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    Staying Safe in the Snow: Tips for Cold-Weather First Aid

    Dr. Mary Williams, RN, DC

    About the author

    Dr. Mary Williams, RN, DC

    Dr. Mary Williams, R.N., D.C is a Doctor of Chiropractic with an extensive background as a Registered Nurse and experienced Core Instructor for the American Heart Association. She has over 30 years of hands-on medical and instructional experience.

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    With snow forts to build and snowball fights to start, winter can be a time of great fun for the whole family. But winter sports can be rough, and the season carries special dangers. Here are a few first aid tips for injuries that can occur as a result of those typical winter dangers—and ways to protect yourself and your family.

    man on an icy sidewalk

    Treat sprains, strains, and broken bones

    When ice covers sidewalks, driveways, and walkways, pedestrians are at particular risk of falls. Some falls just result in an embarrassing moment and a few bruises—but some are more serious.

    Sprains and strains occur when joints, muscles, tendons, and ligaments are stretched to injury—something that can easily happen in a fall on ice. To treat one, remember the acronym RICE. It stands for Rest, Ice, Compression, and Elevation. Here’s how you use it:

    1. Rest the injured limb. You may need crutches, a sling, or a splint, which you can get from your doctor or a medical supply store. You’ll need to keep weight off the injured limb for it to heal.  
    2. Ice the injury. Put ice on the injured area to prevent swelling; ice should be held to the injury for twenty minutes every hour. Don’t put ice directly on exposed skin; use a thin cloth for protection.
    3. Compress the injury. Wrap an Ace bandage around the injured limb or use a specialized sleeve. Compression can give the injured area support as well as helping to reduce swelling.
    4. Elevate the limb. Elevate the injured limb above the heart. This makes it more difficult for the heart to pump blood to the injured area, reducing the swelling.

    In addition, over-the-counter medications such as Aspirin, Tylenol, or Motrin can reduce pain and swelling—but don’t give Aspirin to anyone under the age of 18.

    Even minor strains and sprains should be looked at by a doctor. It’s especially important to go to a doctor if the injured person heard or felt a “pop” when they fell; if the area is numb; if the injured limb buckles when weight is put on it; or there is extensive swelling and severe pain.

    Broken bones and fractures are more serious. Don’t move the injured person unless it’s necessary in order to get them out of an unsafe area. If the bone is clearly misaligned or sticking out of the skin, don’t try to push it back into place. Instead, immobilize it. Apply a splint if you’ve been trained in how to do this; if not, help the person keep the limb still and apply ice packs to reduce swelling. Treat for shock by covering the person in blankets and elevating the legs over the heart, if possible.

    hole in the ice

    Treat hypothermia

    If your internal temperature drops to less than 95 degrees Fahrenheit, you slip into hypothermia—when the body’s temperature is not high enough to support normal metabolism functions. Children, the elderly, and people with low body fat percentages are at particular risk of hypothermia.

    Hypothermia is characterized by moderate to severe shivering, mental confusion, lack of coordination, or a heart rate that either drops or increases significantly. Extremities may turn blue, and skin may become very pale, blue, or swollen. If you suspect someone near you has hypothermia, call 911 immediately. If the person’s breathing either stops or seems very shallow or slow, start CPR.  

    If CPR isn’t needed, the first thing to do is get the person away from the cold if possible. Take them inside; or if that isn’t possible, cover the person’s head and get them off frozen ground. If their clothing is wet, immediately take it off and get them into dry clothing or wrap them in a warm blanket.

    It might seem to make sense to apply direct heat to the body—such as hot water or a heating pad. Don’t—this could lead to more injury. Instead, apply a warm compress to central areas of the body including the chest, neck, groin, and head. It’s never a good idea to try to warm the arms and legs before the rest of the body is warmed, as heat in these areas could force cold blood into the brain, heart, and lungs—which can cause the body’s’ temperature to drop precipitously.

    Other things to avoid include giving the person alcohol or massages.

    foot with frostbite


    Frostbite occurs when skin cells and the tissues underneath freeze up—damaging cell walls. It happens most often in the extremities, as well as in areas where large amounts of skin are exposed to the cold. Fingers, cheeks, chin, ears, and noses are particularly vulnerable.

    Symptoms of frostbite include skin that has turned very pale or red; skin that is hard or looks waxen; and feelings of numbness or prickling. Blisters and significant pain can occur in cases of very severe frostbite.

    If someone near you has frostbite, get them out of the cold if possible. If not, tuck frostbitten hands into the armpits; cover the face, ears, or nose. Avoid rubbing or massaging the skin, as this can cause further injury. Take off any wet articles of clothing.

    Once you’re in a warm environment, soak the frostbitten area in warm water—approximately 99 to 108 degrees Fahrenheit—for 15 to 30 minutes. The water should be warm but not hot. Avoid using direct heat, such as a heating pad or fireplace. Rewarming can sometimes be painful or uncomfortable; Advil, Aspirin, or Ibuprofen can lessen this. Avoid walking on frostbitten feet or toes.

    As frostbitten skin warms, it should turn red and sensation should return—usually in the form of a burning or tingling feeling. If the area stays numb, or if blisters develop, this is a sign of more serious frostbite that requires medical attention.

    skiing in the bright snow and sun

    Protect from sunburn

    You might not realize it, but you’re just as at risk for sunburn in winter as in summer—if not more so. Snowy ground reflects over 75% of the sun’s most damaging rays. It’s important to put sunscreen on all exposed skin before spending time outside.

    Winter is a great season for outdoor sports and play—but it’s also important to be aware and informed of potential dangers. Brush up on your first aid skills for potential cold-weather injuries, and you’ll be prepared for anything.


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