Medicine From The Trenches

Experiences from undergradute, graduate school, medical school, residency and beyond.

Extreme Weather

In many places, especially upstate New York, the snow has been falling and piling up and falling some more. The temperature has been cold and at least one of the Great Lakes (Lake Erie) is frozen over. Our gifts from our Canadian neighbors from the north has been one “Alberta Clipper” after another.
I have enjoyed the fine, dry white powder. It has kept crime down in some of the major cities, (Cleveland and Chicago) and had covered the ski slopes with a great base. I was wondering for a good portion of this winter, if the temperature would ever get cold enough to even make snow, much less have a good base of the real thing.
I learned to ski on the slopes of Alta and Park City in Utah. The snow was always fine powder and very forgiving. When I attempted to come down the intermediate slope at Massanutten Mountain (near Charlottesville, VA), I found that the granular “man-made” snow became a sheet of sheer ice as I moved down the slope. After nearly colliding with a troop of beginners near the end of the run, I vowed to always wait until there was at least a couple of natural snowfalls before I headed back to Massanutten. I would travel to White Tail or Wisp rather than risk my life on an ice slope.
The other thing that this cold weather has brought, is people who are suffering from hypothermia. The young and the elderly are especially at risk. The patients can range from an elderly person who gets locked out of their car or house without proper protection to a child who loses a glove or mitten on the way to school. When the wind chill temperatures are below zero, skin freezes in a matter of minutes.
I have had patients who have been elderly folks who ran out of money for fuel and ended up in a house or apartment that they were attempting to heat with an oven or space heater. The oven or heater just won’t warm the large space enough for them to not suffer from hypothermia. As the temperature gets colder, they become disoriented and lethargic; only to be discovered by a relative or friend and brought to the hospital.
At the hospital, we have to warm them very carefully using heating blankets, warn intravenous fluid and if extreme, a heart-lung machine. In the interim, we check hands, feet and face for frostbite which can result in the loss of fingers, toes, nose or ears. The cold can be quite unforgiving in this respect.
Other patients have been people who skid off the highway in snowy conditions without being able to get out of the car or signal for help. Sometimes the snow may be falling so fast and so quickly, that the tracks leading off the road may be covered very quickly especially during daylight hours when car lights are not as visible.
A couple of years ago, on a Christmas Eve, a patient was brought into the Emergency Department who had fallen asleep at the wheel and driven over a 50-foot embankment. A car that was in front of this gentleman had noticed that the car lights from behind were no longer present. He turned around at the next exit and went back (driving a total of 10 miles out of the way) only to discover car tire tracks heading over the embankment. He used his cell phone to call for help but was unable to reach the car that was well down the embankment.
By the time the EMS arrived on the collision scene, the driver of the car that had gone over the embankment had attempted to climb up the 50 feet onto the road. When we received him, we used hot blowers and warm intravenous fluids to get his core temperature up from 95F. We also removed a badly ruptured spleen and found several thoracic vertebral fractures in addition to multiple broken ribs. He had climbed 25 feet with a flail chest, vertebral fractures and a ruptured spleen in addition to hypothermia.
So as the weather stays cold and snowy, check on any and all of your neighbors. Make sure that they are all present and can be accounted for. Our other source of trauma patients has been pedestrians who are walking in the street because sidewalks have not been cleared. Shovel your sidewalks and shovel your neighbor’s sidewalk/drive (if they can’t).
Don’t forget the car kits: candles and matches in a waterproof container, blankets and nutrition bars in case you get stranded in the cold. Keep your cell phone handy to call for assistance too.
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18 February, 2007 - Posted by | hypothermia, snow

1 Comment »

  1. We’re in Massachusetts so thank goodness we haven’t been hit with snow that hard, but it is still incredibly COLD! My 2 yo. was out of the house with me for no more than an hour(bundled up of course)on Sat. to go food shopping and now has an awful cold/fever 😦

    Comment by Jacqueline | 19 February, 2007 | Reply


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