DROP: Immediately drop before the earthquake drops you! There may not be enough time to run during a violent earthquake. And even though the earthquake may seem initially small, it has the potential to be the beginning of a big one. Drop immediately not only to prevent yourself from falling but also to allow you to move, if necessary.

COVER: You are more likely to be injured by falling or flying objects than from a collapsed building. Objects range from large items, like bookcases and TVs, to smaller items that can fly like picture frames or even a TV remote.

HOLD:  The floor can jerk you around and cause you to lose balance. Ground yourself to a large sturdy piece of furniture. Stay there until the shaking stops.

Afterwards, walk (not run) outside to a safe place where it is clear of trees, power lines, and anything that can possibly fall over. Preparing your friends and family for an earthquake now can prevent potential injuries and can possibly save lives in the event that “the big one” hits Southern California.

Do NOT…run for the doorway. With the exception of unreinforced adobe houses, the doorway in modern housing is no safer than any other part of the building. Drop exactly where you are, cover your head and neck with your arms, and hold onto a stable piece of furniture.

Do NOT…run to another room searching for a stable piece of furniture. It is safer to sit on the floor next to an interior wall away from glass and cover your head and neck with your arms.

Your past first hand experiences in earthquakes may have indicated that these practices are safe. Or sometimes you may have even got under the desk and others thought you had overreacted. However, you likely have not experienced the strength of an intense earthquake that is possible in a large-scale earthquake. Seemingly small earthquakes can be the beginnings of very large earthquakes. DO drop, cover, and hold.

Be aware that, according to seismic trends and history, California is due for a large earthquake that no one today has seen first hand. Stay educated about earthquake safety and keep your family safe by spreading that knowledge.

Heat illnesses progress from heat cramps to heat exhaustion then to the most severe heat illness, heat stroke.

The most common characteristics that can lead to heat emergencies include:

• • Dehydration
• • Alcohol use
• • Heart disease
• • High temperatures or humidity
• • Certain medications including diuretics, neuroleptics, phenothiazines, and anticholinergics
• • Prolonged or excessive exercise
• • Sweat gland problems

The early symptoms of heat illness include:

• • Profuse sweating
• • Fatigue
• • Thirst
• • Muscle cramps

A symptom of heat exhaustion includes being lightheaded and dizzy.

Later symptoms of heat exhaustion include:

• • Headache
• • Dizziness and lightheartedness
• • Weakness
• • Nausea and vomiting
• • Cool, moist skin

The symptoms of heatstroke include:

• • Fever (temperature above 103 °F)
• • Extreme confusion
• • Rapid, shallow breathing
• • Rapid, weak pulse
• • Seizures
• • Unconsciousness
• • Dry, hot, and red skin

If heat exhaustion is not treated, it can quickly progress into a heat stroke. Heat stroke is notably when the skin is hot and dry which indicates that the cooling mechanisms of the body (like sweating) are no longer functioning. Heat stroke is a medical emergency in which brain damage and death are possible. If any signs of heat illness occur, attempt to manually cool the body down by moving to a shaded area, removing layers of perspired clothing and/or dousing the body with cool water. If conditions do not improve, call 9-1-1.

The person loses consciousness at any time.

There is any change in the person’s alertness. (i.e. dizzy or experiencing a seizure)

Other symptoms of heatstroke are present. (i.e. dry, hot skin)

The body reaches an extremely high body temperature above 103F.

The person’s condition does not improve or worsens despite attempts to cool down the body.

Treatment for heat shock is time sensitive. Life altering effects can occur if not treated in time. The body can go into shock and brain damage, organ failure, and even death can occur. Be prepared by staying educated and do not underestimate the seriousness of heat illness.

• • Avoid strenuous exercise in the heat. Consider working out in an air conditioned gym or taking a swim instead.
• • Try working out early in the morning or later in the night. Avoid the peak hours of the day from 10am to 3pm.
• • Drink plenty of fluids every day. Many forget to keep hydrated before physical activity. So drink fluids before, during, and after physical activity.
• • Be careful of hot cars in the summer. It is NOT okay to leave the window open in an unattended car even on a mild day because temperatures can still reach life threatening temperatures.
• • Monitor those at risk including the elderly over 65, children under five, and those taking medications that can alter the body’s reaction to the heat of the sun.
• • Take breaks in air conditioned areas. Even small breaks in a cool area can help the body maintain temperature control.

As the Food and Drug Administration recently announced that they will be revising sunscreen label guidelines, consumers are left figuring out how the words on the bottle translate to protecting their skin. By looking more closely to specific ingredients and terms on sunscreen bottles, you can come to a better understanding of how to use sunscreen.

Active Ingredients: Chemical Vs Physical Sunscreens
Notable physical sunscreen active ingredients like titanium dioxide and zinc oxide are minerals that reflect or scatter UV radiation before it reaches your skin. Chemical sunscreens absorb the energy of UV radiation before it affects your skin. Sometimes sunscreens have a mix of physical and chemical in order to block a full range of UVA and UVB rays, often rendering a broad spectrum label.

Common active ingredients of sunblock and the type of UV light blocked

• Sun Protection Factor
  SPF measures how much UV radiation is required to produce a sunburn on protected skin compared to unprotected skin. As the SPF value increases, sunburn protection increases.
  ● SPF numbers are most important to use in comparison of one sunscreen to another. It does not directly indicate the amount of time you can spend in the sun before burning. This would depend on many other factors that affect amount of sun exposure like an individual’s skin type and the intensities of the sun that vary throughout the day. (http://www.fda.gov/AboutFDA/CentersOffices/CDER/ucm106351.htm)
  ● SPF numbers are only indicators of UVB protection. No system for measuring UVA protection in sunscreens is yet available in the United States.
  ● Sunscreens are not additive. This means that one layer of SPF 15 and an additional layer of SPF 50 does not equate to an SPF 65. In addition, applying half the amount will warrant significantly less than half of the protection.
  ● A minimum of SPF 15 is recommended.

Broad-spectrum
Broad-spectrum sunscreens offer protection against both UVB and UVA rays. While both UVA and UVB rays contribute to aging and skin cancer, UVB rays are the main culprit for burning. UVA rays are more of a constant concern because UVA rays penetrate windows and are present no matter the season.

• “Apply generously.”
  ● Shake well to ensure a mixed consistency.
  ● Be sure to apply enough sunscreen. For most sunscreens, use an ounce (about a handful) to cover your entire body (i.e. if you went to the beach with a bathing suit). If you are mostly clothed, you need about a size of a quarter for the neck and face.
  ● Use on all parts of your skin exposed to the sun. Don’t forget commonly missed areas like behind the neck, back of the legs, ears, sides of the face near the ears, neck, chest, and feet.
  ● Tip: Dot sunscreen evenly on the face then spread. This ensures that all areas get the same amount of protection.

“Water Resistant”
Few may know that there is a difference between water-resistant sunblock and very water-resistant sunblock. “Water-Resistant sunblock” maintains the SPF level after 40 minutes of water immersion while “Very Water-Resistant” sunblock maintains the SPF level after 80 minutes of water immersion.”

No Time to Learn?
You might stop by the drugstore along your way to the beach and be tempted to quickly grab the cheapest and most well-known brand. Instead be sunscreen savvy and look for “broad spectrum” protection, an SPF of 15-30 and one that most comfortably fits your needs. The sunscreen market is full and plenty so you are bound to find one that you like. Wear sunscreen every day and reapply, reapply, reapply!

Skin cancer is a realistic concern today. So, be smart and and be prepared by protecting yourself and the people around you.

The Elderly
Those that are 65 and older are at risk for heat illness. The ability to sense changes in temperatures in the environment decreases in speed and effectiveness with an increase in age.1 Therefore, elderly people may not feel as hot when the temperatures are high and consequently may not feel as thirsty in times of dehydration. Furthermore, the elderly are more likely to have chronic conditions and are more likely to be taking medications which can alter the body’s reaction to the heat.

Children
Those that are below the age of five have not completely developed and are also at a higher risk for heat illness. The smaller the child, the less likely he or she will be able to tolerate the heat. Children will be more dependent on others to regulate their environments and to provide enough liquids throughout the day.

People with Chronic Medical Conditions
Those taking the following medications can be more sensitive to the extreme heat and may be more at risk to heat illness.
(1) Psychotropics, which affect psychic function, behavior, or experience (e.g. haloperidol or chlorpromazine);
(2) Medications for Parkinson’s disease, because they can inhibit perspiration;
(3) Tranquilizers such as phenothiazines, butyrophenones, and thiozanthenes; and
(4) Diuretic medications or “water pills” that affect fluid balance in the body.
Consult your doctor on heat illness sensitivity if you are obese, have heart disease or high blood pressure, or take certain medications for depression, insomnia, or poor circulation.

Beware that strenuous exercise, dehydration, and being ill at high temperatures will also increase your risk of heat illness. Remember to keep cool and use common sense. Drink plenty of fluids, replace salts and minerals, wear appropriate clothing and sunscreen, pace yourself, stay cool indoors, schedule outdoor activities carefully, monitor those at risk, and adjust to the environment.

In order for an electrical fan to cool the body, there must be moisture on the surface of the skin that evaporates to produce the cooling effect. This becomes problematic (1) during heat stroke in which a person stops sweating and (2) in the case when the elderly do not sweat because of delayed heat regulation. For a fan to be effective, you must be sweating or manually add moisture to the skin (i.e. using a damp cloth).

As temperatures rise towards 100F, the effectiveness of the fan decreases. As it reaches approximately 100F, the fan begins to cause harm by circulating overheated air to the skin at a rate that is faster than the body can rid of the heat through cooling mechanisms like sweating. It would result in a consequent net increase in body temperature.

Taking a cold shower or bath would be more beneficial than a fan. The best solution would be to turn on the air conditioner or look for public places that have air conditioning like libraries, cafes, or shopping malls.

Additional Information on Heat-Related Illness and Prevention: http://www.dhss.mo.gov/Hyperthermia/HeatPrecautions.html

By Tammy Ung.

Did you know that airborne illnesses are more likely to spread especially during the summer and winter seasons? With extreme temperatures, people seek to escape the heat waves of the summer and the chills of the winter by heading indoors where the refuge of air conditioning or heaters respectively bring the body to a more comfortable temperature. It is here, indoors, that the confinement of space results in a higher likelihood of inhaling droplets of airborne pathogens from a seemingly innocent cough or sneeze of a neighbor, friend, or relative.

California’s Whooping Cough Epidemic

After the declaration of a statewide epidemic of Pertussis (more commonly known as Whooping Cough) in California mid-June, a total of three deaths in Los Angeles have been reported giving rise to a statewide total of six deaths for the state of California in 2010.

What is Pertussis?

An upper respiratory infection caused by the Bordetella pertussis or Bordetella parapertussis bacteria, Pertussis is the most commonly preventable disease through vaccination.

Symptoms of Pertussis

Whooping cough starts out like the common cold manifesting in runny noses, sneezes, coughs, and/or mild fevers. After one to two weeks after infection, a severe cough emerges in which the patient will cough until all the air in the lungs are gone. Here as the patient tries to inhale, a characteristic whooping sound is made. It is important to know that not all infected whooping cough patients make this whooping sound. Additionally, “coughing spells may lead to vomiting or a short loss of consciousness. Pertussis should always be considered when vomiting occurs with coughing. In infants, choking spells are common.”

Who is Most Vulnerable?

One out of five infants get pneumonia from pertussis and one out of 100 cases can be deadly, especially in infants. Pertussis can be most severe in infants (birth to age one) because they have not received the entire 5 shot series of DTaP (or Tdap) vaccinations against pertussis. In addition, since the first shot of the childhood pertussis immunization occurs at the age of two months, it is crucial to immunize those around new born infants.

Short Term Solution

If you suspect whooping cough, keep a distance from infants and cover your mouth when you cough or sneeze either inside your shirt or in the elbow sleeves of your shirt. A sneeze can reach a proximity of 4 feet! Remember to be consistent in washing your hands with soap and water for an absolute minimum of 10 seconds or use anti-bacterial sanitizer if water and soap are not convenient. Go to the doctor as soon as possible. Whooping cough is treatable with antibiotics.

Pertussis is a real epidemic, get vaccinated.

Long Term Solution

In addition to the typical series of childhood pertussis immunizations, the California Department of Public Health now recommends the Tdap booster vaccine for:

• “anyone 7 years and older who is not fully immunized, including those who are more than 64 years old,

• women of childbearing age, before, during, or immediately after pregnancy, and

• other people who have contact with pregnant women or infants.”

Get vaccinated and and be prepared by staying educated to prevent illness, disease, and even death.