No one wants to spend the holiday season in a hospital waiting room, nursing a fractured wrist or worse.
Over Christmas, the emergency room is “a tale of two cities,” according to Dr. Alecs Chochinov, a Winnipeg doctor and current president of the Canadian Association of Emergency Physicians.
“Sometimes, it can be absolutely overwhelming there,” he said. “Because of the time of year, there can be motor vehicle accidents, there can be mental health problems — there’s a surge of patients. Doctors may be on vacation so we can’t get ahold of them. It seems a bit crazy.”
At other times, it’s quiet, almost peaceful. “When you’re working the Christmas shift, at midnight on those years [and] it happens to slow down, it’s a pretty nice place.”
Here are the kinds of things that emergency physicians say bring people in during the holiday season.
This is the big one, according to Dr. Chad Ball, a trauma surgeon and professor of surgery and oncology at the University of Calgary.
“If you just look generally, ignoring the holidays, the No. 1 mechanism of major injury in Canada by far is actually falls.”
And if conditions are slippery, things get worse, said Chochinov. “We get people in the evening going to and from the car or to and from a party, falling, and it’s very easy to fracture a wrist or break a hip in the dark if you’re wearing heels that you haven’t worn or if you’ve had too much to drink.”
In the 2016-17 fiscal year, although more people went to the emergency room for falls in January and the summer, hospitalizations reached their peak in December, according to data from the Canadian Institute for Health Information. More than 10,000 Canadians were hospitalized after falling in December 2016.
There’s a special category of holiday-related falls too: injuries sustained while putting up Christmas lights. A small study that Ball co-authored found that people got seriously injured when falling off ladders or roofs while hanging lights.
“The most common injuries in that series were mostly chest injuries, so rib fractures, bruising of the lung, collapsed lung would be the most common,” he said. Some people got brain injuries, or broke their arm or leg.
“It’s typically males that are mostly injured doing these things out on ladders where they probably shouldn’t be,” he said. “In fact, people die from Christmas light installation, believe it or not.”
Ball suggests some common-sense approaches to fall prevention. “Stay on even ground. Wear appropriate well-cushioned footwear that fits. Try to avoid going out if you’re elderly on those icy days.”
And when it comes to Christmas lights, get a friend to help you, hire a professional, or do your lights before winter hits.
Another common category of injury that Chochinov sees over the holidays is people trying to do too much: shovelling or skiing hours on end, for example, when they aren’t in good enough shape to push themselves.
“They’ll go out and throw their back out, or they’ll have frostbite in their hands and feet, that sort of thing. More serious things like strokes and heart attacks can come when people who are a little bit older, have risk factors, aren’t in great shape and just feel that they want to get back to the condition of their youth all in one morning or afternoon,” he said.
“They’re a function of, people have a little time off, it’s cold outside, people have had a little too much to drink, sometimes they exercise Christmas judgment instead of normal, logical thinking.”
In this case, moderation is key, he said.
A large proportion of major trauma is linked to alcohol, Ball said. “We’ve never analyzed that specifically over the holidays, but anecdotally, it certainly seems to increase.”
Chochinov agrees that it’s an aggravating factor.
“You can be doing something that could be perfectly normal. But if you’ve had alcohol, you’re more likely to slip, you’re more likely to fall, you’re more likely to not notice you’re going too fast, or the light.”
More patients come into Chochinov’s emergency room with mental health complaints like depression, loneliness and even suicidal thoughts during the holidays, he said.
“Christmas is a very tough time for some people. There’s so often a discrepancy between people feeling they should be festive and happy and how they actually are feeling.”
People should reach out for help if they’re in trouble, he said, and families and friends need to keep an eye on their loved ones.