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ER doctor’s advice on how to avoid getting injured on icy streets

VANCOUVER — An emergency room doctor says hospitals see an increase in injuries during winter months due to slippery streets and sidewalks.

Dr. Afshin Khazei, from Vancouver General Hospital said the spike in ER visits due to falls is “somewhat predictable.”

“Every year when we get the cold spell, icy sidewalks, we see a surge of people coming in who’ve had a fall.”

The most common injuries are fractures and sprains to ankles and wrists.

“Our natural tendency when we fall is to outstretch our arm and catch ourselves with our wrists,” Khazei said.

Ankles can get twisted when feet slide out from under the person as they start to slip.

What are the best ways to prevent a fall?

Khazei said when it comes to fall prevention, proper footwear can go a long way.

“Before you leave the house, make sure you’ve got the right shoes on. Make sure it has the right tread. Ideally, put crampons on,” the doctor advised.

Rubber boots aren’t ideal for icy conditions, he said.

He also suggests slowing down, and leaving a bit early so you don’t feel rushed.

“If you see an icy patch, don’t try to run through it. Walk through it like a penguin – slow, shuffling steps,” he said.

Khazei also advised looking ahead to next year by starting an exercise regime that includes core strengthening, co-ordination and balance, such as yoga or tai chi.

“Those things actually help reduce the risk of falls as well,” he said.

When should I go to the ER?

The first thought for many when they’ve been injured is to head to the nearest hospital emergency room, but Khazei said there are other options as well.

Primary or urgent care centres could be an option depending on severity.

Several centres have opened within the past year, he said, and were opened specifically to help patients who need to see a doctor that day.

Those who are in need of urgent care but not in a life-or-death situation could choose a primary care centre over an ER.

“So things like a wrist sprain, an ankle sprain, possible minor fractures, lacerations and other minor illnesses like a chest infection, urinary infection… those kinds of things would be ideal because they do require timely assessment, but they don’t necessarily need the expertise and resources in an emergency department, which is set up for life-threatening problems,” he said.

Khazei was asked whether ERs are overtasked during winter months due to slip-and-fall injuries.

“I think what happens is our teams in the ER always have to give priority to people with life-threatening problems,” he said.

For example, a person seriously injured in a car crash, or a patient having a heart attack or a stroke would get help before someone with a sprained wrist.

“As a result, when several hundred people fall on the sidewalk in one day, and they all go to the emergency department, it does result in longer waits,” he said.

“So really from a patient perspective, these urgent care centres are another place to access the type of care when it’s not a life-threatening problem.”

Care from the centres is still covered by MSP. Khazei said they were built to “fill a gap” in the public health care system, and hopefully improve wait times.

Generally, his advice is not to go to an emergency room. However, if there is any concern that the fall could be more serious – for example, if the patient hit their head when they fell and is vomiting and dizzy – they should go to the hospital.

Wait times at hospitals and urgent and primary care centres in Vancouver, Richmond and on the North Shore can be monitored online. http://www.edwaittimes.ca/WaitTimes.aspx

As of Tuesday afternoon, the wait time at St. Paul’s Hospital was about two hours, while the wait at the City Centre Urgent and Primary Care Centre – also downtown – was just 16 minutes.

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