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Winter Health Hazards: Heart Attacks, Broken Bones, and More Oh My!

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editors: Melissa Conrad Stöppler, MD

Sports aren't the only venues that use scoreboards. Find a hospital emergency department on the first big snowfall of the year, and there may be a running tally of a few common injuries and illnesses. Morbid humor sometimes allows the nurses and doctors to deal with the next patient rolling through the door. While the calendar may technically reflect autumn, an early December blizzard and blizzards throughout the winter will challenge the capacity of emergency services ranging from first responders to emergency departments and operating rooms.

A large amount of snow usually means a large amount of shoveling, and the first listing on the scoreboard is, with apologies to Fred Sanford, "the big one." Clearing a sidewalk or driveway is an aggressive exercise and requires plenty of aerobic capacity to lift and toss shovels full of snow. It's like taking a cardiac stress test without all the medical people around. If there are blockages and narrowing in the coronary arteries (that supply the heart muscles with oxygen), the extra effort required of the heart to push blood to those exercising muscles may be enough to outstrip the heart of its own blood supply and cause a heart attack (myocardial infarction).

Snow and sliding go hand in hand. Unfortunately, snow and sliding also equal falling; the broken bones that result also can be listed on the scoreboard. While kids seem to bounce, that ability is gradually lost as we age. When older folks get the mail or try to sweep the porch, a fall and landing on their back or side might break a hip, while falling forward on an outstretched hand may cause a wrist or elbow to fracture. Remember that break, crack, and fracture all mean the same thing; the integrity of the bone is lost. The big question is whether an operation is needed. For hips, the answer is almost always yes. Regardless of how the injury is treated, the sad result is some loss of independence while healing and rehabilitation occur.

Number three on the scoreboard are finger injuries. While heart attacks and broken bones aren't often foreseen, this injury is almost always preventable. The story goes like this: while using a snow blower, the person reaches into the chute with his or her hand to remove a snow clog and quickly loses the tip of a finger or two. Even if the machine is turned off, the impeller has enough force to chop things when it is relieved of the snow and ice buildup. The injury usually requires the damaged tissue and parts of bone to be cleaned and removed. A shortened finger usually has a good functional outcome, but there may be a cosmetic downside.

When snow storms start to blanket the ground, it's no wonder that cardiologists and orthopedic surgeons want to have low numbers on the ER scoreboard. The hospital is a place nobody wants to visit (except for the newborn nursery), and while injuries and illnesses do pay the bills, most doctors would prefer preventive maintenance instead of emergency body repair work.


Last Editorial Review: 12/11/2008






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