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As the temperature drops and snowflakes fall, the risk for certain winter-related injuries increases. N. Stuart Harris, MD, MFA, director of the Wilderness Medicine Fellowship at the MGH and an instructor with the National Outdoor Leadership School, offers advice on some of the most common winter weather perils.

Winter weather safety

08/Jan/2010

As the temperature drops and snowflakes fall, the risk for certain winter-related injuries increases. N. Stuart Harris, MD, MFA, director of the Wilderness Medicine Fellowship at the MGH and an instructor with the National Outdoor Leadership School, offers advice on some of the most common winter weather perils.

It’s cold out there

The two most critically important components to staying warm and avoiding cold-weather dangers such as hypothermia and frostbite, says Harris, are being properly insulated and staying dry.

"You should wear multiple layers and adjust accordingly. A weatherproof layer on top is ideal. If you get wet, regardless of the temperature or how well-prepared you are, you will start losing heat through conduction."

If a layer of clothing does get wet, if at all possible, he advises removing the layer rather than keeping it on.

Frostbite is another hazard. "If a body part starts feeling numb, or worse yet, feels wooden and hard, go to an emergency department as quickly as possible. While in route to the emergency department, try to protect the area. If you can get it warm and keep it warm, it is OK to do so, but if you can’t be certain of keeping the part warm, let it remain as is. Warming up the body part and then letting it refreeze is even more harmful than letting it be. Never rub snow across it, as some suggest."

Factors that increase risk Harris notes that alcohol consumption as well as smoking increase the likelihood of injury due to extreme cold.

"Alcohol tends to expand blood vessels, causing you to lose more heat. More importantly, it also clouds judgment: an intoxicated person is much less likely to realize and react to the negative effects cold temperatures are having on his or her body."

Smoking is an obvious danger as well, but tends to increase risk of harm in winter by constricting blood vessels. "Both in the immediate term and over years, smoking tends to decrease blood flow to the extremities, putting hands and feet at a higher risk of frostbite," says Harris.

He further emphasizes that young children, the elderly and those with chronic diseases are most at risk for cold weather-related injuries. For these groups, it is important to be especially cautious about exposure to low temperatures.

On thin ice Cold weather means ice, and while ice-skating is a fun seasonal activity, it is not without its own dangers. Avoid ice-skating in undesignated areas, especially on bodies of moving water, i.e. a creek or river. Even if they seem thoroughly frozen, bodies of moving water can have uneven degrees of freezing -- so while the ice may be thick enough to be safe in one spot, another area, even close by, may not be.

"If you witness someone fall in, call 911 immediately and try to find something, such as a sturdy branch or rope, that you can hold onto from a safe distance while they grab on and try to pull themselves up," says Harris. "Do not risk your own safety and put your rescuers in further danger by trying to pull them out directly. If you were to fall in, the best tactic is to try to lift yourself out broadly, spreading your weight out as much as possible while kicking hard."

Handling snow - safely Using heavy machinery such as snowblowers to clear sidewalks and driveways is another common winter hazard, says Harris. If used correctly, snowblowers are safe. Used incorrectly, snowblowers routinely cause permanent injuries.

"With every large snowfall, we have a number of patients with mangled or amputated fingers and hands because they have tried to clear a blocked snowblower without turning off the engine."

He strongly advises individuals who own snowblowers to never use their hands to clear out snow from the blades.

"Even if the machine is turned off, the blades may lurch slightly when cleared and can cause severe injury," adds Harris.

Indoor risks Though most winter-related injuries occur outside the home, carbon monoxide poisoning is one indoor danger worth noting.

"On the first very cold night of the winter season, when folks first turn up the heat and close down the house so there is little air flow, emergency rooms typically see a number of people come in with possible carbon monoxide poisoning," says Harris.

The build-up of carbon monoxide, an odorless, colorless gas, is difficult to notice, but can result in serious illness and even death. Symptoms of carbon monoxide poisoning can include headache, fatigue, and ultimately, loss of consciousness. Individuals experiencing flu-like symptoms such as fatigue and headache, who believe they may have been exposed to a build-up of carbon monoxide, should seek immediate medical attention. To prevent carbon monoxide poisoning, it is crucially important to have a carbon monoxide detector at home and to check or replace its battery at least once a year.

Winter wellness In general, Harris advises exercising caution at all times and in all situations to avoid harm, noting that the above information is offered for general awareness purposes only and is not meant to replace consultation with or attention from medical professionals. "Living in New England, we get used to the harsh weather -- but we should never underestimate it. Always be prepared."

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