Chief Stone: Precautions To Prevent Fall Injuries Part 2

Division Chief, Emergency Medical Services
Los Alamos County Fire Department

Slips, trips, and falls outside can be caused by several identifiable elements. Being able to identify these issues and avoid them could be as easy as remembering “SCAN”.

One of our wonderful citizens in Los Alamos shared his way of preventing a fall injury, and asked that I share it with you readers. He took a few moments and created a memory device to remind him to look out for objects that could cause him to fall. He is a past fall patient that has had to have work done on his hip because of his fall. The suggestion is to post the word “Scan” in your vehicle and any place that you could use a quick reminder to “scan” ahead for dangers.

A trip occurs when the foot strikes a near-ground obstacle that abruptly arrests the movement of the foot when the body’s center of gravity is in motion. This causes the center of gravity to rapidly move out of the area of the body’s support base (the planted foot), resulting in a fall.

With this information, what should we be looking for while we scan ahead?

Entrances – For outdoor walkways at entrances exposed to the elements, keep the area clean and dry to prevent slipping on wet surfaces.

Lighting – Inadequate lighting also may lead to accidents involving falls in parking lots, trips over curbing, falls on a step or stairs from a parking lot to a store and trips and falls due to holes, cracks and uneven surfaces.

Recommended outdoor lighting levels for general parking, ramps and corners, pedestrian areas and entrances are given in LP 628, Lighting for Safety and Performance.

De-Icing Surfaces

Once physical hazards such as uneven pavement, poor lighting and unmarked ramps are remedied, then attention can be turned to the weather-related conditions of walking surfaces.

Slips and falls from snow, rain and ice are common in northern climates. Falls can be caused by inadvertent accumulation of ice and snow due to misapplication of deicing measures. Misapplication can be caused by selecting less-efficient de-icing chemical(s) and friction additives (sand), and inadequately managing application schedules.

Effective ice removal often occurs during the day with full sun. But full sun will melt adjacent snow or ice, placing water on the de-iced walking surface. This will dilute the solution and tend to refreeze at night. With dropping temperatures, ice can re-form with falls occurring first thing in the morning.

The initial step in de-icing is choosing a de-icing agent. When selecting ice-melting chemicals, here are some things to remember:

  • Rock salt (sodium chloride) is the least expensive but is somewhat corrosive and can damage concrete, interior surfaces and vegetation. It may need a wetting agent when used at low temperatures.
  • Calcium chloride and magnesium chloride are more effective than rock salt, and most effective at lower temperatures. Magnesium chloride is somewhat less corrosive than calcium chloride, which is about as corrosive as rock salt.
  • Calcium magnesium acetate is the most environmentally friendly but is more expensive and is least effective at lower temperatures.

Changes in elevation or terrain.

Actual physical hazards like uneven ground or moving from pavement to gravel tend to create a significant trip hazard.

  • Outdoor falls are triggered by uneven sidewalk and street surfaces, curbs and by slipping.
  • Falls commonly occur on porches and in parks.
  • Falls can occur in parking lots and garages, particularly from tripping over short curbs often placed at the end of parking spaces.
  • Be aware of changes in surroundings (especially changes in terrain); Scan ahead and try to stay on level ground while watching for steps, holes, uneven areas, and obstacles in your path.
  • Plan how you will negotiate a curb, the height can be misleading when using inclines, or cutaways for bikes.

When it comes to fall prevention, you can take extra time, “SCAN” ahead and be careful.

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