Ah, summer in Bermuda, a time for all sorts of outdoor activities, from swimming off our shores and playing in our parks to beaching, boating and biking. Being exposed to nature can also expose you to some of its hazards. Here is a survival guide to staying safe while still having fun this summer.

Unlike Portuguese men o’ war, other jellyfish often go unseen. Their shape can be described as bell- or umbrella-like, with a jelly-like substance making up its mostly transparent structure. Some do have tentacles, which hang from the border of the bell. Portuguese men o’ war are more clearly seen as a bluish bubble floating on the ocean surface. These have much longer and more dangerous tentacles that can extend up to 30 feet. These tentacles contain venom. Avoid them. Even when a man o’ war has washed up on the beach and appears to be dead with its bubble popped, its tentacles are still capable of causing injury.
If stung by a jellyfish, most people will experience nothing more than a slight itch. A red rash may develop if tentacles contact the skin. A Portuguese man o’ war sting, however, can be extremely painful. The tentacles of a man o’ war can leave a red welt that can fill with fluid.

What to do
The first thing to do when stung by a man o’ war is to rinse the area with salt water. Then remove the tentacles by lifting them away from the skin. This is best done with a pair of tweezers or towel. Next, “shave” the area with a flat, dull object (a credit card works well). Vinegar can be used to help with the sting of a jellyfish, but it should not be used for a Portuguese man o’ war. Vinegar can cause the further release of toxins into the skin. Warm compresses, an oral and/or topical antihistamine, such as Benadryl, and Ibuprofen can all be used to ease discomfort. If any swelling of the lymph nodes, lips, tongue or throat occurs, you should seek immediate medical treatment.

What not to do
Do not use fresh water to rinse the area stung, as this will cause the tentacles to release additional toxins, as will using vinegar on a man o’ war sting. Take care not to rub or press the tentacles into the skin, and never try to remove the tentacles with your bare hands.

Poison ivy has a red stem with three glossy leaves on the end. The leaves have quite pronounced veins, and they appear fuzzy from underneath. The roots, stems, leaves and fruit of the plant contain urushiol oil, the sap responsible for causing allergic reactions in sensitized people. This oil can stay potent on clothing, tools, toys, etc., for years after the initial contact is made. The main symptom of exposure to poison ivy is a red, itchy rash that will usually occur within one to three days of exposure. Often streaky in appearance at first, the rash then begins to develop oozing blisters.

What to do
If you suspect contact with this plant, wash the entire body with soap and water, preferably within 10 to 15 minutes. All clothing should be laundered. If a rash appears despite washing, cold compresses will help relieve the discomfort. Most rashes resolve themselves within one or two weeks. Antihistamines, such as Piriton or Benadryl, can be taken orally, and a topical application of calamine lotion or hydrocortisone cream can help dry up the rash and provide relief from the itch. If the rash covers more than two thirds of the body, is on the face or genital area or if signs of infection are present (pain, increased redness and pus), you should contact your doctor immediately. If the rash is severe, or covers multiple areas of the body, a doctor may prescribe oral corticosteroids and/or stronger steroid creams.

What not to do
While tempting, scratching the rash with fingernails may introduce bacteria to the area, leading to infection. Do not scratch the rash; apply a soothing compress or soak the area in the bath instead. Prevent re-exposing the body to the plant by avoiding the area of contact. Wear protective clothing if there is a possibility of coming into contact with the plant again.

Almost everyone knows a bee sting when they get one, and they hurt! It is important to call 911 if the person stung experiences trouble breathing, faintness or dizziness or a swollen tongue; be especially alert if the victim has a history of severe allergic reaction to insect stings.

What to do
If there is a history of severe reactions to stings, inject with epinephrine if a pen is available. The outer muscle of the thigh is the suggested site for injection. Scrape the area with your fingernail to remove the stinger. If tweezers are available, they work well. Apply ice and elevate the area stung if on arms or legs. If stung on the hand, remove any bracelets, watches or rings, as the area may swell. Take an antihistamine tablet, such as Benadryl or Piriton, and acetaminophen (Tylenol) or ibuprofen (Advil) if needed for pain. Keep the area of the sting clean while healing (usually two to five days) to prevent infection.

Female mosquitoes feed on blood, and as she is filling herself, she injects saliva into our skin. The proteins in this saliva trigger a mild immune-system reaction, resulting in those itchy, red bumps. In Bermuda, the majority of bites are harmless, although very annoying. To avoid being bitten, we can use insect repellent on areas of skin not covered by clothing; treat outdoor furniture with an insecticide designed for outdoor equipment; wear long sleeves and pants, as well as a wide-brimmed hat when planning to be in an area that may lead to a bite; and reduce the risk of mosquitoes around the area by eliminating standing water. Mosquitoes need water to breed, and by ensuring that water does not collect around your home, you reduce your chances of being bitten.

What to do
Often, the first sign of a bite is a white bump that will appear within minutes. A red, itchy swelling will often develop, sometimes as long as a day or two after being bitten. Occasionally, a person will develop small blisters or a harder reddish-brown bump; others will develop what looks like a bruise. In the majority of cases, itchiness is the only complaint, which can be eased by taking an oral antihistamine, such as Benadryl or Piriton, and applying a cream such as hydrocortisone or calamine lotion. Even a simple cold pack may relieve itching. If you experience increasing pain in the area, fever or swollen lymph nodes, seek treatment from your doctor.

What not to do
Although easier said than done, don’t scratch the bite. Doing so can introduce bacteria into the area, causing a more serious infection. Do not ignore symptoms such as nausea, fever, swollen glands, headache or generalized body aches that may occur. If these symptoms are present, seek immediate medical attention.


This is probably one of the most common, yet mos
t avoidable, summertime complaints. It is essential to apply sunscreen with an SPF of at least 15, covering both UVA and UVB rays, at least 15 to 30 minutes before exposure to sun. Reapply after periods of swimming or sweating, even if the manufacturer says its product is waterproof. Remember to apply to ears and lips, and wear a hat and sunglasses to protect the top of your head and eyes.

What to do

You will notice red, painful skin developing, usually peaking at 12 to 24 hours after exposure begins. This is a common symptom of what is known as a first-degree burn. Swelling, warmth, blisters, fever, chills and weakness, all depending on the length of sun exposure, can accompany sunburn. These symptoms usually indicate a deeper burn that has resulted in a second-degree burn. Most cases do not require a visit to the doctor; however, if after a few days the symptoms are not improving, you experience headache or confusion, dizziness, vision changes or draining pus from blisters, you should see a doctor immediately. Avoid the sun until your skin has completely healed, which may take a couple of weeks. Apply a cool compress to soothe hot skin. Stay hydrated by drinking more water or other nonalcoholic beverages. Take cool baths or showers to ease the pain, and apply an aloe- or vitamin-E-based lotion to keep the skin hydrated. Aloe gel stored in the refrigerator is a wonderfully cooling treat to your damaged skin. Taking aspirin (if you are able) or ibuprofen will relieve pain and reduce inflammation. In more severe cases, the doctor may prescribe oral or topical corticosteroids to shorten the course of pain and inflammation, and if infection is present, a course of antibiotics will be started.

What not to do
Do not re-expose your damaged skin to the sun. Do not engage in activities that will further dehydrate you. Prevention is best, once the damage is done, but only time will heal you. Remember, have a fun summer but limit direct exposure to sun during peak periods, apply and reapply sun block, wear a hat and protective clothing and stay hydrated.


Sea urchins are invertebrates with a globular body and spines protruding outward from the entire body. They live on the ocean floor, sometimes embedded in reefs and rocks. Some species have poison in their spines that cause pain and muscle spasms after piercing the skin; more seriously, breathing problems can occur.

What to do
Use tweezers, if available, to remove any protruding spines in the wound. Apply vinegar to the area,best done using a vinegar-soaked cloth or towel. The vinegar will help alleviate the pain. Immerse the puncture in water as hot as can be tolerated for 20 to 40 minutes. Vinegar application can be repeated if pain is still present, or an antibiotic cream, such as Polysporin or Neosporin, can be applied. There are some suggestions that applying a vinegar wrap secured by tape to the foot and left on overnight will greatly reduce pain and any further swelling on the following day. Seek immediate medical treatment if there are any changes in heart rate, any difficulties breathing or any signs that the foot may be infected.

What not to do
Do not dig at any spines left in the skin. They will dissolve on their own with vinegar application and repeated soakings. Cutting at or piercing the area with a pin or other sharp object only increases your chances of developing an infection.

Lindo’s pharmacist Rebecca White earned her bachelor of science in pharmacy at Massachusetts College of Pharmacy and has been practicing for over 16 years. She is a registered pharmacist with the Bermuda Pharmacy Council and is a member of the Bermuda Pharmaceutical Association.