As the parent of four very active children, Dr. Shaneka Kulasingham is no stranger to taking precautions to prevent medical emergencies while travelling.
And as an emergency physician at St. Joseph’s Healthcare Hamilton in Ontario, Kulasingham is also abundantly familiar with the common emergencies that people face in the summer.
As Canadians enter another hot season, experts like Kulasingham recommend taking preventive measures to protect against injuries, summer heat and bugs — and to seek professional medical help if regular first aid doesn’t provide relief.
Dr. Shaneka Kulasingham is an emergency physician at St. Joseph’s Healthcare Hamilton and an assistant clinical professor at McMaster University’s department of emergency medicine. (Submitted by Shaneka Kulasinghman)
“With the warmer weather, longer daylight hours and everyone is out more, [focus] a little bit on prevention,” Kulasingham told Dr. Brian Goldman, host of The Dose podcast.
Kulasingham also says basic medication like Advil and Tylenol, non-drowsy antihistamines like some formulations of Reactin and Claritin, as well as nausea-relief medication like Gravol are all useful to include in a first-aid kit.
Orthopedic injuries become more common in summer
As people spend more time outdoors in the summer, Kulasingham says her emergency department sees more orthopedic injuries, like broken bones, sprains, strains and tears.
“Make sure that you’re wearing protective gear,” she told Goldman.
Helmets, knee pads and elbow pads are all useful.
She acknowledges that different people have different pain tolerances. But something like a rolled ankle that can bear weight with minimal discomfort likely doesn’t need major medical intervention, she said.
Instead, some combination of PEACE and LOVE recovery should be enough to heal the injury. That strategy emphasizes rest in the first few days of an incident, then a slow reintroduction of physical activities.
“If the pain persists, there’s swelling and more bruising, then probably you need to have at least your family doctor or an emergency visit to check that out,” she said.
Reducing harmful heat exposure
Whether it’s the heat, humidity, or both, summer weather can be excruciating without protection.
Heat-related illnesses are the No. 1 most common health hazard in the summer, according to Frankie Garcia, a registered nurse who works for Summit Health Travel Clinics in Toronto.
Heat cramps are typically muscle cramps and spasms, often in the legs and abdomen, paired with heavy sweating.
Maria Mejia is a training co-ordinator with St. John Ambulance’s national office in Ottawa. (Submitted by Maria Mejia)
Without relief from the heat, they can escalate to heat exhaustion. Symptoms include heavy, profuse sweating, fatigue, nausea, dizziness, headache, a rapid pulse, feelings of weakness and cool, pale and clammy skin.
If body temperatures rise to 40 C, people can experience confusion and other neurological side effects, including disorientation, seizures, slurred speech and loss of consciousness.
“What causes heat stroke is a complete shutdown of the ability of the body to cool itself completely,” said Garcia. “This is an emergency at this point.”
In these instances, people should seek immediate medical attention, go to a cool place, remove excess clothing and cool the body using ice packs or cold water.
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When it comes to burns — whether from the sun or from spilling a hot beverage by a campfire — Kulasingham says the first step in treatment is cooling off the affected area until the initial sting fades.
She also said to avoid re-exposure to strong heat or sunlight.
Anti-inflammatories like Advil and Aleve can help, while antibacterial ointments like Polysporin can ensure that burns don’t get infected.
Dealing with insects
Summertime means bugs, as anyone who’s ever spent any amount of time outdoors can tell you. That includes ticks, wasps and mosquitoes.
Among the most effective repellants is bug spray with the ingredient DEET, she said, which makes it hard for bugs to smell humans.
Dressing appropriately can also help. Long-sleeve clothing, tucking shirts into pants and pants into socks can help prevent tick bites, for example.
In the event of an insect bite, however, Kulasingham reassures that the “majority of bites do not get infected.”
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“Unless you’re having an anaphylactic reaction … most bites tend to cause a local reaction,” said Kulasingham.
Calamine lotions, antihistamines and cold compresses can help reduce the discomfort of an insect bite, she says.
Lyme disease — an infection transmitted to humans through tick bites — is of particular concern during the summer, as well as anaplasmosis, another disease spread by the same ticks.
If patients suddenly develop flu-like symptoms or rashes after being bitten by an insect, that’s a sign to speak with a medical professional, Kulasingham says.
First-aid kit essentials
Whether going on a hike or camping trip, most health experts recommend a first-aid kit.
Frankie Garcia is a registered nurse who works for Summit Health Travel Clinics in Toronto. (Submitted by Frankie Garcia)
Maria Mejia, a training co-ordinator with St. John Ambulance’s national office in Ottawa, recommends the following:
Adhesive tape
Adhesive bandages and “butterfly” bandages, to cover small cuts
Roller gauze, for absorption of fluids like blood and securing a splint
Sterile gauze, for covering and cleaning wounds
A few triangular bandages, to make an arm sling
Splints, to immobilize bone and soft tissue injuries
Disposable bags, for waste and to make ice packs
Sterile saline, to flush out wounds or eyes.
Space blanket, to reduce heat loss and prevent hypothermia
Non-latex gloves that fit well
A CPR face shield or pocket CPR mask to deliver rescue breaths if needed
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
