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Sue Bush
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Surviving Winter Inside Out

By Susan Bush
12:00AM / Thursday, December 07, 2006

North Adams Regional Hospital Emergency Department Medical Director Dr. Paul Donovan
North Adams - Sometimes cold weather threats are detected indoors.

Elderly folks, who may be impacted by fixed incomes and rising fuel costs, may be unwittingly putting themselves at risk for hypothermia, warned North Adams Regional Hospital Medical Director Dr. Paul Donovan.

A Risky Equation

In an effort to save money and conserve heating fuel, elderly individuals will often lower a home thermostat. The consequence is a lowered room temperature which, coupled with an inactive lifestyle, a drafty home or compromised nutrition, can lead to varying levels of hypothermia, Donovan said. Prescription medications and existing medical conditions may contribute to the risk of an indoor case of hypothermia.

"This can happen with elderly people who live at home and turn the thermostat down to save money," he said. "They may be affected by a combination of medication, medical condition, inactivity and a cold home."

Hypothermia is defined as a living body temperature that drops to below 95 degrees Fahrenheit, Donovan said. Confusion, dizziness, and lethargy are included among the signs that hypothermia may be occurring and people who are not treated may become comatose and sustain heart damage. Hypothermia can lead to death. Friends or relatives who suspect hypothermia should seek medical help immediately.

Babies And Layers

Babies are also at greater risk for hypothermia.

"The younger you are, the higher your metabolism has to be to maintain body temperature," he said.

Layered dressing and blanketing works well for babies because babies are very susceptible to changes in temperature, Donovan said. Their smaller bodies are affected quickly by heat and cold, and layering permits a rapid response to temperature changes, such as leaving a very warm home and entering a cold car or exiting cold spaces and entering warm rooms. Beware of wrapping anything tightly around a baby's mouth and nose and closing off oxygen pathsways.

Wet And Cold? Get Inside Fast!

Outdoor hypothermia is usually brought on by prolonged exposure to cold air temperatures or in situations that result in getting wet while outdoors, such as falling through an ice-covered pond or into a river or stream. Those who have become wet while outdoors in cold temperatures should seek medical attention immediately.

Woodstove Safety Tip

Another indoor risk brought on by cold outdoor temperatures occurs when folks place pots of water atop functioning woodstoves to add humidity to the air.

The pots and the water inside can become quite hot and if the pots tumble from the stove, anything below, including a child, can sustain serious burns, Donovan said. Children and pets should find safe, heat-resistant barriers between themselves and woodstoves, fireplaces or other hot appliances, Donovan said.

Let Common Sense Reign

Frostbite, slip-and-fall injuries, head trauma; these conditions and more arrive at hospital emergency departments throughout New England during most winter seasons.

In many cases, injured folks are given medical treatment and the incident becomes a chapter of family lore, but there are times when injuries result in permanent damage or death.

It's a common sense approach to icy surfaces and bitter cold temperatures that will carry most people safely though the winter, according to Donovan.

Dry coats, gloves or mittens, and hats provide barriers to frostbite and hypothermia, while winter-appropriate footwear can protect against falls as well, Donovan said. He reiterated the oft-dispensed wisdom of layered dressing and also echoed warnings against cotton clothing next to the skin.

"Stay away from cotton next to the skin," he said. "When it gets wet, it stays wet."


Fingers, toes, ears, noses, cheeks; these skin surfaces are usually the areas most often left exposed to cold air. Frostbite most often appears as a white patch or area and fingers or toes may appear club-like, Donovan said.

Treatment includes re-warming the affected area using warm, not hot, water. If the situation occurs during camping or other remote outdoor activity, the affected person should be brought to a safe location with appropriate facilities to avoid a frostbite recurrence, Donovan said.

"You do not want to rewarm an area and have it re-freeze," he said. "That is when real damage can occur."

"Real damage" includes infection, and irreversible skin, tissue, and nerve damage and severe frostbite has led to amputation, Donovan said.

Re-warming an area affected by frostbite can be painful and produce tingling sensations, Donovan said.

From Top To Bottom

Snowmobile aficionados often wear helmets and the example should be followed by other outdoor sports enthusiasts, Donovan recommended. Head injuries caused snowboarding, skiing, and even neighborhood sledding accidents are not uncommon during the winter, and protective head gear can offer some protection.

Fashionistas - who may be loathe to trade in flimsy high-heeled boots with little traction for the practical but often less attractive winter-soled footwear - have found themselves perched on ER examination tables with shredded pantyhose, broken bones, sprained ankles and bumps and bruises incurred from falls on icy sidewalks or slick parking lots, Donovan said.

A simple precaution means trading in "fashion footwear" for shoes or boots designed for winter wear, he suggested.

Flu shots are strongly recommended for the young, the elderly, and those with chronic health conditions, Donovan said. Safety on the roadways is improved when folks slow down during winter driving conditions, he noted.

Carbon monoxide and smoke detectors should be installed in homes and be in working order.

Shoveling Snow

And while certain chores may be necessary during the winter months, those who are often found in prone positions clutching remote controls may want to proceed with caution, he said.

Snow shoveling requires considerable exertion and those who are typically inactive are probably not in the proper physical condition for the task.

"Someone who hasn't been off the couch in months and is now outside shoveling snow has to be careful," Donovan said.

People should remember to move snow around in small, light-weight amounts as opposed to heaping mounds of snow onto a shovel, or trying to push dense amounts of snow manually. If possible, it may be advisable to pay someone to clear the driveway or sidewalk.

"Because of the cold stress in the winter, people need to be aware of their physical condition and be careful," he said.

Vision is impaired during the winter because of the early sunsets and resulting darkness, so illuminated walkways and drives can reduce the incidence of slips and falls, Donovan said.

Keep Hands Away From Moving Parts

And there is a behavior that can be completely avoided that would eliminate a very specific injury, he noted.

"Every year, we have a dozen or so hand injuries from people who put their hands inside a snowblower while the blower was turned on," Donovan said. "Please tell people not to do that. If the snowblower gets clogged or jammed, turn it off before you stick your hands up into it."

Susan Bush may be reached via e-mail at or at 413-663-3384 ext. 26.
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