MEDICAL SURFARI: ENJOY WINTER THRILLS SAFELY

The first good snowfall of the winter season often inspires some winter frolicking. Although most adults prefer to sidle up to a roaring fire with a mug of hot chocolate or hot spice cider, the children waste no time getting out the sleds and scurrying for the hills. When schools close, it is not long before our neighborhoods are dotted with snowmen, snow angels, sled tracts and footprints of every size. However, winter fun carries the risk of winter injuries. Most of these can be prevented with good supervision and protective winter gear.

At our latitude, snow and ice are around for a limited time and children want to take full advantage of it. Parents and caregivers must keep a watchful eye on winter play, making certain that their children are properly dressed for the weather and setting a limit on outdoor playtime when temperatures are frigid.

Exposure to cold without adequate protective gear can result in frostbite. Dress children warmly in proper winter attire. Make certain that they wear a coat, warm socks, boots, gloves or mittens and a hat. Set reasonable time limits on outdoor play. Make them come in periodically for warm drinks. Avoid taking infants outdoors in temperature below 40 degrees. Infants lose body heat very quickly. If a child complains of numbness or pain after playing outdoors, be alerted to the possibility of frostbite. Take the child indoors and closely warm the painful or numb area using warm, but not hot, water. Immediately consult a physician.

Slippery driveways and sidewalks can be particularly hazardous to pedestrians. Keep them well shoveled and apply material to improve traction. Dress children in bright (not white) protective outerwear. All children under 10 should be immediately supervised during winter play.

In recent years nearly 22,000 children per year were treated in emergency rooms for injuries related to ice skating and nearly 34,000 for injuries related to sledding. With good supervision and extra care, children can often enjoy these winter sports without injury. Never let children skate on ponds or lakes that are unapproved. Check with local police or recreation departments to find out which areas have been approved. Never allow children to skate alone. If a child falls through the ice, he or she should stretch his or her arms over the ice and kick as if swimming to attempt to crawl back onto the solid ice. When sledding, choose terrain that is free of obstacles and far from traffic. Check carefully for snow-covered hazards such as rocks, tree limbs and stumps that could endanger sledders. Carefully inspect sledding equipment for sharp or jagged edges. Choose sledding equipment with secured hand holds, good energy absorbing pads, and easy-steering mechanisms. Avoid lying flat on a sled while riding down a hill. Always sit up --lying flat increases the chances of head and abdominal injuries.

Snow skiing, snow boarding and snow mobiling may pose risk for injury as well. When learning to ski, enroll in at least one skiing or snow boarding lesson to get started on the right track. Wear eye protection and sun protection at all times. Never ski alone and don't ski out of control. Snow mobiling especially poses risks for head injuries and this is the leading cause of snow mobile related deaths. The American Academy of Pediatrics said, "Operating snow mobiles is inappropriate for children under age 16." Anyone using a snowmobile should wear an approved helmet.

Most people associate drowning with summer months, but the increased use of hot tubs and whirlpools as well as the danger of hidden bodies of water or weak ice make winter drownings a risk as well. Always supervise children in and near a pool, hot tub or any body of water. Be aware of children overheating in hot tubs and whirlpools and make sure pools and spas that are outdoors are secured by a four-sided fence that is at least 5 feet high. The fence should have a self-closing and self-latching gate.

With proper supervision and protective winter gear, everyone can enjoy the thrills of winter sports and activities safely -- let it snow!

Worldwide web resources

These sites are a good resource for more good information on winter fun and safety.

National Safety Council

http://www.nsc.org/lrs/lib/fs/health/cold.htm

This site provides a fact sheet on "Surviving the Cold Weather," which includes preventing and treating frostbite and hypothermia.

WeatherEye

http://weathereye.kgan.com/expert/blizzard/WinterSafe.html

This site provides tips on staying safe this winter, particularly while traveling. It includes information on carrying a Winter-Survival Safely Kit in your vehicle.

The Wilderness Emergency Medical Services Institute

http://www.wemsi.on.ca/cold.html

This site discusses cold related disorders from a medical perspective. It stresses that cold adaptation is primarily achieved through proper clothing, shelter and behavior.

Dr. Scott Gibbs is a neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63701.