It’s no surprise that summer in Wissahickon Valley Park is the most popular season. And with the All Trails Challenge (fow.org/alltrailschallenge/), which started in May, running all summer long, some visitors may be exploring unfamiliar parts of the park’s 50 miles of trails and encountering new conditions. Friends of the Wissahickon’s year-round goal is for everyone to leave the park happier and healthier than when they came in, but summer presents special challenges, from heat and humidity to ticks and poison ivy.
Dr. Lee Jablow, Medical Director of the Department of Emergency Medicine at Chestnut Hill Hospital, one of our community partner organizations, provides the following tips to keep safe when enjoying the Wissahickon this summer.
Simple Ways to Avoid the Emergency Department
Patients are often admitted to the hospital because they didn’t keep up with hydration. Most people need 64 ounces of water a day — about eight ounces every two hours while they’re awake — and more if they’re sweating and in warm weather. During vigorous exercise, additional water is lost not just in the form of sweat but also in exhaled water vapors from heavier breathing. Philadelphia’s high summer humidity makes it even harder to cool down. Working muscles too hard without adequate hydration can be serious business, potentially leading to a condition called rhabdomyolysis and a week-long hospital stay and risk of kidney damage. Prevention is simple: hydration and pacing your exercise.
Second, patients often come to the emergency department after mild overexertion or a relatively minor injury. We would generally administer a nonsteroidal anti-inflammatory drug (NSAID) by injection. Truthfully, it works the same as an over-the-counter NSAID, such as ibuprofen, that you could take on your own. Keep this medicine with you and try it first before heading to the ED. Rule of thumb: If the pain doesn’t improve in an hour or gets worse, seek medical attention, and tell the ED caregivers what pain medication you took and when. (Note: Avoid NSAIDs if you have kidney or heart disease, diabetes, or bleeding issues.)
Watch Your Step
If you’re running on the trails, you tend to focus your vision straight ahead, so it’s easy to lose sight of what’s under your feet, including tree roots, branches, and uneven surfaces. It’s the reason we see a lot of FOOSH — fall on outstretched hand — injuries from people instinctively reaching out their arms to catch themselves after tripping and falling forward. It’s the most common of the so-called defensive injuries and results in a break at the end of the forearm just before the wrist bone.
Also, remember to protect your head. When riding a bike or climbing, please wear a helmet at all times. That goes for horseback riding, too.
Common First Aid Mistakes
A big one is using hydrogen peroxide for minor cuts and scrapes. Patients think peroxide’s bubbling action means it’s working, but it actually impairs natural wound healing. All you need is plain soap and water. To control more serious bleeding, the first line of defense is to press a single fingertip very hard against the wound. This distributes greater force directly to the area and compresses it with more pounds per square inch than using additional fingers or the palm, which can diffuse the pressure.
Another one is tick removal. We live in a heavily endemic area for Lyme ticks, so it’s not unusual to find that one has hitchhiked a ride home with you from the park. The best way to remove the entire tick is not with tweezers, which can leave pieces behind, but by wetting a sponge with soapy water and making small circles for about 60 seconds, then larger circles for about four or five minutes. Although it takes about 36 hours for a tick to attach itself, bite, and transmit the Lyme pathogen, it’s best to shower soon after being in heavily wooded areas. Then, do a body check (or have someone do it for you) and keep in mind ticks like to hide in moist, dark areas such as armpits, groin, behind ears, etc.