Summer heat, snow or ice: It doesn’t matter the forecast, Cook Children’s Health Care System is ready for its patients and families.

 As severe winter weather blankets North Texas, Cook Children’s employees continue to shine. Their dedication to patient families and one another ensures that every child receives the care they need, regardless of the conditions outside.

 Dozens of staff members have stayed overnight at “Hero Hotel,” designated on-site spaces providing a safe and secure place to sleep. This allows essential personnel to remain available while avoiding travelling on dangerous roads.

 Additionally, Cook Children’s facilities crews have worked tirelessly to clear roads and sidewalks at the Fort Worth and Prosper medical centers. Food services and environmental services teams are working around the clock to ensure staff members have clean linens and warm meals.

 Cook Children’s Urgent Care Centers, Primary Care, Home Health and specialty clinics continue to monitor the weather closely. Click here to view closures and delayed openings at our Cook Children's locations. 

Keeping Warm and Having Fun

“If you are going to be outside, dress appropriately,” said Sharon Evans, injury prevention manager at Cook Children’s Health Care System.

Experts advise caregivers to dress little ones in several thin layers to keep warm and dry. Children are at more risk from the cold because their bodies lose heat more quickly. Insulated boots, mittens or gloves, and a hat are recommended.

Make sure children change out of any wet clothes as soon as they come indoors.

“While playing in the snow or “sledding” be aware of your surroundings, be careful to not run into trees or out into the street and mailboxes can be real dangers,” said Evans.

Know the Signs of Hypothermia 

According to the American Academy of Pediatrics, hypothermia, or abnormally low body temperature, "is a dangerous condition that can occur when a person is exposed to extremely cold temperatures." This is a medical emergency, and treatment should be sought immediately. 

 Symptoms of hypothermia include: 

• Blue skin
• Shivering
• A cool chest and stomach are signs that children may be dangerously cold.
• If you see these symptoms, take action immediately to get kids out of the cold. Seek immediate medical attention if you are not able to warm the body.
• Victims of hypothermia can include babies sleeping in cold rooms. 

 Warning signs for infants include: 

• Bright red, cold skin
• Very low energy 

 Warning signs for adults include: 

• Shivering, exhaustion
• Confusion, fumbling hands
• Memory loss, slurred speech, drowsiness 

Coats & Car Seats

While keeping kids warm is a priority during the winter, it should never come at the expense of car seat safety.

“Stay home and inside if possible. If you must be on the roads make sure everyone is buckled up correctly,” said Evans.

Bulky coats, such as puffy jackets, can create extra space between the child and harness straps or seat belt, which can increase the risk of injury in a car crash.  It is recommended to dress in thin layers and use a blanket or put the coat on backwards after the child is buckled in. 

If caregivers decide to start the car to allow it to warm up prior to entering the vehicle, it is important to make sure the car is in a ventilated area, such as an open garage, and that they lock the vehicle when they are not inside.  This will make sure that a child does not enter the vehicle unsupervised and become trapped in the vehicle.

Evans adds families should have snacks, water, and extra blankets in their car in case you get stranded. 

“If you are stranded and waiting for help on the side of the road, please make sure everyone stays buckled up,” said Evans, “often cars may slide/spin near you and hit your car.”

In addition, just as local officials advise people to stay off the roadways, if possible, ice can make dangerous driving conditions for ATV’s, Golf Carts and Go Karts.

 Safe Sleep

With winter weather, keeping infants warm is a priority for caregivers, and it is essential to do so safely.

“Caregivers often use extra blankets and hats for warmth, but these soft items can easily become a suffocation or entanglement hazard,” said Samantha St. John, program coordinator at Cook Children’s Center for Community Health.

A safer alternative is a sleep sack, also called a wearable blanket. A sleep sack provides warmth and comfort without risk because it fits securely around the baby's upper body and is sized so the fabric cannot cover their face, while still allowing plenty of room at the bottom for comfort and movement.

St. John suggests a general rule to follow dress a baby in one more layer of clothing than an adult would find comfortable in the same environment.  In winter months this could mean baby is in a long sleep fleece onesie with a wearable blanket/sleep sack. When dressing baby for bedtime or nap time during the extremely cold temperatures, it may be necessary to add socks, mittens, or hats to baby. Caregivers want to make sure that these items cannot come off during sleep and become a loose item in the crib.  It is also important to make sure baby is not going to overheat.  Signs of overheating can include sweating, a hot chest, or flushed skin.  

 Remember the ABCs of Zzzs:

• Alone: The sleep space should be clear of any soft items, such as blankets, stuffed animals, pillows, and bumper pads, leaving only a mattress with a tight-fitted sheet.
• Back: Babies should always be placed flat on their back for every nap and every night.
• Crib: A crib, bassinet, or portable play yard with a firm, flat mattress and a fitted sheet is the safest sleep surface. 

Related Stories:

• Arctic Cold Front: Readiness Tips for Parents
• What To Know During The Winter Weather This Week
• Know When to Use Telemedicine, Urgent Care, or the ER for Kids

De acuerdo a NWS se espera entre 3 a 6 pulgadas de nieve al norte de la I-20.

Lo mejor que uno puede hacer es tener un plan para mantener a todos en su familia seguros y calientitos.

Siga estos consejos de MedStar en preparación para el tiempo invernal:

• Asegúrese de tener números de teléfono importantes anotados, incluyendo sus proveedores de atención médica, farmacia y veterinario.
• Asegúrese de tener suficiente medicamento a la mano para varios días.
• Si depende de dispositivos médicos en su hogar, tenga un plan de respaldo en caso de que se quede sin electricidad durante un período prolongado, como un generador o paquete de baterías y el equipo de oxígeno.
• Tenga un plan de comunicación para su familia.
• Sepa cómo obtener información confiable durante la tormenta.
• Reúna suministros por si necesita quedarse en casa por varios días sin electricidad.

Abríguese 

• Asegúrese de que los recién nacidos estén vestidos apropiadamente. Vístalos en capas y cúbrales la cabeza, las manos y los pies.
• Para mantenerlos más calientitos, vista a sus pequeños con lana en lugar de algodón. Los artículos esenciales de invierno incluyen gorros, guantes, sudaderas o camisetas que pueden colocarse debajo de abrigos o chaquetas.
• La piel azul, los escalofríos, el pecho y el estómago frío son señales de que los niños pueden tener un frío peligroso (hipotermia). Si ve estos signos, tome medidas de inmediato para sacar a los niños del frío. Busque atención médica inmediata si no puede calentar el cuerpo. 

Esté atento a los síntomas de hipotermia.

Según los Centros para el Control y la Prevención de Enfermedades (CDC, por sus siglas en íngles), la hipotermia, o temperatura corporal anormalmente baja, "es una condición peligrosa que puede ocurrir cuando una persona se expone a temperaturas extremadamente frías".

Las señales de advertencia para los adultos incluyen:

• Tiritar
• Sentirse agotado o muy cansado
• Confusión
• Torpeza con las manos
• Pérdida de la memoria
• Habla enredada
• Somnolencia

Las señales de advertencia para los bebés incluyen:

• Piel fría y de color rojo brillante
• Muy poca energía

Entre las víctimas de la hipotermia se encuentran los bebés que duermen en habitaciones frías.

Si hay un apagón, tenga mucho cuidado con el monóxido de carbono.

Durante la tormenta invernal de Texas en febrero de 2021, Cook Children's trató a 13 pacientes por intoxicación por monóxido de carbono en una noche.

Consejos para proteger su familia durante este tiempo:

• No utilice una parrilla o un tanque de propano para calentar su casa, ni nada similar.
• No prenda su vehículo dentro de un garaje adjunto a su casa con la puerta cerrada.
• No caliente su casa con un horno o estufa a gas.
• No queme carbón dentro de su casa.
• Busque atención médica si sospecha que ha sufrido una intoxicación por monóxido de carbono.
• Asegúrese de que los detectores de monóxido de carbono de su casa funcionen correctamente y estén instalados en áreas que lo despierten si suena la alarma.
• Busque recursos locales, como refugios para calentarse.

Los signos de intoxicación por monóxido de carbono pueden incluir:

• Dolor de cabeza
• Náuseas
• Mareos
• Vómitos
• Malestar estomacal
• Dolor de pecho
• Confusión
• Síntomas similares a los de la gripe

Los asientos de seguridad en el invierno

El uso adecuado de la silla de seguridad del auto es una de las formas más importantes en que los padres pueden mantener seguros a sus hijos pequeños, especialmente cuando conducen en condiciones climáticas adversas.

• No abroche a sus hijos en la silla de seguridad del coche con su abrigo. En caso de un accidente, el relleno de un abrigo o de capas gruesas se aplanará, dejando espacio debajo del arnés de la silla de seguridad. Esto aumenta el riesgo de que un niño se resbale a través de las correas y salga a través del asiento del coche. En su lugar, vista a su hijo con capas finas. Una vez abrochado el cinturón, deslice el abrigo hacia atrás con las mangas sobre los brazos del niño. De esta manera, el abrigo actúa como una cobija y no afecta el ajuste del arnés.
• Programe tiempo adicional para llegar a su destino. Y no olvide tomar en cuenta el tráfico.
• Prepare una bolsa de emergencia para su auto. Es una buena idea tener cobijas, ropa de invierno, gorros y guantes disponibles en caso de que se quede atrapado. También tenga alimentos no perecederos guardados.
• Evite los puentes elevados, si es posible. Planifique rutas alternativas para llegar a su destino y evite las zonas de mucho tráfico.
• Deje suficiente espacio con el vehículo que va delante para frenar gradualmente. Cuando las condiciones meteorológicas sean adversas, se toma para frenar el doble de tiempo que
• normalmente se necesita para detenerse por completo.

The best thing you can do is to have a plan in place to keep your family safe and warm through this first taste of winter.

Take these tips from MedStar on what a winter weather plan should include:

• Make sure that you have important phone numbers, including your health care providers, pharmacy, and veterinarian.
• Assure you have enough medication for several days on hand.
• If you rely on medical devices in your home, have a backup plan in case you lose power for an extended period of time, such as a backup generator or battery pack and backup oxygen bottles.
• Have a communication plan for your family.
• Know how to get reliable information during the storm.
• Gather supplies in case you need to stay home for several days without power.

Dress Warmly

• Make sure newborns are dressed appropriately. Dress them in layers and cover their heads, hands and feet.
• For the most warmth, dress your little ones in wool instead of cotton. Essential winter items include hats and gloves, as well as sweatshirts or T-shirts that can be layered under overcoats or jackets.
• Blue skin, shivering and a cool chest and stomach are signs that children may be dangerously cold. If you see these signs, take action immediately to get kids out of the cold. Seek immediate medical attention if you're not able to warm the body.

Keep an eye out for signs of hypothermia.

According to the Centers for Disease Control and Prevention (CDC), hypothermia, or abnormally low body temperature, "is a dangerous condition that can occur when a person is exposed to extremely cold temperatures." 

Warning signs for adults include:

• Shivering, exhaustion
• Confusion, fumbling hands
• Memory loss, slurred speech drowsiness

Warning signs for infants include:

• Bright red, cold skin
• Very low energy

Victims of hypothermia can include babies sleeping in cold rooms.

If you lose power, be very cautious of carbon monoxide.

During the Texas winter storm in February 2021, Cook Children’s treated 13 patients for carbon monoxide poisoning in one night. 

Here are some tips for keeping your family safe during this time:

• Don’t use anything such as a BBQ grill or propane tank to heat your home.
• Don’t run a vehicle inside of a garage attached to your home.
• Don’t heat your home with a gas oven or stovetop.
• Don’t burn charcoal inside your home.
• Do seek medical attention if you suspect carbon monoxide poisoning.
• Do ensure the carbon monoxide detectors in your home are properly functioning and installed in areas that will wake you if it alarms.
• Do check for local resources, such as warming shelters, to keep your family safe.

Signs of carbon monoxide poisoning can include:

• Headache
• Nausea
• Dizziness
• Vomiting
• Upset Stomach
• Chest Pain
• Confusion
• Flu-like symptoms

If you have to travel, have a plan in place to keep yourself and your child safe.

Proper car seat use is one of the most critical ways parents can keep their young children safe when driving during inclement weather conditions. Here are a few safety tips to consider:

• Don’t strap your children into their car seats with their heavy coats on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backward with the sleeves on the child’s arms. This way, the coat acts as a blanket and doesn’t affect the fit of the harness.
• Give yourself extra time to get where you are going. And don't forget to account for traffic. 
• Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats, and gloves available in case you become stuck in winter weather. You’ll also want to have nonperishable snacks packed away.
• Avoid overpasses if possible. Plan alternate routes to your destination and avoid high traffic areas when possible.
• Give yourself enough space from the car in front of you to gradually brake. When weather conditions are poor, give yourself double the time it normally takes to come to a complete stop.

Severe winter weather is hitting North Texas over the weekend and early this week—with below-freezing temperatures, piercing wind chills, and the potential for snow and ice. 

Road and school closures are a possibility, which means you and your little ones might be stuck at home for a few days—but even if the roads stay clear, you’ll likely have to brave some pretty intense cold. No matter what the weather brings, our Cook Children’s experts have shared some of their go-to tips and tricks for staying safe, healthy, and entertained in the days to come.

Tips for Staying Healthy at Home  

Erin Bridgewater, M.D., pediatrician at Cook Children's Pediatrics Celina, offered some ways to ensure you and your family stay healthy through a potential freeze. 

1. Make sure your medicine cabinet is stocked. There’s no need to hoard, but it’s important to make sure you have some basic medications handy in case your child gets sick and the weather makes it hard to get to a doctor. Tylenol, Motrin, Pedialyte, and Benadryl are all great to have on hand.  “If your child requires prescription medications for asthma, seizures, or other chronic illness, make sure you are not running low when winter storms are coming,” said Dr. Bridgewater.
2. Practice carbon monoxide safety. In the case of a power outage, you might be desperate to find alternative ways to heat your home. Never use a gas stove for household heat, and only operate portable stoves and charcoal grills outside and at least 20 feet away from windows. “If you have a new generator you want to try out, make sure to read the manual and use it properly,” said Dr. Bridgewater. “Also make sure you have working carbon monoxide detectors on each level of your home. Improper use of generators in or around the home can lead to deadly carbon monoxide accumulation and poisoning.” If you lose heat and all else fails, consider stocking up on handwarmers and bundling up with winter wear and blankets until the power comes back on. 
3. Bundle Up.  It's safe to let your kiddos go out and play in the snow, as long as it's not too terribly cold. “Remember that cold weather does NOT cause head colds—viruses do. Just make sure your little ones are properly bundled. They may prefer several light, but warm layers over super bulky clothing.” 

Tips for Staying Safe Outside  

Sharon Evans, Trauma Injury Prevention Coordinator, filled us in on safety precautions for the car and playing outside.

1. Never dress your child in a coat in their car seat. No matter how much you tighten the harness, a coat will still allow for enough slack to cause potential dangers during a crash. “For infants, you can heat up the car while you put them in their infant seat inside. Place a blanket over the harness, and then take them out to the car once it’s warmed up,” Sharon explains. "If they’re older, just harness them in and put their jacket backwards over the harness so they can take it off as the car heats up.”
2. Always wear a helmet when playing on ice. Whether it’s sledding, ice skating, or anything in between, it’s easy to fall on ice. Wearing a helmet could protect your child from a serious head injury. “We usually don't have the proper equipment for sledding, for example, so protecting your child's head is really important."
3. Ensure your child is wearing safe clothing. “Some hoodies and coats have drawstrings around the neck, which could be choking hazards." Parents should ensure their kids have good rubber-soled boots to reduce their risk of slipping on ice. “It's fun to play and slide around in the ice and snow, but you don't want them falling and breaking a bone or hurting their head."

Tips for Keeping Your Family Entertained 

Ashley Pagenkopf, MS, CCLS, Child Life Specialist at Cook Children's, told us how to turn being stuck inside into fun and adventurous quality time. 

1. Stock up on hands-on, creative supplies. “I like to have crafting stuff available, things that kids can color or paint that you might not get out on a regular day to play,” Ashley said.
2. Focus on stimulating, long-form activities. Ashley emphasizes the importance of engaging in activities that pass the time, like painting a mural on an old delivery box or building and reconstructing Legos. “I always try to encourage creativity and have things that kids enjoy doing,” she said. “Anything that you can build and then change to try something new is really helpful.” 
3. Make it a movie day. This option won’t work if your power goes out (but we’re hopeful that won’t happen)! Snuggle up and watch your kids’ favorite movies—keeping in mind screen time limitations, which we’ll get to on number 5. She also suggests keeping fun snacks and yummy beverages on hand. “Having some popcorn or hot chocolate with marshmallows is really fun for kids."
4. Set expectations for outside playtime. Only let your kids go outside for 20-25 minutes at a time, taking breaks to come back in and warm up for a while in between. “When kids see snow and ice, they just want to run out and play, and that's typically how they get hurt,” Ashley explains. “I try to prepare my kids by telling them exactly what clothes they need to put on and setting an expectation for how many times we’re going to go outside throughout the day.” 
5. Limit screen time as much as possible. Be careful letting your kids watch TV all day, as they will inevitably become irritable from too much time in front of the screen. “Getting outside is great as long as you have the right clothes, but also getting up and moving around and maybe having a dance party inside is helpful,” she said. “I would encourage families to limit screen time to the afternoon or evening, because if you start the day with it, your kids won’t want to do anything else.”

No matter what the winter weather brings, we hope you stay warm, healthy, and safe and can enjoy some quality time with your family. Inclement weather may cause many of our primary care offices and specialty clinics to close or delay openings. Click here to view closure updates and delayed openings at our Cook Children's locations.

A wintery mix of snow and freezing rain is expected Sunday night through Monday. Amounts are forecasted to remain relatively low; however, anything that falls will likely result in impacts given the very cold air that will already be in place.

The best thing you can do is to have a plan in place to keep your family safe and warm through this first taste of winter.

Take these tips from MedStar on what a winter weather plan should include:

• Make sure that you have important phone numbers, including your health care providers, pharmacy, and veterinarian.
• Assure you have enough medication for several days on hand.
• If you rely on medical devices in your home, have a backup plan in case you lose power for an extended period of time, such as a backup generator or battery pack and backup oxygen bottles.
• Have a communication plan for your family.
• Know how to get reliable information during the storm.
• Gather supplies in case you need to stay home for several days without power.

Dress Warmly

• Make sure newborns are dressed appropriately. Dress them in layers and cover their heads, hands and feet.
• For the most warmth, dress your little ones in wool instead of cotton. Essential winter items include hats and gloves, as well as sweatshirts or T-shirts that can be layered under overcoats or jackets.
• Blue skin, shivering and a cool chest and stomach are signs that children may be dangerously cold. If you see these signs, take action immediately to get kids out of the cold. Seek immediate medical attention if you're not able to warm the body.

Keep an eye out for signs of hypothermia.

According to the Centers for Disease Control and Prevention (CDC), hypothermia, or abnormally low body temperature, "is a dangerous condition that can occur when a person is exposed to extremely cold temperatures." 

Warning signs for adults include:

• Shivering, exhaustion
• Confusion, fumbling hands
• Memory loss, slurred speech drowsiness

Warning signs for infants include:

• Bright red, cold skin
• Very low energy

Victims of hypothermia can include babies sleeping in cold rooms.

If the power goes out, be very cautious of carbon monoxide.

During the Texas winter storm in February 2021, Cook Children’s treated 13 patients for carbon monoxide poisoning in one night. 

Here are some tips for keeping your family safe during this time:

• Don’t use anything such as a BBQ grill or propane tank to heat your home.
• Don’t run a vehicle inside of a garage attached to your home.
• Don’t heat your home with a gas oven or stovetop.
• Don’t burn charcoal inside your home.
• Do seek medical attention if you suspect carbon monoxide poisoning.
• Do ensure the carbon monoxide detectors in your home are properly functioning and installed in areas that will wake you if it alarms.
• Do check for local resources, such as warming shelters, to keep your family safe.

Signs of carbon monoxide poisoning can include:

• Headache
• Nausea
• Dizziness
• Vomiting
• Upset Stomach
• Chest Pain
• Confusion
• Flu-like symptoms

If you have to travel, have a plan in place to keep yourself and your child safe.

Proper car seat use is one of the most critical ways parents can keep their young children safe when driving during inclement weather conditions. Here are a few safety tips to consider:

• Don’t strap your children into their car seats with their heavy coats on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backward with the sleeves on the child’s arms. This way, the coat acts as a blanket and doesn’t affect the fit of the harness.
• Give yourself extra time to get where you are going. And don't forget to account for traffic. 

• Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats, and gloves available in case you become stuck in winter weather. You’ll also want to have nonperishable snacks packed away.
• Avoid overpasses if possible. Plan alternate routes to your destination and avoid high traffic areas when possible.
• Give yourself enough space from the car in front of you to gradually brake. When weather conditions are poor, give yourself double the time it normally takes to come to a complete stop.

Inclement weather may cause many of our primary care offices and specialty clinics to close or delay openings. Click here to view closure updates and delayed openings at our Cook Children's locations.

Many counties in North Texas are under an Ice Storm Warning or a Winter Storm Warning. Travel conditions are expected to worsen as additional sleet and freezing rain deteriorates roads areawide. Travel is NOT recommended, according to the National Weather Service. Delay or plan alternate routes for travel. Slow down when driving and allow for additional travel time.

Ice has the potential to accumulate on trees and power lines Wednesday afternoon into early Thursday morning, according to the National Weather Service. Prepare for tree limb breakage and localized power outages in this region.

Dozens of Cook Children’s staff members are preparing for another night of winter weather. About 70 employees are expected to spend a second night at Cook Children’s Medical Center - Fort Worth to ensure they’re ready to take care of the children who need them tomorrow.  

In addition, our facilities crews have worked all day to make sure the roads and sidewalks around the Fort Worth and Prosper hospitals are safe. And our food services and environmental services teams are going above and beyond to make sure everyone working through the storm has clean sheets and warm meals. We are grateful for each and every one of them!

Take these tips from MedStar on what a winter weather plan should include:

• Make sure that you have important phone numbers, including your health care providers, pharmacy, and veterinarian.
• Assure you have enough medication for several days on hand.
• If you rely on medical devices in your home, have a backup plan in case you lose power for an extended period of time, such as a backup generator or battery pack and backup oxygen bottles.
• Have a communication plan for your family.
• Know how to get reliable information during the storm.
• Gather supplies in case you need to stay home for several days without power.

Carbon Monoxide

If the power does go out, be very cautious of carbon monoxide.

During the Texas winter storm in February 2021, Cook Children’s treated 13 patients for carbon monoxide poisoning in one night. Sam Selby, D.O., worked the overnight shift in the emergency department on Feb. 15, 2021 and saw families use propane or diesel-burning engines that are meant for outside use with adequate ventilation.

Dr. Selby described how families used generators inside or too close to their homes or garages to keep warm. Generators emit fumes and can cause carbon monoxide poisoning.

“Carbon monoxide poisoning prevents your blood from being able to bind to or carry oxygen. You suffocate while you are still breathing,” Dr. Selby explained. 

Here are some additional ways to keep your family safe during this time:

• Don’t use anything such as a BBQ grill or propane tank to heat your home.
• Don’t run a vehicle inside of a garage attached to your home.
• Don’t heat your home with a gas oven or stovetop.
• Don’t burn charcoal inside your home. 
• Do seek medical attention if you suspect carbon monoxide poisoning.
• Do ensure the carbon monoxide detectors in your home are properly functioning and installed in areas that will wake you if it alarms.
• Do check for local resources, such as warming shelters, to keep your family safe. 

Coats & Car Seats

Don’t strap your children into their car seats with their heavy coats on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backward with the sleeves on the child’s arms. This way, the coat acts as a blanket and doesn’t affect the fit of the harness.

Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats, and gloves available in case you become stuck in winter weather. You’ll also want to have nonperishable snacks packed away.

Dressing Warmly

When Outside

• Make sure newborns are dressed appropriately. "A good rule of thumb is to dress newborns in as many layers as you're wearing," said Diane Arnaout, M.D., Cook Children’s Medical Advisor for Digital Health. "That includes covering their heads, hands and feet. Those areas can lose a lot of heat and be harder to keep warm."
• For the most warmth, dress your little ones in wool instead of cotton. Essential winter items include hats and gloves, as well as sweatshirts or T-shirts that can be layered under overcoats or jackets.
• Blue skin, shivering and a cool chest and stomach are signs that children may be dangerously cold. If you see these signs, take action immediately to get kids out of the cold. Seek immediate medical attention if you're not able to warm your body.

Recognizing Hypothermia

According to the Centers for Disease Control and Prevention (CDC), hypothermia, or abnormally low body temperature, "is a dangerous condition that can occur when a person is exposed to extremely cold temperatures." To learn more about the warning signs of hypothermia, click on this site from the Centers for Disease Control and Prevention (CDC).

Warning signs for adults include:

• Shivering, exhaustion
• Confusion, fumbling hands
• Memory loss, slurred speech drowsiness

Infants:

• Bright red, cold skin
• Very low energy

Victims of hypothermia can include babies sleeping in cold rooms.

Wind chills are expected to be below zero degrees on Thursday, according to the National Weather Service. Be sure to dress warmly, cover up any exposed skin and limit your time outdoors. Hypothermia begins when our body temperature drops two to four degrees. 

By Thursday night, low temperatures will fall into the single digits across most of the Dallas-Fort Worth region. By Friday morning, temps will be in the teens or possibly in the single digits with high wind gusts.

People exposed to extreme cold are susceptible to frostbite in a matter of minutes. Areas most prone to frostbite are uncovered skin and the extremities, such as hands and feet.

Take these tips from MedStar on what a winter weather plan should include:

• Make sure that you have important phone numbers, including for your health care providers, pharmacy, and veterinarian.
• Assure you have enough medication for several days on hand.
• If you rely on medical devices in your home, have a backup plan in case you lose power for an extended period of time, such as a backup generator or battery pack and backup oxygen bottles.
• Have a communication plan for your family.
• Know how to get reliable information during the storm.
• Gather supplies in case you need to stay home for several days without power.

Carbon Monoxide

If the power does go out, be very cautious of carbon monoxide.

During the Texas winter storm in February 2021, Cook Children’s treated 13 patients for carbon monoxide poisoning in one night. Sam Selby, D.O., worked the overnight shift in the emergency department on Feb. 15, 2021 and saw families use propane or diesel-burning engines that are meant for outside use with adequate ventilation.

Dr. Selby described how families used generators inside or too close to their homes or garages to keep warm. Generators emit fumes and can cause carbon monoxide poisoning.

“Carbon monoxide poisoning prevents your blood from being able to bind to or carry oxygen. You suffocate while you are still breathing,” Dr. Selby explained. 

Here are some additional ways to keep your family safe during this time:

• Don’t use anything such as a BBQ grill or propane tank to heat your home.
• Don’t run a vehicle inside of a garage attached to your home.
• Don’t heat your home with a gas oven or stovetop.
• Don’t burn charcoal inside of your home. 
• Do seek medical attention if you suspect carbon monoxide poisoning.
• Do ensure the carbon monoxide detectors in your home are properly functioning and installed in areas that will wake you if it alarms.
• Do check for local resources, such as warming shelters, to keep your family safe. 

Coats & Car Seats

Don’t strap your children into their car seats with their heavy coats on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backward with the sleeves on the child’s arms. This way, the coat acts as a blanket and doesn’t affect the fit of the harness.

Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats, and gloves available in case you become stuck in winter weather. You’ll also want to have nonperishable snacks packed away.

Dressing Warmly

When Outside

• Make sure newborns are dressed appropriately. "A good rule of thumb is to dress newborns in as many layers as you're wearing," said Diane Arnaout, M.D., Cook Children’s Medical Advisor for Digital Health. "That includes covering their heads, hands and feet. Those areas can lose a lot of heat and be harder to keep warm."
• For the most warmth, dress your little ones in wool instead of cotton. Essential winter items include hats and gloves, as well as sweatshirts or T-shirts that can be layered under overcoats or jackets.
• Blue skin, shivering and a cool chest and stomach are signs that children may be dangerously cold. If you see these signs, take action immediately to get kids out of the cold. Seek immediate medical attention if you're not able to warm the body.

Recognizing Hypothermia

According to the Centers for Disease Control and Prevention (CDC), hypothermia, or abnormally low body temperature, "is a dangerous condition that can occur when a person is exposed to extremely cold temperatures." To learn more about the warning signs of hypothermia, click on this site from the Centers for Disease Control and Prevention (CDC).

Warning signs for adults include:

• Shivering, exhaustion
• Confusion, fumbling hands
• Memory loss, slurred speech drowsiness

Infants:

• Bright red, cold skin
• Very low energy

Victims of hypothermia can include babies sleeping in cold rooms.

Want to know more about winter weather safety? 

Check out these articles from Checkup Newsroom contributors:

• Cold Weather and Kids. How to Keep Your Family Safe at Home, Outside and in the Car. 
• Bracing for Freezing Weather: Plan Ahead to Protect Your Family on the Road
•  Common Winter Mistakes Parents Make
• Cook Children’s Sees Spike in Carbon Monoxide Poisoning Patients During Freezing Temperatures

By Michelle Bailey, M.D.

I’m writing this from home, dressed in three layers and with all unnecessary electrical items turned off. I’m anxious about when the power may go in and out, and if the water will continue dripping from the faucets. During extreme weather, with doctor’s offices closed, it may be worrisome to think about what you would do if your child is sick.

Right now with the power on, I am available, as are many other Cook Children’s Pediatric and Urgent Care clinics, to do telemedicine Zoom or phone visits. But if a medication is necessary, you’d still be responsible for going into a pharmacy to pick it up. Under some extreme circumstances, there are a few things you can find in your medicine cabinet to use in a pinch. Of course, follow any doctor recommended advice and call 911 if your child is having a medical emergency that needs immediate assistance.

The following is simply what can be done - if absolutely necessary - in extreme circumstances: 

• Heating formula or breastmilk bottles: While it’s nice to have a bottle warmer, if the power is out, it is not necessary. Your baby can and will drink milk even if it is cold. So go ahead and offer pumped breastmilk from the fridge, or mix formula powder with room temperature nursery water or even bottled water from the fridge. Room temperature breastmilk or formula should be consumed within 1-2 hours.

• Vomiting: The main goal is to keep your child hydrated. If you have powdered electrolyte solution on hand, such as Pedialyte powder packs, use this. Otherwise, offer frequent sips of water. Motion sickness medication and antihistamines, such as Dramamine and Benadryl, can also offer some relief to nausea and vomiting.

• Fever: If your child’s temperature is above 100.4F, use a weight-based dose of fever reducing medication. If you are out of medication, use natural ways to reduce temperature such as removing a layer of clothing, place cool wet rags to the forehead, armpits and back, and offer sips of cold water, popsicles or even yogurt. There is no “brain boiling” temperature, but you will want to keep your child comfortable by lowering their fever. Remember, fever is an actual thermometer measured temperature of above 100.4F, not just how warm your child feels.

• Wheezing, coughing, fast or difficulty breathing: If your child is in respiratory distress, call for an ambulance. If they are having a worsening cough or wheezing and you have a nebulizer and albuterol medication at home, start using it as directed on the prescription. It is always helpful for your child with asthma or wheezing to have a backup albuterol inhaler and spacer, in the event power goes out and you cannot use the nebulizer machine. If it has been awhile since you put together the nebulizer and tubing, here is a refresher video, click on the “using a nebulizer” tab: https://cookchildrens.org/pediatrics/McKinney/Pages/video-library.aspx. And in the most extreme of circumstances, if your child is wheezing or having trouble breathing and you are out of nebulizer medication, and/or or power is out, and you don’t have the albuterol inhaler, and you can’t drive to the emergency room, and 911 says they are 30 minutes away…. you get it, worst of worst scenarios, then offer your child some coffee or other highly caffeinated beverage. Caffeine is a weak bronchodilator, which can reduce respiratory muscle fatigue and can improve lung function for up to two hours. This is not to say coffee or soda is a replacement for your child’s prescribed inhaler, but it can make a difference when minutes matter during an impossibly unprecedented situation.

Again, call your child's pediatrician FIRST and speak to the doctor or nurse before trying any of the above. Please stay safe and stay warm!

The National Weather Service previously warned of widespread freezing rain and sleet across North and Central Texas, which left roadways wet and slick.

Going into the weekend and early next week, temperature highs will range in the teens up into the 30s, and some areas are expected to see 2-7 inches of snow. If you don’t have a reason to leave home, please stay inside, stay safe and stay warm. If you have to go out, have a plan in place and rid yourself of any distractions so you can focus on the road.

Proper car seat use is one of the most critical ways parents can keep their young children safe when driving during inclement weather conditions.

“The injuries we see from car wrecks are because parents are making the same mistakes over and over with car seats,” explains Sharon Evans, trauma injury prevention coordinator at Cook Children’s.

The American Academy of Pediatrics recommends parents keep their children rear-facing as long as they fit within the height and weight requirements printed on their car seats. Evans says another prevalent issue is the lack of transitioning children into booster seats.

“Children should be in a booster seat until they’re 4-foot-9. We often see parents letting them go into a seat belt too early,” Evans explained.

She reminds parents to keep children calm and quiet when traveling, whether that means playing their favorite music, letting them bring a safe toy, or talking with them before leaving home. “Children can read your emotions,” she said. “If you’re uptight, they will be able to sense it.”

Here are more tips for parents to consider before getting behind the wheel:

1. Leave enough time for your commute. Give yourself extra time to get your children to school and yourself to work, accounting for other drivers on the road.
2. Don’t strap your children into their car seats with their heavy coats on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backward with the sleeves on the child’s arms. This way, the coat acts as a blanket and doesn’t affect the fit of the harness.
3. Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats, and gloves available in case you become stuck in winter weather. You’ll also want to have nonperishable snacks packed away.
4. Avoid overpasses if possible. Plan out alternate routes to your destination and avoid high traffic areas when possible.
5. Give yourself enough space from the car in front of you to gradually brake. When weather conditions are poor, give yourself double the time it normally takes to come to a complete stop.