Shoveling snow safely: heart attack risk, technique, and warning signs¶

Shoveling heavy snow in the cold is one of the few household chores that can bring on a heart attack in an otherwise healthy looking adult. The work is hard, the air is cold, and the people doing it are often older, out of shape, or already living with heart disease they do not know about. Emergency departments see a wave of chest pain, back injuries and falls after every major snowfall.

This guide explains why snow shoveling strains the heart, who is at the highest risk, how to shovel with less strain, which warning signs mean you must stop at once, and what to do if you or someone near you collapses. For the broader picture of cold weather exertion, see snow shoveling and heavy exertion in extreme cold. For the heart attack itself, read heart attack.

Laksanayang niki mangkin¶

1. Suud nyedok lan negak yening ragane ngrasayang tekanan dada, sesak, meremas, sakit ring lengan, rahang, leher utawi punggung, sesak napas, sirah ringan, utawi peluh dingin. Sampunangja semeton mautsaha muputang pakaryane punika.
2. Call your local emergency number (911 in the United States and Canada, 112 across the European Union, 999 in the United Kingdom). Say that you think someone is having a heart attack. Other countries are listed on the nomer darurat halaman.
3. Sit or lie in a position that is comfortable, loosen tight clothing, and keep warm with a coat or blanket. Unlock the door and turn on an outside light so responders can find you.
4. If the person collapses, is not responding and is not breathing normally, start CPR at once and send someone for an automated external defibrillator (AED). See CPR.
5. Do not drive yourself to the hospital. Do not wait to see if the pain passes. Ambulance crews can start treatment on the way.

Why shoveling can trigger a heart attack¶

Several things happen at once when you shovel snow in the cold. Each one adds stress, and together they can overwhelm a heart that has narrowed arteries.

• Cold narrows blood vessels. Cold air makes arteries tighten, which raises blood pressure and reduces blood supply to the heart muscle.
• Heavy lifting raises heart rate and blood pressure. Lifting and throwing snow is an isometric effort, like lifting weights. It pushes heart rate and blood pressure up quickly, often more than a brisk walk or a treadmill test.
• Holding your breath makes it worse. Many people hold their breath when they lift. This raises pressure in the chest and strains the heart further.
• Cold air makes blood stickier and more prone to clotting. In some people this raises the chance that a clot forms on a plaque in a heart artery.
• People rush. There is a plow coming, a car to dig out, or an appointment. The urge to finish quickly makes people skip breaks.
• Breakfast and sleep matter. Shoveling before eating, soon after waking, or after a night of poor sleep puts the heart under extra stress.

A study of snow shoveling injuries in the United States found that emergency departments treated more than 11,000 shoveling related injuries and medical emergencies each year, and heart problems were the main cause of deaths. The American Heart Association (AHA) and the Mayo Clinic and other cardiology groups warn that adults who are inactive most of the year are especially vulnerable.

Who is at highest risk¶

Anyone can be hurt, but the risk is much higher for the following people. They should avoid shoveling altogether and arrange for help.

• People who have had a heart attack, bypass surgery, a stent, or have known heart disease
• People with high blood pressure, high cholesterol or diabetes that is not well controlled
• Smokers and former smokers
• Men over 45 and women over 55, and anyone else with a strong family history of early heart disease
• People who are overweight or who do not exercise regularly
• Anyone who has been told to avoid heavy lifting, or who has a pacemaker or implanted defibrillator and has not asked a doctor about exertion
• People with lung disease such as asthma or chronic obstructive pulmonary disease, because cold air can trigger breathing trouble
• Anyone who takes medicine that affects heart rate or blood pressure, or who feels dizzy after exertion
• People recovering from illness or a recent flu

If you are in any of these groups, ask a doctor whether you can shovel, and plan other ways to clear snow. Consider a neighbor, a family member, a local volunteer, a teenager looking for work, a snow removal service, or a municipal program that helps older adults. See ngajegang anak lingsir mangda aman ring cuaca dingin for assistance programs.

Before you shovel¶

Decide whether you need to shovel¶

Not all snow needs clearing at once. If the snow is deep, wet and heavy, or more is coming, consider waiting. A few hours later the sun may soften it, and a second round of light work is easier than one long effort. Delay shoveling until you have warmed up and had something to eat. Do not shovel if the air temperature or wind chill is dangerously low, for example below about minus 20 degrees Celsius (minus 4 degrees Fahrenheit) with wind, because breathing very cold air can itself trigger chest pain and breathing problems.

Warm up¶

Spend five to ten minutes warming up. March in place, swing your arms, do gentle squats, and stretch your shoulders, back and hamstrings. Cold muscles strain and tear easily, so warm them before you lift.

Dress for the cold¶

• Wear several thin layers rather than one thick one, so you can remove a layer when you heat up and add one when you cool.
• Nganggen topi, santukan akeh panes angga sane ical malarapan antuk sirah, lan selendang utawi penutup prarain anggen ngangetang udara sane kairup.
• Pilih sarung tangan sane tahan air utawi sarung tangan sane madue genggaman sane becik.
• Nganggen sepatu bot sane tahan air antuk telapak kaki sane dalem lan nenten licin. Labuh ring es inggih punika penyebab utama tatu sekop. Nyingak nglebur ring es lan runtuh.
• Ngindayang kapas sane nglawan kulit, santukan kapas sane basah ngawinang dingin ragane. Anggen lapisan dasar wol utawi sintetis.
• Ambil hp lan simpen ring saku jero.

Ngajeng sane enteng tur nginum toya .¶

Sampunang sekop ring weteng sane bek, santukan pencernaan masaing sareng otot-otot ragane antuk getih. Sampunang taler nyekop ring weteng sane suwung, santukan semeton merluang bahan bakar. Madue jajanan sane ringan lan nginem toya sadurung ngawitin lan rikala istirahat. Sampunang nginum alkohol sadurung utawi sesampun nyedok. Alkohol nglimbakang pembuluh darah sane nampek ring kulit, sane ngawinang iraga merasa anget sinambi iraga gelis kilangan panes, lan punika prasida ngawinang pikobet irama jantung sayan kaon. Ngindarin kafein lan nikotin paling kidik ajam sadurung makarya sane abot, santukan makakalih nincapang denyut jantung lan tekanan darah.

Priksa piranti Sametoné¶

Anggen sekop sane manut sareng tegeh ragane, antuk gagang sane melengkung utawi prasida kasesuaiang sane ngawinang punggung ragane tetep lurus. Blade sane alitan antuk permukaan plastik kirang nahan salju lan kirang bobot. Semprot bilah punika enteng antuk minyak goreng utawi semprotan silikon sadurung ngawitin, mangda salju punika meluncur mati bandingang nempel. Sekop dorong antuk sendok sane jimbar dangan ring punggung lan manah bandingang sekop ngangkat, lan dorong salju ring roda becikan malih.

Teknik nyedok¶

Tetujonnyane inggih punika ngalih salju antuk utsaha sane pinih kidik lan tegangan sane pinih kidik ring punggung lan manah.

1. Dorong, sampunang ngangkat. Dorong salju ka samping rikala prasida. Dorong nganggen energi sane kirang yening saihang sareng ngangkat lan ngentungang.
2. Ambil beban sane alit. Isi sekop wantah atenga, yadiastun karasayang lambat. Atengah muatan salju sane basah kantun prasida bobotnyane makudang-kudang kilogram.
3. Angkat antuk batis. Yening patut ngangkat, bengkotang lutut, lurus punggung, lan beban punika nampek ring angga. Gegelang sekop punika raket, tur lurusang batis mangda prasida ngangkat.
4. Sampunang memutar. Sampunang ngentungang salju ring bahu utawi ka samping rikala cokor tetep katanem. Mabalikang makejang awak ceninge, majalan nuju tongos ceninge ngutang, tur genahang saljune ka beten bandingang teken ngutang.
5. Tetep ngambekang. Ngambekang mangda tetep. Buang bayu rikala ngangkat utawi nyolek, tur sampunang nahanin bayu. Yening ragane nenten prasida mabebaosan antuk lengkara sane cendet rikala ragane makarya, ragane sampun makarya sane kalintang jemet.
6. Makarya antuk lapisan. Yening saljune dalem, ngilangang dumun lapisan sane pinih duur, raris lapisan sane pinih sor. Antuk salju sane abot pisan, basah, sekop makudang-kudang kali nglintangin angin ribut.
7. Sering istirahat. Istirahat makudang-kudang menit nyabran 10 ngantos 15 menit, lan ngranjing ring jero mangda prasida ngangetang raga lan nginum toya. Linggihangja bandingang ring ngadeg rikala semeton mararian.
8. Pace ragane. Atur kecepatan sane mantap lan nyaman. Sampunang malomba jam, tur sampunang mautsaha ngresikin wewidangan sane ageng ring asiki galah.
9. Anggen tim. Bagiang karya sareng anak lan saling nonton. Yening ragane padidian, orahang teken anak ane sedeng nyedok tur pidan ragane ngajap-ajap lakar mulih.
10. Bresikin genah sane patut dumun. Kawitin antuk margi nuju jelanan ragane lan rute sane pacang kaambil ambulans. Jalan setapak lan undagan lebih penting tekening makasami jalan masuk.

Where to pile snow¶

Pile snow away from the street, hydrants, drains, vents and utility meters. Keep gas meters, dryer vents, furnace exhausts and chimney vents free of snow, because blocked vents can send carbon monoxide into the house. See karbon monoksida. Sampunang numpuk salju ring tembok umah, ring dija salju punika prasida leleh dados dasar, tur sampunang numpuk ring semak-semak sane rapuh.

Tanda-tanda peringatan: mararian apisan¶

Suud nyedok lan istirahat yening wenten sane kacingak ring sor puniki. Do not push through.

Women, older adults and people with diabetes¶

Heart attack signs can look different in women, older adults and people with diabetes. Instead of the classic crushing chest pain, they may notice unusual fatigue, shortness of breath, nausea, back or jaw pain, lightheadedness or a feeling of dread. Do not wait for chest pain to appear. If something feels wrong and you are in the cold after heavy exertion, treat it as serious.

What to do if someone has a heart attack while shoveling¶

1. Call your local emergency number first. Tell the dispatcher where you are, that the person has chest symptoms after shoveling, and whether the person is conscious.
2. Help the person sit down and rest. Move them out of the cold if you can, and keep them still. Half sitting, with knees bent and the back supported, is often the most comfortable position.
3. Keep them warm and calm. Put a coat or blanket over them. Loosen tight clothing around the neck and chest.
4. Anutin pitutur dispatcher indik aspirin. Dispatcher dados ngorahin anak sane eling mangda ngunyah aspirin yening ipun nenten alergi lan nenten madue alasan mangda ngelidin. Sampunang ngicenin napi-napi antuk cangkem yening anake punika ngantuk, muntah utawi nenten prasida ngelekang antuk aman.
5. Prepare for an AED. Send someone to find an AED, and unlock the door. Many public buildings, shops and gyms have them.
6. Watch their breathing. If they stop responding and are not breathing normally, begin CPR right away.

CPR in the snow¶

If the person collapses, put them on their back on a firm surface. If you are outside, try to place something under them to insulate them from the snow, such as a coat or a shovel board, but do not delay compressions to do so. Push hard and fast in the center of the chest, at a rate of 100 to 120 compressions per minute, to a depth of about 5 to 6 centimeters (2 to 2.4 inches) for an adult, and let the chest rise fully after each push. If you are trained, give two rescue breaths after every 30 compressions, and if you are not trained, use hands only compressions. Use an AED as soon as it arrives and follow its voice prompts. Do not stop until the ambulance crew takes over, the person starts breathing normally, or you are too exhausted to continue.

For the full process, see CPR. For recognizing a heart attack and the role of an AED, see heart attack.

Other injuries from shoveling¶

Heart attacks are the most serious risk, but they are not the most common injury. Understand the others so that you can prevent them.

Back, shoulder and muscle strains¶

Lower back strain is the most common shoveling injury. It comes from twisting, lifting with a bent back, and moving heavy loads while cold. Prevent it by pushing rather than lifting, keeping the load close, and taking breaks. If back pain is severe, spreads to the legs, causes numbness, weakness or loss of bladder or bowel control, seek urgent medical care.

Slips and falls¶

Slips on ice are a leading cause of broken wrists, hips and head injuries. Spread salt, sand or non clumping cat litter on walkways, and wear boots with good grip. If you fall and hit your head, read tatu ring sirah. For wrist and arm injuries, see tulang sane pegat lan keseleo.

Frostbite and cold exposure¶

Fingers, toes, nose and ears are the first to freeze. Wet gloves and boots speed it up. Watch for pale, waxy, numb or hard skin, and go inside to warm gently. Do not rub frostbitten skin. See hipotermia miwah beku.

Snow blower injuries¶

Snow blowers cause serious hand and finger injuries every winter. Never put your hand into the chute to clear a jam. Turn the machine off, wait for all parts to stop moving, and use the clearing tool or a stick. Keep children away, never leave a running machine unattended, and use ear protection. Fuel powered models also produce carbon monoxide, so run them outdoors only, not in a garage.

Roof snow removal¶

Clearing snow from a roof carries separate risks of falls, ice, and power line contact. Do not climb onto a roof in snowy or icy conditions. For snow loads, ice dams and warning signs of roof collapse, read snow load warning signs and safe roof snow removal.

Choosing a method: comparing ways to clear snow¶

Decision flow while shoveling¶

flowchart TD
    A["You need to clear snow"] --> B{"Do you have heart disease<br/>or another high risk factor?"}
    B -->|"Inggih"| C["Ask for help or hire a service"]
    B -->|"Nénten"| D["Warm up, dress in layers<br/>and drink water"]
    D --> E["Push snow in small loads<br/>and breathe steadily"]
    E --> F{"Any chest pressure, pain,<br/>breathlessness or dizziness?"}
    F -->|"Inggih"| G["Stop and sit down"]
    G --> H["Call your local emergency number"]
    F -->|"Nénten"| I["Rest every 10 to 15 minutes"]
    I --> J{"Is the job finished?"}
    J -->|"Nénten"| E
    J -->|"Inggih"| K["Go inside, warm up<br/>and rest"]

Helping a neighbor or relative¶

Many shoveling deaths happen to people who are alone. If you can, offer to shovel for an older neighbor or one who has a health condition. If you cannot, check in by phone before the storm to ask whether they have arranged help. Do not leave a neighbor out in the cold working alone while you watch.

If you find someone collapsed in the snow, check whether they respond and breathe normally. Call your local emergency number, begin CPR if they are not breathing normally, and use an AED if one is available. Move them from the cold when you can, but do not delay chest compressions to do so. When the person is breathing, keep them warm and still, because cold exposure makes any medical event worse. If they are very cold to the touch, see hipotermia miwah beku.

Community help programs¶

Some towns offer free snow clearing for older adults, people with disabilities and people who are ill. Search for your city or county website, or ask at your local senior center or library. In the United States you can call 211 for local services. In the United Kingdom, your local council and organizations such as Age UK can often point to volunteer schemes. Ask a neighbor with a teenager or a young adult, many of whom are glad to earn a little.

Preparing before snow arrives¶

• Buy salt, sand or pet safe de-icer before the storm, and store it where you can reach it.
• Service your snow blower and check that fuel is fresh.
• Keep a pair of waterproof gloves, a hat and a scarf by the door.
• Choose a shovel that fits your height and strength, and keep it in an easy to reach place, not buried in a shed.
• Plan who will clear snow if you cannot, and write down their number.
• Teach teenagers and other family members the warning signs.
• Pasang alarm asep lan alarm karbon monoksida ring sabilang tingkat umah ragane, lan uji nyabran sasih.

For the full winter plan, see winter storm home preparedness and 72 hour plan.

Checklist before you start shoveling¶

• I have no chest pain, breathing trouble, dizziness or illness today.
• I have checked the temperature and wind chill and the conditions are safe for exertion.
• I have warmed up for five to ten minutes.
• I am wearing layers, a hat, gloves and non slip boots.
• I have had a light snack and a drink of water, and no alcohol.
• My phone is in my pocket, and someone knows I am outside.
• I will push the snow rather than lift it, and take small loads.
• I will rest every 10 to 15 minutes and stop at the first warning sign.

How heavy is the snow you are lifting¶

Snow weight varies far more than most people expect. Light, dry powder can weigh about 1 kilogram (2 pounds) per shovel load, while a full shovel of wet, packed snow can reach 7 kilograms (15 pounds) or more. Moving even a small driveway can mean lifting several tonnes in total. That is why the same job that felt easy last week can be dangerous after a wet storm.

These weights are rough guides. If a shovelful feels heavy, it is, so reduce the load.

After you finish¶

When you go indoors, take off wet outer layers and put on dry clothes. Drink a warm, non alcoholic drink and eat something. Sit for a while rather than moving straight to another chore. Mild soreness is normal. Chest pressure, unusual tiredness, or breathlessness an hour or two later is not, and it can still be a heart event. If symptoms appear after you come in, treat them in the same way, sit down and call your local emergency number.

Watch yourself and others for hours after the work. Older adults, especially, may feel fine and then develop symptoms later in the evening. Hands and feet that stay numb, white or waxy after warming may be frostbitten, which needs medical advice.

Talking to your doctor¶

If you have heart disease, high blood pressure, diabetes, lung disease or you have been inactive for years, ask your doctor before snow season whether you can shovel. Ask specifically about heavy lifting, cold air and what warning signs matter for you. If you take medicine for the heart, ask whether you should carry it when you go outside and when to use it. Do not change or stop any medicine without medical advice. Many cardiology groups also recommend building fitness gradually through the year so that winter chores do not come as a sudden shock to the body.

Teenagers and children¶

Healthy teenagers can usually shovel, but they still need breaks, water, warm clothing and supervision. Young children should not shovel heavy snow, and they should not be left to play near piles beside a road or near a plow. Tunnels and forts in deep snow can collapse and bury a child. Check on children who are playing in snow and bring them in when they are wet or shivering. Teach older children the warning signs of frostbite and tell them to come indoors if their fingers or toes feel numb.

Pitakén sané sering katakénang¶

Why is shoveling snow so hard on the heart?¶

Shoveling combines heavy lifting, cold air and often a sudden start after months of little exercise. Cold narrows the arteries and raises blood pressure, while lifting and breath holding push heart rate and pressure up further. In a person with narrowed heart arteries, this mix can trigger chest pain or a heart attack.

Who should not shovel snow at all?¶

People who have had a heart attack, stent or bypass, who have known heart disease or poorly controlled high blood pressure or diabetes, and anyone with a pacemaker or lung disease should speak to a doctor before shoveling. Older adults who are not active, smokers and people with a strong family history of heart disease should also think about getting help. Hiring a service or asking a neighbor is a safe choice.

How often should I rest while shoveling?¶

Rest for a few minutes at least every 10 to 15 minutes, sit down if you can, and drink water. Stop earlier if you feel tightness in the chest, shortness of breath, dizziness or a cold sweat. If you cannot speak a short sentence while working, slow down.

What should I do if I think I am having a heart attack while shoveling?¶

Stop at once, sit down, and call your local emergency number rather than driving yourself. Tell the dispatcher your symptoms and your location, unlock the door, and keep warm. If you are with someone who collapses and is not breathing normally, start CPR and find an AED.

Sumber sampun katureksa¶

Guidance on this page was checked against the American Heart Association (United States) advice on snow shoveling and heart attack warning signs, the Centers for Disease Control and Prevention (United States) pages on cold weather safety and heart disease, the National Weather Service (United States) wind chill and winter safety guidance, Ready.gov and the Federal Emergency Management Agency (United States) winter storm advice, the American Red Cross winter safety and CPR guidance, the National Health Service (United Kingdom) pages on heart attack and cold weather exercise, the British Heart Foundation (United Kingdom) winter advice, Health Canada winter safety guidance, and the Heart and Stroke Foundation of Canada. Where agencies differ, this page uses the more cautious advice.

Learn first aid and CPR¶

A hands-on course gives you the practice that reading cannot. The Red Cross, St John Ambulance and many local providers teach CPR, AED use and heart attack response in a few hours. Consider taking a course with the people who share your home, especially if anyone has a heart condition.

Panuntun sané mapaiketan¶

• Heart attack
• CPR
• Snow shoveling and heavy exertion in extreme cold
• Slipping on ice: how to fall and when to seek care
• Keselamatan badai musim dingin: pemanasan umah lan kelangsungan hidup dingin