When the forecast says snow and ice, the St. Louis Children’s Hospital emergency staff knows 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 and even trash can lids and head for the hills. Soon after, the emergency department will fill with victims of sledding accidents, frostbite or other winter sports injuries.

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. In our excitement, we often forget safety fundamentals. The same advice that was given a good 10 years ago is still true.

Most sledding injuries happen to school-age children at home or in a nearby park. Children younger than age 5 most commonly suffer severe injuries to the head, neck, face and abdomen. Advice for parents is 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, parents should insist on helmets and keep all kids away from steep hills in icy conditions.

Older children experience 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 in the path of another speeding sled. Parents should always inspect the hill’s terrain before allowing their child to use it.

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 or mittens, jackets, and hats are your best bet. For increased warmth, dress your child in layers and use mittens instead of gloves. Make sure little ears are covered, too.

Consider limiting time spent outdoors, taking breaks inside to replace any damp clothing. Examine the skin for any changes and offer warm fluids before sending your child back into the colder temperatures.

Frostbite develops when cold temperatures damage skin tissue and blood vessels. It causes the skin to feel waxy, frozen and numb, and possibly to 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.

Minor frostbite can be treated at home by applying warm towels or placing the affected area in circulating lukewarm water for 20 minutes. Do not use hot water because it will burn the skin. 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. The best thing a parent can do is prevent frostbite in the first place by keeping their kids as warm and as dry as possible.


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