Að renni á ís: hvernig á að detta, hvenær á að leita að umönnun og hvernig á að koma í veg fyrir það¶

Hálka á ís gerist á innan við sekúndu og meiðslin sem það veldur geta breytt lífi einhvers. Vetrarhögg senda mörg þúsund manns árlega á bráðamóttökur með úlnliðsbrot, mjaðmabrot, axlir úr lið, bakmeiðsli og höfuðáverka. Eldra fólk, fólk með veik bein og fólk sem tekur blóðþynnandi lyf eru í mestri hættu á alvarlegum afleiðingum af því sem lítur út eins og minniháttar fall.

Þessi leiðarvísir fjallar um hvað á að gera á því augnabliki sem þú byrjar að detta, hvernig á að athuga sjálfan þig og aðra þegar þú ert kominn á jörðina, hvaða meiðsli þarfnast bráðrar aðhlynningar og hver getur beðið, hvernig á að standa upp á öruggan hátt og hvernig á að koma í veg fyrir fall með réttum skófatnaði, göngutækni og söltun. Fyrir sérstök meiðsli, sjá beinbrot og tognun, höfuðáverka og mænuskaða.

Gerðu þetta núna¶

1. Vertu þar sem þú ert í smá stund eftir fall. Athugaðu hvort verkir séu í höfði, hálsi, baki, mjöðmum, úlnliðum og ökklum áður en þú reynir að hreyfa þig.
2. Hringdu í neyðarnúmerið þitt (911 í Bandaríkjunum og Kanada, 112 í Evrópusambandinu, 999 í Bretlandi) ef þú lemur höfuðið og missir meðvitund, finnur fyrir rugli, kastar upp, ert með verki í hálsi eða baki, getur ekki hreyft útlim eða ert með bein sem lítur út fyrir að vera bogið eða ekki á sínum stað. Sjáðu neyðarnúmer fyrir önnur lönd.
3. Ekki standa hratt upp og ekki láta neinn draga þig upp ef þú gætir verið með meiðsli á hálsi, baki, mjöðm eða fótlegg. Bíddu eftir hjálp.
4. Ef þú getur hreyft þig og ekkert virðist mikið meiddur skaltu rúlla þér til hliðar, fara á hendur og hné, skríða í stöðugan stuðning og standa einn fót í einu. Sestu svo niður á heitum stað og athugaðu þig aftur.
5. Ef einhver liggur á ís skaltu halda honum heitum með úlpu eða teppi og ekki hreyfa hann ef þú heldur að hann hafi meiðsli á hálsi, baki eða mjöðm. Kuldi getur aukið á vandamál þeirra fljótt.
6. Leitaðu læknishjálpar innan dags fyrir höfuðhögg ef þú tekur blóðþynningarlyf, ert eldri en 65 ára eða ef þú færð höfuðverk, syfju, uppköst eða rugl síðar.

Hvernig á að falla á ís með minni meiðslum¶

Þú munt sjaldan hafa tíma til að hugsa, en hvernig þú lendir skiptir miklu máli. Æfðu hugmyndina í hausnum fyrir veturinn, þar sem fólk sem hefur hugsað út í það er líklegra til að bregðast vel við.

Meginreglurnar¶

• Slappaðu af og forðastu að berjast við fallið. Stífleiki gerir meiðsli verri. Reyndu að láta líkamann fara lausan og rúlla.
• Taktu hökuna að brjóstinu. Þetta verndar höfuð og háls frá því að lenda í jörðu. Ekki kasta höfðinu aftur.
• Ekki reka út hendurnar. Að lenda á útréttri hendi er algengasta orsök úlnliðsbrots og það getur líka brotið framhandlegg, olnboga eða kragabein. Haltu handleggjunum beygðum og nálægt líkamanum eða láttu þá leggjast fyrir framan þig.
• Land on padded parts. Try to turn your body so that you land on the side of your buttocks, thigh or the back of your shoulder, which have more muscle and fat. Fall sideways or backward, with your knees bent, instead of straight forward or straight backward on your tailbone.
• Roll with the fall. Rolling spreads the force. Curling into a ball, with your chin tucked, helps you slide and roll instead of stopping dead on one point.
• Do not try to catch yourself with your knees or elbows. These joints break and dislocate easily.
• Let go of what you are carrying. If you are holding a bag, a shovel or a cup, drop it. Hold on to it only if a child is in your arms, and in that case twist so that your body takes the fall and protects the child.

If you start to fall backward¶

Backward falls cause the most serious head injuries, since the back of the head can hit the ground with great force. Tuck your chin tightly to your chest, bring your arms across your body, and try to twist onto your side. Aim for the buttocks and the muscle of your back and not your head or spine.

If you start to fall forward¶

Bend your knees and let your body collapse in a roll, with your arms bent. Tuck your head to one side and turn your shoulder toward the ground, so that you roll over the shoulder and not onto your face. Avoid putting your palms out stiff.

If you are carrying a child¶

Turn your body so that you land on your side or back with the child on top of you. Keep a strong hold of the child, curl around them, and protect their head with your hand.

Right after a fall: check yourself¶

Many people jump up and say they are fine. Shock and adrenaline can hide pain for several minutes, so stay down for a short time and check carefully.

1. Stay still and breathe. Take slow breaths. If you feel faint, stay lying down.
2. Check your head and neck. Do you have a headache, dizziness, nausea, blurred vision, or neck pain? If you hit your head or feel any of these, do not get up quickly.
3. Check your back and spine. Pain in the middle of your back, tingling, numbness, or weakness in the arms and legs are red flags. Stay still and call for help.
4. Check your hips and legs. Can you bend your hip and knee? Can you bear weight? A leg that looks shorter or turned outward, with a lot of groin or hip pain, points to a hip fracture.
5. Check your arms and wrists. Look for swelling, bruises, bent shape or pain when you move your fingers or turn your hand.
6. Check for bleeding. Press firmly on any bleeding with a clean cloth.
7. Try to move slowly if you have no signs of a serious injury, as described below.

When to call your local emergency number¶

Call at once if the person, or you, has any of the following after a fall:

• Loss of consciousness, even for a short time, or confusion, unusual behavior or slurred speech
• Repeated vomiting, a seizure, or a severe, worsening headache
• Clear fluid or blood from the ears or nose
• Neck or back pain, numbness, tingling, or weakness in the arms or legs
• A bone that is visibly bent or out of place, or a bone that has broken the skin
• A leg that looks shorter or twisted, with severe hip or groin pain and inability to bear weight
• Heavy bleeding that does not stop with firm pressure
• Öndunarerfiðleikar, brjóstverkur eða miklir verkir í kvið
• Vanhæfni til að standa upp og hætta á ofkælingu af því að liggja í kulda
• Signs of a stroke, such as face drooping, arm weakness or speech difficulty, which might have caused the fall. See stroke

Head injuries after a slip¶

Falls on ice often cause the head to strike hard ground, curbs, steps or a car. The skull may be fine, but the brain can still bruise or bleed inside. Symptoms can appear immediately or develop over hours or days.

Warning signs that need urgent care¶

• Loss of consciousness, even for a few seconds
• Headache that is severe or gets worse
• Repeated vomiting
• Confusion, memory loss, unusual sleepiness, or trouble waking
• Slurred speech, weakness or numbness, loss of balance, or trouble walking
• One pupil larger than the other, double vision or blurred vision
• Flog
• Tær vökvi eða blóð úr nefi eða eyrum
• Óvenjuleg hegðun eða pirringur, sérstaklega hjá börnum

Hærri áhættuhópar¶

Fullorðnir 65 ára og eldri, fólk sem tekur blóðþynningarlyf eins og warfarín eða nýrri segavarnarlyf og fólk sem tekur aspirín eða svipuð lyf reglulega, getur fengið blæðingu inni í höfðinu, jafnvel eftir smá högg. Þetta getur gerst hægt, á dögum eða vikum. NHS (Bretland) og önnur heilbrigðisþjónusta ráðleggja að allir sem eru á blóðþynnandi lyfjum og lenda í hausnum ættu að fara í skoðun hjá lækni sama dag, jafnvel þótt þeim líði vel. Sjáðu mjaðmarbrot eða höfuðáfall á blóðþynningarlyfjum hjá öldruðum og síðbúnum blóðþurrð.

Heima eftir smá höfuðhögg¶

If you have none of the warning signs and a clinician has said you can go home, rest, and have an adult stay with you for the first 24 hours. Use a cold pack on the bump wrapped in a cloth. Do not drink alcohol, and avoid driving, sports and heavy exertion until you feel normal. Return for urgent care if any warning signs appear. For full details, read höfuðáverka. If the person is unconscious and not breathing normally, begin CPR. See CPR.

Wrist, arm and shoulder injuries¶

When people fall on an outstretched hand, the force travels up the arm. The result is often a broken wrist, a fractured forearm, a broken elbow, a dislocated shoulder or a broken collarbone.

Signs of a wrist or arm fracture¶

• Pain that is severe, especially when you move the wrist or grip
• Swelling and bruising, often within minutes to hours
• A bent, crooked or fork shaped wrist
• Numbness or tingling in the fingers, or pale or blue fingers
• Not being able to turn the palm up or down, or grip an object

What to do¶

1. Stop using the arm and keep it still. Do not try to straighten a bent limb.
2. Support the arm in the position you find it, with a sling made from a scarf, a jacket, or a folded towel, or hold it against the chest with the other hand.
3. Remove rings, watches and bracelets before swelling starts.
4. Apply a cold pack wrapped in a cloth for up to 20 minutes at a time, never directly on the skin.
5. Do not eat or drink anything until a clinician has seen you, in case you need an operation.
6. Get medical care the same day. Call your local emergency number if the skin is broken, the fingers are blue, pale, cold or numb, or the injury is severe.

See beinbrot og tognun og open fractures for details on splinting and for bone that breaks the skin.

Hip, pelvis and leg injuries¶

A hip fracture is a medical emergency, especially for older adults. The person usually cannot stand or bear weight, and has severe pain in the hip, groin or thigh. The leg may look shorter, and the foot may turn outward. Do not lift or move the person. Call your local emergency number, keep them warm and still, and place padding around the leg if you have it. See hip fracture or pelvic fracture in an older adult for what to avoid.

Ankle and knee injuries are common as well. If the joint looks deformed, you cannot put any weight on it, or the pain is severe, treat it as a possible fracture and seek urgent care. Mild sprains can often be treated by resting the joint, applying a cold pack, wrapping it gently, and raising it, with a medical review if the pain does not improve in a few days.

How to get up after a fall¶

Only try to stand if you have no sign of a serious injury. Take your time, since getting up too fast can cause dizziness and a second fall.

1. Lie still for a minute and breathe slowly.
2. Roll onto your side, then onto your hands and knees. Use your arms and the muscles in your legs.
3. Crawl to a sturdy support, such as a railing, a car, a wall or a chair. Avoid pulling on something that is not secure.
4. Place one foot flat on the ground with your knee bent, then push up with your arms and legs, and bring the other leg up.
5. Sit in the nearest chair and rest. Check again for pain, dizziness or weakness.
6. Warm up, and tell someone what happened, even if you feel fine.

Ef þú getur ekki staðið upp¶

Call out for help, use your phone, wear any alert device and call your local emergency number. Stay warm by covering yourself with whatever you can reach, and move your arms and legs if you can do so without pain. Do not stay lying on ice or snow longer than necessary, because cold can lead to hypothermia within an hour or two, especially in older people. Sjáðu ofkæling og frost og aldraðir falla bata þegar þeir geta ekki staðið.

Ef þú ert að hjálpa einhverjum¶

1. Biðjið þau að hreyfa sig ekki og spurðu hvar það er sárt.
2. Leitaðu að viðvörunarmerkjunum hér að ofan.
3. If they appear fine and want to get up, let them rise slowly and use your arm for balance. Ekki lyfta þeim í handleggjunum.
4. Ef þeir eru með mikla verki, geta ekki hreyft útlim, slegið höfuðið eða eru á blóðþynningarlyfjum skaltu hringja í neyðarnúmerið þitt.
5. Haltu þeim heitum með úlpu, hatti og teppi og settu eitthvað undir þau ef þau þurfa að bíða á köldum jörðu.

Koma í veg fyrir fall á ís¶

Hægt er að koma í veg fyrir flest fall á ís. The best prevention combines good footwear, a careful way of walking, and keeping paths clear and treated.

Veldu réttan skófatnað¶

• Wear boots or shoes with thick, flexible rubber or composite soles that have deep, widely spaced tread. Hard plastic or smooth leather soles are slippery.
• Leitaðu að sóla merktum fyrir kulda og ís, þar sem sumt gúmmí helst mjúkt við lágt hitastig og annað harðnar.
• Veldu lágan, breiðan hæl. Avoid high heels, platforms and smooth dress shoes.
• Notaðu færanlegar gripspinnar, nagla eða íshandfang sem teygja sig yfir stígvél. Take them off before you walk on indoor hard floors, since they are slippery on tile and can damage floors.
• Consider boots with built in studs or special grip patches for very icy conditions, but check they fit well and are comfortable.
• Wear warm, dry socks and make sure your boots fit well. Cold feet make walking less steady.
• Wear gloves, not hands in pockets, so that your arms can help you balance.
• Use a walking pole or a cane with an ice tip if you have trouble with balance. Ice tips are small metal spikes that fold out from the end of the cane.

Ganga eins og mörgæs¶

1. Take short, shuffling steps and keep your feet flat. Do not take long strides.
2. Beindu fótunum örlítið út á við, sem víkkar grunninn þinn.
3. Haltu hnjánum örlítið boginn og þyngdarpunktinum yfir framfætinum.
4. Keep your arms out from your sides, slightly, to help you balance. Ekki hafa hendur í vösum.
5. Ekki senda texta, fletta eða bera mikið álag sem kemur þér í ójafnvægi. If you must carry a bag, spread the weight between both hands or wear a backpack.
6. Hafðu augun á jörðinni framundan og leitaðu að skínandi blettum sem gætu verið svartur ís. Sjáðu glampi frost og svartur hálkuakstur.
7. Gakktu hægt og taktu þér tíma, þar á meðal þegar þú stígur fram af kantsteinum, og notaðu handrið.
8. Prófaðu yfirborðið áður en þú flytur þyngd þína. Stígðu með tána niður og settu þyngd þína á fótinn aðeins þegar hann grípur.
9. Farðu til hliðar í bröttum brekkum og farðu í snjónum við hlið stígsins ef hann hefur betra grip.

Be careful with common traps¶

• Getting in and out of vehicles. Hold on to the door frame or the roof, step out with one foot at a time, and check the surface.
• Shiny surfaces, which are likely to be black ice. Assume that wet looking pavement in freezing weather is ice.
• Shaded areas, bridges, ramps and entrances to buildings, which refreeze first.
• Steps and stairs. Use the handrail, and take one step at a time.
• Curbs and drainage grates, which are often hidden under snow.
• Parking lots, where meltwater runs and refreezes.
• Wearing smooth soled shoes inside buildings after walking in snow. Wet floors in entrances are slippery, so wipe your feet.

Salting and clearing walkways¶

Clearing and treating your own steps and paths protects you, your visitors and delivery workers. Many cities require owners and occupiers to clear footpaths within a set time after snowfall, so check local rules.

How to treat a path¶

1. Clear snow first with a shovel, since salt works best on a thin layer of ice and loose snow dilutes it. Use safe technique. See shoveling snow safely.
2. Spread the material thinly and evenly, and do not pile it. A handful per square meter is often enough.
3. Treat before a storm when possible. Salt brine or pretreatment stops ice from bonding to the pavement.
4. Reapply after meltwater refreezes, particularly at night and early morning.
5. Pay special attention to steps, ramps, handrails, entrances, and the places where a downspout drains across a path.
6. Direct downspouts away from walkways so that meltwater does not refreeze on them.
7. Store salt in a closed bin near the door, and keep it away from children and pets.
8. Wash salt from pets' paws and from floors, and use salt moderately to protect plants, concrete and groundwater.

Landlords, employers and shared spaces¶

Ef þú ert leigusali, vinnuveitandi eða hefur umsjón með sameiginlegu rými skaltu líta á stíga og bílastæði sem umönnunarskyldu. Haltu skriflega skrá yfir hvenær þú hreinsaðir og meðhöndlaðir yfirborð, settu viðvaranir fyrir blaut gólf og hálkubletti og settu upp handrið þar sem þörf krefur. Ef þú dettur á eign annars, taktu myndir af ísnum, tímanum og skófatnaði þínum, tilkynntu fallið til eiganda og leitaðu til lögfræðings ef þú slasaðist alvarlega. Reglur eru mjög mismunandi milli landa og þú ættir að athuga með yfirvöld á staðnum.

Sérstakir hópar¶

Older adults¶

Older adults have a higher chance of falls and a higher chance of serious injury. Weak bones, slower reflexes, medicines that cause dizziness, vision changes and joint problems all raise the risk. For them, indoors is safest on icy days. Arrange for groceries and medicine to be delivered, get help with clearing paths, and use a cane with an ice tip if needed. See keeping older adults safe in cold weather og older adults emergency planning.

Children¶

Children fall often, and they bounce better than adults, but head injuries still matter. Teach children to walk with their hands out of pockets, to avoid running on ice and to stay off frozen ponds. For sledding hazards and ice safety, see falling through ice.

People who are pregnant¶

A fall in pregnancy needs a medical check even when you feel fine, since a hard impact to the abdomen can harm the placenta. Contact your midwife, doctor or maternity unit after any fall, and call your local emergency number if you have bleeding, fluid leaking, severe pain, or reduced movement of the baby.

People with osteoporosis or on blood thinners¶

These people have a higher chance of fractures and internal bleeding. Seek care after any fall that involves the head, hip, back or ribs. Keep a list of your medicines in your wallet or phone so that emergency staff know what you take.

Decision flow after a fall on ice¶

flowchart TD
    A["Þú hefur fallið á ís"] --> B["Vertu kyrr og athugaðu sjálfan þig"]
    B --> C{"Höfuðáfall, meðvitundarleysi,<br/>háls- eða bakverkur eða boginn útlimur?"}
    C -->|"Já"| D["Vertu kyrr, haltu hita<br/>og hringdu í neyðarnúmerið"]
    C -->|"Nei"| E{"Geturðu hreyft alla liðamót<br/>án þess að hafa mikla verki?"}
    E -->|"Nei"| D
    E -->|"Já"| F["Rúllaðu þér upp að höndum og hnjám<br/>og farðu hægt upp með stuðningi"]
    F --> G{"On blood thinners, over 65<br/>or a head knock?"}
    G -->|"Já"| H["Leitaðu til læknis<br/>sama dag"]
    G -->|"Nei"| I["Hvíldu þig, settu á þig kuldapakka<br/>og passaðu þig á nýjum einkennum"]
    I --> J{"Höfuðverkur, uppköst, rugl<br/>eða versnandi verkir síðar?"}
    J -->|"Já"| H
    J -->|"Nei"| K["Return to normal activity<br/>and check your footwear"]

Samanburður á algengum ísfallsmeiðslum¶

Checklist for a safe winter walk¶

• I am wearing boots with deep tread and soft rubber soles, or ice grips.
• My hands are free and in gloves, not pockets.
• I have a charged phone in an inside pocket.
• Someone knows where I am going if I will be out long.
• I will walk with short, flat footed steps and use handrails.
• I will treat shiny pavement as ice and avoid shaded patches.
• I have cleared and salted steps and paths at home.
• I know the signs of a serious head or hip injury and will call for help.

Algengar spurningar¶

What is the best way to fall on ice?¶

Tuck your chin to your chest, keep your arms bent and in front of you instead of stretching out your hands, and try to land on the padded parts of your body such as the side of your buttocks or thigh. Relax as much as you can and roll with the fall. Avoid landing on your wrists, elbows, knees or the back of your head.

When should I go to the hospital after slipping on ice?¶

Call your local emergency number if you lose consciousness, are confused, vomit, have neck or back pain, cannot move a limb, have a visibly bent bone or cannot bear weight on a leg. Seek care the same day for a head knock if you are over 65 or take blood thinners, and for any wrist or ankle pain that is severe or gets worse. Do not wait to see if symptoms pass when you hit your head.

Why do wrist fractures happen so often when people slip on ice?¶

Most people throw out a hand to break a fall, and the force of the landing travels through the hand into the wrist and forearm. The wrist bone at the thumb side tends to break at that point, especially in people with thinner bones. Keeping your arms bent and rolling with the fall can reduce the risk.

Is rock salt safe for pets and plants?¶

Steinsalt getur pirrað lappirnar og skaðað plöntur og steypu ef mikið er notað. Notaðu aðeins þunnt lag, skolaðu og þurrkaðu lappirnar á gæludýrinu þínu eftir göngutúra og íhugaðu gæludýraöryggishreinsiefni eða sand fyrir grip. Geymið öll hálkuefni þar sem að gæludýr verða veik að borða þau.

Heimildir athugaðar¶

Þessi leiðarvísir var skoðaður í samræmi við Centers for Disease Control and Prevention (Bandaríkin) síðurnar um að koma í veg fyrir fall og falla eldri fullorðna, vetraröryggisleiðbeiningar National Weather Service (Bandaríkin), leiðbeiningar American Academy of Orthopedic Surgeons um úlnliðsbrot og vetrarfall, skyndihjálparleiðbeiningar frá Bandaríska Rauða krossinum um höfuðáverka og ráðleggingar um höfuðáverka í ríkinu, fall og úlnliðsbrotnir, vetrarráðgjöf Royal Society for the Prevention of Accidents (Bretland), vetrarráðgjöf Canada Safety Council og vetraröryggissíður Health Canada. Þar sem stofnanir eru ólíkar eru varkárri ráðleggingar notaðar.

Lærðu skyndihjálp¶

Á skyndihjálparnámskeiði í skyndihjálp er kennt spelku, höfuðáverkaskoðun, blæðingarstjórnun og endurlífgun með æfingum, sem síða getur ekki gert. Rauði krossinn, St John Ambulance og margir staðbundnir veitendur bjóða upp á stutt námskeið. Að taka einn fyrir veturinn undirbýr þig til að hjálpa nágranna eða ættingja sem rennur í ís.

Tengdir leiðsögumenn¶

• Beinbrot og tognun
• Höfuðáverka
• Aldraðir falla bata þegar þeir geta ekki staðið
• Blikkfrost og svartur hálkuakstur
• Shoveling snow safely