Tinsel, toys, ladders & lights- ¡cuidado!

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By Penny Krich, M.D.

While the holiday season is usually a time for family, decorating everything from the outside of the house to the top of the tree has become part of the holiday tradition. However, no one wants to dampen the festive spirit with a trip to urgent care or, even worse, the emergency room. Every year, emergency department doctors treat a variety of patients with serious injuries, from children who have eaten tinsel to those with trauma from a serious fall from a ladder or even a new bike.

Unfortunately, this scenario is all too common in the average American household. In recent years, more than 13,000 people have been treated in the emergency room for holiday-related injuries. This is an increase of 30 percent since 2007, with a majority of these injuries resulting from falls. Emergency room traffic also gets a significant bump after the holidays, suggesting that many try to keep the holiday spirit and tough it out with their injury. While the holidays are a busy time of the year for everyone, it is important to make sure and take safety precautions seriously in order to avoid common mistakes that can have serious consequences.

Fall-related injuries can result from a variety of activities. These include standing on the top of a ladder, using unstable furniture to decorate the tree, slipping on a wet surface, or even a child falling from a new bike, skateboard, etc. Here in Phoenix, we do not have to worry about injuries such as slipping on ice. However, because we experience more mild weather, families are more likely to spend time outdoors. This can mean more time playing outdoors with new toys, or deciding to hang holiday decorations yourself instead of leaving it to a professional. 

Because we like being outdoors so much during winter, one of the most common holiday traditions, besides decorating a tree, is putting lights up on the house. According to the Home Safety Council, four out of five U.S. households use ladders around their homes in preparation for the holiday season. However, when not used properly, ladders can be extremely dangerous. In a study completed by the Centers for Disease Control and Prevention (CDC), it has been reported that of all holiday fall-related injuries, 51 percent were specifically from falling from ladders and 46 percent of all people treated had injuries to one of their extremities (hands, arms, legs or feet). Other common trips to the emergency room include burns caused by candles or Christmas tree fires, lacerations from broken bulbs or ornaments, and tragic injuries resulting from crowds and even stampedes during the busy shopping season. 

During a fall, our first instinct is to brace ourselves by putting hands and arms out in front to shield our body from the impact. This creates a well-documented mechanism of injury known as “falling on an outstretched hand,” or simply called FOOSH. It is because of this natural reaction that 34 percent of holiday injuries end with fractures of the extremities, especially the hand and wrist, along with lower leg injuries including the ankle. While we can’t change our body’s reaction to help us break our fall, we can lower our chance of injury by making sure the surface we stand on is safe and stable.

Soft tissue injuries, such as sprains and strains, bruising and minor swelling, are very common. Each of these injuries can be treated at home with rest, ice, compression and elevation (RICE). However, should the injury become worse, I recommend visiting the doctor, because a more serious injury can initially have similar symptoms and appear minor.

If a fall does happen, there are specific signs adults should keep an eye out for to let them know whether a trip to the doctor is necessary:

Swelling: This can happen at, or around, the point of impact and can be a symptom of a break, also called a fracture, in the bone or even a sprain to the joint. Look for rapid or severe swelling. A large, quickly expanding bruise can mean a significant pocket of blood is forming under the skin.

Pain and loss of function: Intense pain is a warning sign and a good indicator to seek medical attention. Be aware that symptoms, such as loss of strength (loss of grip strength in the hand), reduced range of motion, and nerve pain or changes in sensation, can be equally worrisome.

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