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NewsJanuary 9, 1998

Many winter accidents happen the moment you step out your door. Marcia Abernathy, an R.N. and director of emergency services at Saint Francis Medical Center, said most of her winter patients are people who have injured themselves after they drive or walk on slick, icy surfaces. Many of those injuries, she said, happen because people in warm houses put on their warm shoes on and then step out into the cold...

Jessica Mccuan

Many winter accidents happen the moment you step out your door.

Marcia Abernathy, an R.N. and director of emergency services at Saint Francis Medical Center, said most of her winter patients are people who have injured themselves after they drive or walk on slick, icy surfaces. Many of those injuries, she said, happen because people in warm houses put on their warm shoes on and then step out into the cold.

"Warm shoes on cold pavement equals ice," she said. "Because the shoes are warm, they melt the snow or ice just enough to make the surface very slick."

Until a person's shoes are the same temperature as the surface they're walking on, she said, falls and slips are likely.

But slippery surfaces are just one of the many winter safety hazards she and others warn against.

Abernathy said people should be wary of outdoor exercise during the winter months. Extreme cold, she said, is already a stress on the respiratory and cardiovascular systems. Added exertion like shoveling snow, she said, is often too much for the body to handle.

Older people, said Abernathy, should be particularly careful during the cold months.

John Taylor, an R.N. and a flight nurse on Southeast Missouri Hospital's LifeBeat helicopter team, said older people are much more susceptible than middle-aged adults to things like frostbite and hypothermia.

Temperature regulation systems in an older person's body may not be working as well as they used to be, he said, especially if they are ill or frail. Their blood vessels may be what is commonly called "hardened," and may not be as responsive to temperature changes.

Older people might also be taking medications that impair their temperature-sensing abilities.

"The greater their age, the greater their susceptibility," said Taylor.

Abernathy said older people should let someone know what their winter schedule is and have that person check on them periodically.

Taylor and Abernathy said children, like older people, also need special care during the winter.

When it comes to heat loss, said Taylor, a child's body operates very differently than an adult's.

"It's kind of like rocks," said Taylor. "If you put a large boulder out in the sun all day and it absorbs that heat, by the end of the evening it will still be warm to the touch. If you leave a small rock out in the sun all day and then feel it in the evening, it's going to be very cool."

Taylor said that, because of its ratio of mass to surface area, the small rock loses its heat much more quickly. Children, like the small rocks, have a large amount of skin surface for their low body masses and will lose heat more quickly than adults.

Abernathy said that when a child goes out to play in the snow, their head, feet and hands should be completely covered. She also warned parents not to dress their children too soon.

"When a child stays bundled up inside the house for a long time, they break a sweat," said Abernathy. "That moisture may cause them to get extra chilly after they step out into the snow."

As part of their Safe Kids Coalition, Southeast Hospital issued many tips for child safety, including dressing children warmly and setting reasonable time limits on outdoor play.

The coalition also recommends that parents monitor children closely while they ice skate, sled and ski.

"Kids are going to get out and play," said Taylor. "There's no doubt about that. They're going to be out there having a good time, and it's up to parents to pay attention how long they've been out there and exactly how cold they're getting."

But kids aren't the only ones who need to realize just how cold they're getting.

Taylor said over the holidays, he and his helicopter team have to rescue many stranded who have gotten hypothermia and frostbite. Incidents like these, he said, can be easily prevented.

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"If you're planning on traveling anywhere, pack your car ahead of time with things like blankets, flashlights, extra clothing and high-energy food," said Taylor. "Hot drinks like coffee and hot chocolate are also helpful to have along."

Taylor said motorists should stay in their car if it breaks down so that they can maintain as much warmth as possible until help arrives.

He said people should also stay away from alcohol, as it causes people to feel a "false sense of warmth". Alcohol causes increased blood supply to the skin, which makes you feel warm when you're actually losing heat.

Above all, said Taylor, people who go outside in the cold weather should just use their heads.

"Actually, people should probably cover their heads -- we lose a lot of heat through our heads," he said. "But people should also just use common sense and be cautious about going out in the winter time."

General tips for winter safety:

- Be careful when you first step out of your house with warm shoes on, as the warmth may cause walking surfaces to become slick.

- Avoid strenuous outdoor exercise, like shoveling large amounts of snow.

- Avoid alcohol, as it gives you a false sense of warmth when you're actually losing body heat more quickly.

- Wear brightly colored -- but not white -- clothing when you're walking during snowy conditions.

- Make sure you have a flashlight, blankets, extra clothing and high-energy foods in your car before long trips. Write down phone numbers you could call for help and keep them in your car.

- Bundle up in loose fitting, layered clothing, and wear a hat.

- Watch for frostbite and other symptoms of cold-weather exposure.

Things older people should do:

- Let someone know your winter schedule, and have them check on you regularly.

- If you have respiratory problems, be sure and cover your neck and face well before you go outside.

Things parents should watch for:

- Make sure small children don't wander out of unlocked doors into cold weather.

- Make sure your child's hands, feet and head are covered, but don't bundle them up too soon as they make break a sweat inside the house.

- Never let a child go ice-skating on a frozen pond that you haven't approved for skating.

- Never let children skate alone.

- Set reasonable time limits on outdoor play.

- Avoid taking infants outside when it is colder than 40 degrees.

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