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How to avoid a trip to the ER this summer

Richard Kwun, M.D.

Many visits to Barton Memorial Hospital’s Emergency Department are preventable by using a combination of common sense, preparation and safety equipment.

While Lake Tahoe provides a wealth of recreational activities, it is important to remember that you are beginning your day at an elevation of 6,200 feet and higher, depending on where your accommodations are located.

For those with lung or heart problems, acclimating yourself by spending a few nights at a slightly lower elevation can reduce the effects of altitude sickness, which can include shortness of breath, mild headaches and nausea. Do not forget your medications, even if you do not use them every day, especially albuterol if you have asthma, an oxygen tank if you have emphysema or an epinephrine pen if you have a severe allergy to insect stings. Talk to your primary physician about prescribed medication, such as ondansetron or metoclopramide for nausea and acetazolamide for altitude sickness.



Once at Lake Tahoe, and before you go on that epic hike, mountain bike ride or kayak on the lake, make sure you do not overextend yourself. If you have not hiked more than 10 miles before or biked more than 10 miles at altitude, then that hike up Mount Tallac or bike ride on Mister Toad’s Wild Ride should not be attempted. Prevention of injuries such as altitude sickness, muscle cramps and sprains begins with realistically determining what your body can handle.

Now that you have figured out what you will do, remember to start with a good night’s rest.



For outdoor activities, always bring more water than you think you need, because often times you underestimate the amount of water you will need. Dress appropriately and dress in layers, since mornings at Lake Tahoe begin cool, giving way to bright sun and 80-degree temperatures in the afternoon. Make sure you dress in bright colors on the lake, so boaters can see you easily.

For mountain bikers, full body protection – including a helmet, body armor, elbow and knee pads – can prevent or lessen the severity of concussions, sprains, strains, lacerations, abrasions and fractures. Do not forget sunglasses to protect your eyes, and wear plenty of sunblock to prevent painful sunburns.

Even with the best preparation, injuries and illness will happen. Hypothermia can occur in warm temperatures, especially if you are wet, underdressed and have prolonged exposure to water. Get out of wet clothes quickly if you feel excessively cold. If you begin to feel lightheaded and have been out in the sun all day, take a break and drink fluids, as you may be experiencing dehydration, which can lead to heat exhaustion. If your symptoms are more serious, a visit to an urgent-care center or the Emergency Department may be warranted.

Stay safe this summer, and stay out of the ER!

– Richard Kwun, M.D., is the attending physician in the Emergency Department at Barton Memorial Hospital.


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