is quite amazing,” said Brian Go, MD, cardiologist with WakeMed Physician Practices – Raleigh Cardiology. “The process starts with the excellent staff, with EMS and the emergency room and proceeds all the way through to Outpatient Cardiac Rehab. The patient transitions seamlessly (and sometimes very quickly) from one care team to another. A perfect example of teamwork is seen in the Cardiac Cath Lab. … WakeMed has also supplied the resources for optimal care, such as the excellent Cath Lab staff and helicopter transportation.”

In addition to maximizing the efficiency of the process and guaranteeing the resources necessary to provide excellent patient care, WakeMed also encourages a little healthy competition among care providers with its Code STEMI Wall of Fame. This “wall of fame” in the Cath Lab boasts about the shortest door-to-balloon times achieved.

At the time of writing, Dr. Go and Dr. Desai are tied for the fastest door-to-balloon times on the Code STEMI Wall of Fame at 15 minutes for all of 2013/2014. This is significantly faster than the national average, which is 64.5 minutes, according to the American College of Cardiology’s National Cardiovascular Data Registry. At 43 minutes, WakeMed’s average door-to-balloon time is also well below the national average.

But, as Dr. Go said, time is not the only important factor, and he and all of the members of the care team recognize that sometimes the process itself is more important.

“I do take pride that for the past couple of years, I have accessed most patients with a STEMI through a radial (arm) artery, not through the groin,” said Dr. Go. “Recent studies indicate that in the setting of a STEMI, radial access may not only have benefit with decreased bleeding and hospital stay but also with mortality. Radial access is technically more challenging and can take a bit longer to prep, and it has taken me some time to get my STEMI times down to where they once were.”

WakeMed is also concentrating on helping to educate patients on the signs and symptoms of a heart attack and thus encouraging them to call 911 sooner.

“WakeMed has looked at every facet and has implemented best practices from all over the country,” said Dr. Desai. “In the process, we’ve become better than most other hospitals in the state and in the country. I’m part of the process, but the credit goes to everyone, no doubt.”

Women’s health has always been a top priority for WakeMed. This commitment to area women is most recently reflected in two national recognitions, specifically highlighting the quality of care we provide to birthing mothers and women over age 65.

Raleigh Campus Ranks Among Leading Hospitals for Low C-Section Rate
When it comes to avoiding unnecessary C-sections, WakeMed Raleigh Campus is one of the leading hospitals in the nation, according to Consumer Reports, a long-time, trusted resource for product and service research, evaluation and rankings.

The recent study looked at C-section rates among mothers anticipating a low-risk delivery at more than 1,500 hospitals across 22 states. Of these hospitals, Raleigh Campus ranked tenth. Each hospital reported at least 5,000 low-risk deliveries over a two-year period between 2009 and 2012. The rankings took into account C-section rates for all mothers (not only first-time mothers) anticipating a low-risk delivery (full-term, no multiples and baby positioned head down). They did not account for factors that may increase the risk for a C-section, such as heart problems, pregnancy-related high blood pressure or chronic diseases. The report found that only 11.6 percent of low-risk deliveries at WakeMed were delivered via C-section. The national benchmark is 12.6.

According to Bonnie Gustavison, director of Women’s & Children’s Services on the WakeMed Raleigh Campus, a C-section is major surgery and proves to be riskier for patients as well as more costly. After a C-section, the newborn has more difficulty transitioning to life outside the womb, and the mother endures a more difficult recovery in addition to an extended hospital stay. Gustavison added that the doctors and nursing staff on the Raleigh Campus are committed to supporting low-risk mothers in active labor, ensuring that the care and treatment of the mother during labor (i.e. movements and positioning) are conducive to a natural birth.

“The health and well-being of our birthing mothers and newborns is, and always has been, our top priority. To receive this ranking from Consumer Reports is a testimony to our incredible doctors and nursing staff,” commented Dr. Seth Brody, medical director of Obstetrical Quality on the WakeMed Raleigh Campus. “Their dedication to the highest quality of patient care and safety allows us to facilitate so many successful births without C-section surgery. We couldn’t be happier with the work our team is doing to deliver healthy, happy babies.”

Cary Hospital Excels in Providing Superior Women’s Health Services
Across town, WakeMed Cary Hospital was one of four North Carolina hospitals – and the only Triangle-area hospital – to receive a Healthgrades 2014 Women’s Health Excellence Award™. Healthgrades is a leading online resource for comprehensive information about physicians and hospitals. Their Women’s Health award recognizes top-performing hospitals that provide care to women over age 65 for common conditions and procedures treated in the hospital. The 15 conditions and procedures include heart attack, heart failure, joint replacement and stroke, among others.

Each year, Healthgrades evaluates and reports on the quality of hospital services provided to women across the country in three categories: gynecologic surgery, maternity care and women’s health. This year, 176 hospitals received recognition in the women’s health category, which is based on Medicare data from 2010 through 2012.

“We are proud to have received this prestigious recognition from Healthgrades and feel it is a true testament to the dedication our doctors, nurses and specialists have always shown to the women in our community,” commented Gail Sturtevant, RN, executive director of nursing for Cary Hospital. “At Cary Hospital, we will continue to strive to be a resource for area women of all ages who need various treatments and hospital-related care.”

Learn More About Women’s Health at WakeMed
For more information about WakeMed’s women’s health services, including pregnancy, childbirth and other services specific to the women in our community, visit our website.

The Raleigh Campus Farmers’ Market is now open.  Please join us in the outdoor courtyard today until to 2 pm.  

 Our favorite vendors have all returned this week, including:

 Produce

• Ball’s Berries & Produce – Offering wide variety of North Carolina-grown produce – today featuring cantaloupes, seedless watermelon, shelled peas, tomatoes, blueberries and more.
• Little River Farms – Pesticide-free produce grown – today featuring shitake mushrooms, sungold cherry tomatoes, zucchini and Russian kale.
• Grocers on Wheels – Bringing the grocery store to southeast Raleigh – today featuring specials on NC products including mild hoop cheese, honey, blackberries, blueberries and kale.  See more Grocers on Wheels products here. 
• Jones Family Farms – One of the VERY FEW certified organic farms in North Carolina – today offering green beans, okra, potatoes, garlic and cucumbers.
• Moore Family Farms – Beautiful fresh herbs and flowers – today also featuring tomatoes, jalapeno peppers, corn and cantaloupes.

Specialty Foods

• Natural Choice – Jams, jellies and German mustard – today offering first FIG PRESERVES of the season (in limited supply) as well as a special batch of apricot preserves made from sweet Angelcot apricots.
• JAM Catering Service – Canned everything from homemade hot, sweet and bread and butter pickles to chow chow to strawberry shortcake in a jar- today offering samples of the popular Neiman Marcus bars.

Other

• Allvecia Soaps – Fragrant handmade soaps, bath salts, brown sugar scrub and mango butter cream made right here in our own community
• NEW TODAY! Laura Azzi Fine Arts – Come see a wide variety of beautiful watercolor paintings for sale, also specializing in personalized pet portraits in watercolor, pen and ink.

Additionally, WakeMed’s own Sheila Debastiani, supervisor of invasive cardiology, will be singing and playing guitar for our enjoyment beginning at 11:50.  WakeMed Graphic Design Architect Julie Macie’s son Brendan will also be playing the banjo. 

 Many vendors accept credit/debit.  All vendors accept EBT.  The temperature is beautiful today.  Hope to see you at the market!

For adults and children who cannot swim, extreme caution must be used when enjoying time in a pool, lake, river or ocean. Drowning is one thing, but if someone has a near-drowning experience and seems fine after being pulled to safety, are there any implications later on? Although rare, secondary drowning could be a concern.

What is Secondary Drowning?
Secondary drowning is a lung injury that happens when a person is submerged under water and he or she aspirates a large volume of water along with salt, dirt and/or chlorine directly into the raw lungs. The risk is that the lungs’ lining, surfactant, can be washed away, creating health issues. Tell-tale symptoms, such as coughing, wheezing, fever and a change in mental state (i.e. confusion), will typically show up within six to 24 hours. A serious lung infection or brain damage could ultimately result if the person is not treated quickly.

However, a person must breathe in a significant amount of water to experience secondary drowning (more than just choking on water). Children, especially those who are learning how to swim, suck in and choke on water all the time.  This is typically nothing to worry about. In fact, secondary drowning is far less common in those who are neurologically intact. For example, if someone suffers a seizure under water, they are at a much greater risk of suffering from the condition. 

Long-Term Effects
With prompt treatment, there are usually no long term effects. Chemical pneumonitis could result but improves in a week or so. There have been rare cases of permanent lung injury resulting from a secondary drowning episode, but again, this is rare.

Prevention
Prevention is always critical near the water, especially when it comes to a child or adult who does not know how to swim. Here is some advice:

• Learn how to swim!  Swimming is a vital life skill.  A person’s chance of drowning decreases by 80 percent when they’ve had swim lessons. According to the American Academy of Pediatrics, 4 is a good age to start giving children swim lessons. Adults who do not know how to swim should take lessons as soon as possible. Contact the YMCA for adult swim lesson options and potential discounts.
• Don’t depend on the lifeguard to watch your children in the water. Ensure you are always supervising your child directly, and look for signs of struggle or exhaustion as a sign to take a break.
• Always swim in a safe environment. If a pool is not crystal clear and you cannot see the bottom, don’t swim in it.

Graham Snyder, MD, is an emergency physician with Wake Emergency Physicians, PA, and medical director of the WakeMed Center for Innovative Learning. Learn more about the emergency services at WakeMed.