Public Service Announcement: Staying Safe in the Cold From the Canadian Medical Association

OTTAWA, Jan. 20, 2012 /CNW/ - The key to surviving a Canadian winter, it's widely agreed, is to embrace it. Shutting the door in November and spending five months longing for spring just isn't good for you, physically or mentally. Much better, for your heart, your mood and your health, to get outside and get some exercise.

It's true; there are some risks to winter.  But with proper clothes and sensible precautions, only the most extreme cold temperatures need come between you and the benefits a Canadian winter can offer.

Assuming the weather isn't severe enough to pose an actual threat - and of course, most of the time it isn't - you should go out and enjoy the fresh air, properly dressed. That means lots of layers, as well as hats, gloves and waterproof gear.

"Children and the elderly are more vulnerable to cold, and kids in particular are prone to get so excited in their games they ignore chills," notes CMA President Dr. John Haggie, "So keep a close eye on them and limit time outside when it's really cold."

The most common injuries suffered in the cold are frostbite (and its less-severe version, frost nip) and hypothermia (where the body's temperature drops dangerously low). In frostbite, body tissues freeze, and extremities — fingers, toes, ears and noses — are most vulnerable. Mild frostbite, or frost nip, turns skin white and numb. It's more serious when skin is white, blotchy or blue. In the worst cases, the tissue under the skin freezes.

All types should be treated the same way, with gentle rewarming, either in a bath just above body temperature, about 40°C, or with warm breath. Don't apply heat directly to the skin, and don't rub affected areas — that can move frozen cells around and damage other cells. Finally, don't try to rewarm skin until the victim is somewhere warm where they can stay warm (going back into the cold with partially warmed skin can lead to even greater tissue damage).

Hypothermia also has degrees of severity — starting with complaining of cold, all-over shivering, and numbness in the same areas affected by frostbite — fingers, toes, ears and the nose. You'll know it's more serious if the victim's speech or movements are uncoordinated, and he or she seems confused, or acts oddly. People with severe hypothermia no longer feel the cold. In many cases, the confusion and impaired judgment they suffer are what lead to death: people with severe hypothermia are apt to make bad decisions about how to help themselves.

Severe hypothermia requires emergency medical attention, but first aid is much the same as for frostbite — remove wet clothing and gently start rewarming the victim.

Cold is not the only hazard of winter. Data from the Canadian Institute of Health Information show that people who do venture out find quite a lot of ways to hurt themselves. Injuries from hockey have actually dropped in recent years. In 2004-2005, 1,093 Canadians were admitted to hospital because of an injury playing hockey; that number was 907 in 2008-2009. Pleasure skaters do a little better, with between 600 and 650 people per year admitted to hospital.

Snow is generally softer than ice, but there's a lot of speed and hazards involved on the slopes. The number of people admitted to hospital after skiing and snowboarding mishaps was 1,812 in 2008-2009.

"Knee injuries are the most common in downhill skiers," says Renata Frankovich, an Ottawa physician and member of the board of the Canadian Academy of Sport and Exercise Medicine. Skiers twist their knees and tear the ligaments." Broken wrists are the big problem for snowboarders, because they reach out their hands to save themselves when they fall.

Helmets and other protective gear are important in sport, but so is knowing your abilities and your limitations, Dr. Frankovich says, "Going beyond your ability is often a factor, in every sport, maybe it's going down a run you're not skilled enough for." Fatigue is also a factor, Dr. Frankovich says, with many people saying they hurt themselves on the last run of the day. As you tire, you may lose control, and as the sun begins to set daylight fades as well, making it harder to see hazards.

The most dangerous outdoor activity of all, however, is snowmobiling. Excessive speed, often unfamiliar terrain and, all too often, alcohol, combine to produce the most severe winter injuries, including broken spines. When that happens, victims don't just face missing one season on the snow; many are affected for the rest of their lives.