‘Snowbank is the wrong hill to die on’

Doctors, medical first responders caution shovellers prone to cardiac arrest following storms

Going too hard at the snow after a storm can have deadly consequences. Dr. Nick Giacomantonio leads cardiovascular prevention and management at the Queen Elizabeth II Health Sciences Centre in Halifax. When winter weather hits, he is certain there will be more cardiac-related cases throughout Atlantic Canada. Recognizing the symptoms The isometric exercise increases pressure in the body, keeping air in the lungs and pressure in the body as energy gets transferred to the arms. “When you do that, you significantly increase your blood pressure quickly, and your heart rate,” said Giacomantonio. “And if you're at risk for a heart event, then that can precipitate it.” And as the weather systems keep piling up more layers of snow and ice, the grunt work becomes heavier, precipitating a heart attack. “We see an increase in patients who become either new patients or unstable patients because they go out and shovel heavy snow at or shortly after a snowstorm … high blood pressure, diabetes, high cholesterol, very strong family histories — that combination puts them at particular risk. And they may have an underlying condition that they don't yet know about.” He stresses that outdoor activity is not prohibited. “Our whole idea is to keep patients longer in their community with the disease, doing what they want to do, are able to do. But that 'able to do' is defined by several things that are usually reviewed and OK’d by their doctor, their healthcare giver." This means there are warning signs to look out for. “If they shovel and notice they have sudden onset of chest pressure, particularly if it goes into the arm or jaw and is associated with unexplainable sudden sweating, and particularly nausea, then they should stop what they're doing.” Those with established heart disease should take nitroglycerin as prescribed by their doctor. He adds that sweating or shortness of breath is normal for exercise. But if it is unusual, people should slow down and stop. After resuming, if it "comes back with a vengeance," then the person should stop completely. Giacomantonio said snow shovelling is just like any other form of exercise — and warming up is needed. "You start on your treadmill with a walk. And then when you feel ready, you’d increase the speed or increase the incline. If you're doing weights, you start out with light weights and then increase to the maximum weight you're comfortable with. It should be no different when you're going out and shovelling snow. And if the snow exceeds what you're comfortable with, don't do it.“ “People go gung ho, right out of the door, grab the shovel and start pushing like a madman. Don't do that. Warm up. Take little bits of snow, get a feeling for it. Right? Also, bundle up. Doing hard work in very cold air worsens the possibility. So if it's really cold out, you should have a balaclava on or a mask across your face that would have you breathe warmer air, which is easier on your lungs and your heart.” Medical first responder calls increase It’s not just people with heart issues. Pregnant people or bad orthopedic problems should be wary, especially on the ice. Fire departments do not track data for cardiac-related calls in conjunction with snowstorms. But, without a doubt, they see an increase in calls. “There's a higher risk and higher chance of overexerting yourself, essentially causing just pain or hurt,” said Truro, N.S., fire chief Blois Currie. “You would see an increase this time of the year, in those kinds of calls. Interestingly, Clair Peers of the Onslow Belmont Fire Brigade said his department tends to notice more calls for cardiac issues in the early morning, something Steve Currie also notices on his pager. Blois Currie, on the other hand, said Truro sees them at any time of day. Peers and deputy chief Darrell Currie agree that with technology evolving over the years and more people using snowblowers, they have observed calls related to shovelling becoming less common, though the case may be different within towns. Currie also highly recommends that people who can stay home do so — there is no point in going for a cruise and causing congestion for emergency vehicles trying to get to a scene in inclement weather. Medical first responders are especially important in rural areas further from EHS. “It's winter, it's Nova Scotia, and, you know, we're going to get this kind of weather,” said Peers. During a recent storm, they assisted Great Village Fire with its half-track Utility Terrain Vehicle to access assistance for a woman in a remote area. He describes it like a side-by-side ATV that can access all kinds of places. “We aren't equipped to offer the same medical attention as EHS is, but sometimes it's just getting there and being with people and (having) oxygen,” said Peers. “Just calming them and (providing) assistance. Sometimes it's CPR, things of that nature, that are pretty important in the first few minutes of a medical issue.” It is important not to be scared – or stubborn – to ask for help. “There is a pride,” said Giacomantonio. “There is a desire for people to take care of themselves. That's commendable. But if you're in harm's way, don't do yourself harm … pick another fight – a snowbank is the wrong hill to die on.”