Chilling Facts on Winter Emergencies

How parents can prevent and care for injuries

When the forecast says snow and ice, St. Louis Children’s Hospital emergency staff members, like the ones staffing the Emergency Room at Progress West Hospital, know they’re in for a busy time.  Children will run outside to play, wearing clothing not meant for the conditions.  They’ll grab their sleds, snowboards, even trashcan lids, and head for the hills. Soon after, the emergency department will fill with victims of sledding accidents, frostbite or other winter sports injuries.

Quick Resources For Parents:

• Orthopedic services provided by Washington University Orthopedics at Progress West Hospital  

• Emergency services provided by St. Louis Children's Hospital at Progress West Hospital

• Primary care family doctors and pediatricians 

• Helmet, car seat, sleep and home safety checks from Safety Stop at Progress West Hospital

• Wondering whether to come in or wait and call the doctor in the morning?  Download the Kid Care app from St. Louis Children's Hospital

Sledding fun can quickly go downhill

In the St. Louis climate, snowfall good enough for sledding only happens once in a while, so families want to get out and enjoy it while they can. Mark Manary, MD, SLCH pediatric emergency specialist, knows that in the excitement people often forget safety fundamentals. Ten years after he and his colleague, William Hollifield, MD, did a study to determine why so many children were being injured in sledding accidents, Dr. Manary still gives the same advice.  

The study showed most sledding injuries happen to school-age children at home or in a park nearby. Children younger than age 5 suffer the most severe injuries to the head, neck, face and abdomen. Dr. Manary advises parents to make sure children ride sleds sitting up — not lying on their stomachs — facing down the hill, and use a rope to steer. Because sleds can hit speeds of 10 to 20 miles per hour, Dr. Manary says parents should insist on helmets and keep all kids away from steep hills in icy conditions. 

Wearing a helmet can reduce the risk of head injury. Drs. Manary and Hollifield also found older children have more limb injuries because they tend to use their arms and legs to break falls or to avoid obstacles. The plastic sleds they often ride are more dangerous because they hit every object on the ground and usually can’t be controlled. Plus, thrill-seeking teens may look for bumpy hills that send them flying, which can cause them to land with a jolt to their spines or into the path of another speeding sled.

“Parents should always inspect the hill’s terrain before allowing their child to use it,” Dr. Manary says. In addition, sledders and ice skaters should avoid the lure of ponds, lakes and rivers that often don’t freeze solid enough to be safe. 

Aim for warm and dry

Whether a child is building a snowman, sledding, or just waiting for the school bus, parents should take precautions against frostbite, especially on days when temperatures dip and high winds blow. Because dry clothing is 20 times warmer than wet clothing, insulated and waterproof boots, gloves, jackets and hats are the best bet.

Frostbite develops when cold temperatures damage skin tissue and blood vessels. It causes the skin to feel waxy, frozen and numb, and to possibly blister. The nose, ears, cheeks, fingers and toes are the most often affected areas. 

“Small children and infants are especially prone to frostbite because they can’t express how cold they are,” says Robert Kennedy, MD, SLCH pediatric emergency specialist. 

He says minor frostbite can be treated at home by applying warm towels or placing the affected area in circulating lukewarm water for 20 minutes. Don’t use hot water because it will burn the skin. “Some people mistakenly think you treat frostbite by rubbing snow on it, but that only makes the injury worse,” he says. Also, avoid dry heat and fire. Frostbitten areas lose their ability to feel, so skin could burn easily.

If blisters develop, don’t pop them. See your pediatrician as soon as possible to help prevent infection. Then be very careful not to expose the frostbitten area to cold until your doctor has given you permission to do so.

“Previously frostbitten areas are more prone to getting frostbite again,” Dr. Kennedy says. “The best thing parents can do is prevent frostbite in the first place by keeping their kids as warm and as dry as possible.”