hand & finger safety

It can be very easy to forget about hand and finger safety when we

• play and celebrate
• work (including housework)
• are busy

But we cant neglect finger and hand safety! Here are some guidelines to help you keep your hands and fingers safe.

pinch or crush by doors of cars, buildings, homes

This is one of the most common type of finger injuries, and typically it happens because someone else accidentally closed the door on another person's hands or fingers.

Happens to babies, children and even adults.

Usually it's milder at the closing part versus at the hinge part:

Most damage and pain is inflicted at the closing hinge (double red boxes) versus the closing end which is the orange boxes. To prevent such door injuries, here's what to do:

1. Installing door finger pinch guards, and there are two types of these that I installed in my own homes, businesses and clinics: 

2. Educate, remind, remind.

Most of the time, people do not intend to hurt others, especially children...so it falls on us to remind one another on finger and hand safety at doors, to

• keep one's own fingers and hands away from moving parts, hinges or doors AND
• to keep a lookout for other's fingers and hands as-and-when one closes doors

3. Consider replacing doors with sliding doors

FIREWORKS SAFETY

From what I understand, fireworks are a staple of United States Fourth of July celebrations. And coming from Malaysia, I totally get it - growing up in Negeri Sembilan, Kuala Lumpur and Johor in the 80s to 2000s, all of us played with fireworks.

It's thrilling and fun, but it can be dangerous.

We played the mild stuff, that shoots into the air and hand-held colorful stuff that may possible burn at worst mildly, or the classic harmless "pop-pop" firecrackers - all generally 99% safe stuff.

But I'd heard of friends who enjoyed playing the dangerous stuff, such as the "meriam buluh" or in English, it's called the bamboo cannon. I would hear of their friends or family members, who had lost fingers and hands when the bamboo cannons explode without warning.

Scary stuff. 

In the US, about 200+ people visit the emergency room with fireworks-related injuries in the weeks before or around the 4th of July. Usually these injuries are the hands and fingers, but fireworks can also cause serious injuries to ears, face and eyes!

Typical fireworks injuries are caused by

• firecrackers
• bottle rockets
• sparklers (which can burn at about 2000 degrees! Hot enough to melt metal - think about how dangerous it can be)

GARDENING SAFETY

If you have green fingers and a yard (or an area) or passion for gardening, wonderful!

Gardening is a great way to get 

• physical activity
• bond with friends, family and even neighbours
• beautify your neighbourhood 
• or if you're like, like planting productive plants / trees, you can also plant herbs, fruit trees and other productive plants like the anti-mosquito plants

That being said, there's a couple of things you need to do to protect yourself and take proper safety precautions with tools, chemicals and insects too.

Here are some gardening precautions to avoid injuries and pains:

USE GARDENING GLOVES

Wearing the proper gardening / yard gloves will prevent / protect your skin from blistering or abrasions, but also from 

• fertilizers
• pesticides
• bacteria
• fungus

that live in the soil. When exposed to soil, even the smallest cuts or even abrasions on your skin can lead to possible major finger or hand infection.

Leather gloves also protects you from thorny plants, poison ivy, snakes / bugs, rodent bites and other skin irritants in the garden. It will also prevent sun damage as well as fingernail damage.

AVOID PROLONGED REPETITIVE MOTIONS

I recommend patients who enjoy gardening to "break up" their gardening tasks into blocks of 15 minutes rotation, rather than hours of just 1 task such as digging, raking, trimming hedges, planting bulbs etc.

This is so that the same muscles are not strained over and over.

USE GARDEN TOOLS...NOT YOUR FINGERS OR HANDS

Use a hand shovel or rake rather than your fingers for digging. Sometimes there's sharp objects (other than bacteria) in the soil that can cut and hurt you. 

Clear the garden area first before starting your task to prevent injuries.

USE RIGHT TOOL FOR THE RIGHT JOB

There's a specific and right tool for the specific task or job, use it well. 

• When it comes to shears / cutting tools, look for one with a safety lock
• Avoid products with specific form-fitting handles...because these tend to suit / fit ONE size of hand only. If it doesnt fit you, it'd place more strain and stress on your hand.
• Always, always follow manufacturers instruction.
• Keep sharp tools away from children at all times.
• Always unplug any electrical tools or wires when not in use.
• Use protective gear.

CHECK YOUR POSTURE

Posture here refers to your entire body - how your body is position, your hand and shoulder angle using tools etc. There is higher performance when your body is relaxed and in neutral position, and least strains. Conversely, awkward reaches or positions will cause more strains and injuries.

HOW TO GET A RING OFF your finger safely

Ah, many of us has personally experienced the difficulty of getting a ring that's stuck off our finger. Especially if there's changes due to 

• arthritis / osteoarthritic changes of the finger joints
• body / hand changes over the years

Here's how we recommend getting a ring off safely:

1. Use a lubricant - soap or oil OR
2. Lift / elevate the hand over your hand for about 10 minutes with ICE around the finger below the ring OR
3. Use a dental floss or thread to compress the swollen finger, starting at the 2nd part of the finger (ring is at the 1st part nearest to knuckle and finger nail is at the 3rd part). Wrap the dental floss snugly from nail towards ring. This will compress the finger and then slide the ring out (lubricate if you need to)

If all fails, you can consider cutting the ring off with a ring cutter found in jewelry stores, fire departments and emergency rooms.

LAWN MOWER SAFETY

Unfortunately, there are hundreds of thousands of patients who are injured by lawn mowers or related injuries every year (that's 100,000s+!). 

Usually how people get injured with lawn mowers are:

• Cuts: Cuts can occur anywhere on the body but most often occur on the hands and feet from the sharp blades. To make things worse, even very small wounds or cuts can introduce bacteria into the wounds - that's why infections are common, and antibiotic medicines usually are necessary.
  
• Burns: The hot engine, gas tank or exhaust of a lawn mower can cause burns. Which is why we recommend push lawn mowers instead of gas ones (a better workout too!)
• Missile Injuries: If there's any loose objects in the lawn, such as wires or pebbles, these can be flung at a high speed from the spinning blades (usually from gas-powered mowers)
• Fractures (Broken Bones): The rotating blades of a mower can cause broken bones if you come in contact with them
• Amputations: in some cases, the sharp blades of a mower can slice off / amputate parts of toes, foot and fingers. Sometimes, infections, burns or fractures can be bad enough to require amputation too.

HOW TO PREVENT LAWN MOWER INJURIES

• Read your mower's instruction manual prior to use.
• I prefer to use non-gas powered ones to prevent high-powered blade injuries or burns from hot exhaust. Choose one that has a guard / protection over hot and sharp parts.
• Keep your lawn mower well maintained and in good working condition (and blades sharp).
• Clear / pick potential flying objects such as pebbles, toys, wires before you start mowing.
• Wear safety goggles, hearing protection, yard gloves and long pants as well as close-toe (covered) shoes.
• Do not drink any alcohol or medicines that may impair your alertness.
• Do not remove safety devices or safety guards.
• NEVER insert hands or feet into mower to remove any stuck grass or items. Often the motor has "1 more turn" even after it's been turned off. Turn off the motor and disconnect the power (if you use gas one) first and wait THEN use a stick instead
• Do NOT lift a mower using your hands from the bottom - the blades can cut through skin and joints even if they are not spinning or moving. Whenever you plan to move the mower, make sure it's turned off and disconnected if its a gas / powered one.
• Do not cut grass when it's wet or damp.
• NEVER allow children under 16 to operate a lawn mower (powered or driven kind). Keep children off the lawn during lawn mowing.
• Do not pull a mower backwards.

If you ever suffered a lawn mower injury, please seek medical attention immediately, even though it may seem small as bacteria can go in (soil and grass does have bacteria). Clean the wound with soup and water and see a doctor.

PUMPKIN CARVING SAFETY

Halloween injuries isnt the kind of boo scares we like...but unfortunately, every Halloween there's a number adult AND children injuries, who get injured cos of pumpkin carving. They can get mild to severe injuries to their fingers and hands, and Halloween is truly ruined for them.

Some need simple stitching, but others need surgical repairs and even hand therapy for months.

To prevent hand and finger injuries during Halloween, consider these pumpkin carving safety tips:

1. CARVE IN A CLEAN, DRY, WELL-LIT AREA Wash and thoroughly dry all of the tools that you will use, including: carving tools, knife, cutting surface, and your hands. Any moisture on your tools, hands, or table can cause slipping that can lead to injuries.
2. ALWAYS HAVE ADULT SUPERVISION "All too often, we see adolescent patients with injuries because adults feel the kids are responsible enough to be left on their own," says Wint. "Even though the carving may be going great, it only takes a second for an injury to occur."
3. LEAVE THE CARVING TO ADULTS Never let children do the pumpkin carving. Wint suggests letting kids draw a pattern on the pumpkin and having them be responsible for cleaning out the inside pulp and seeds. When the adults do start cutting, they should always cut away from themselves and cut in small, controlled strokes.
4. BLUNT IS BETTER "A sharper knife is not necessarily better, because it often becomes wedged in the thicker part of the pumpkin, requiring force to remove it," says Wint. "An injury can occur if your hand is in the wrong place when the knife finally dislodges from the thick skin of the pumpkin. Injuries are also sustained when the knife slips and comes out the other side of the pumpkin where your hand may be holding it steady."
5. USE A PUMPKIN CARVING KIT Special kits are available in stores and include small, serrated pumpkin saws that work better because they are less likely to get stuck in the thick pumpkin tissue. "If they do get jammed and then wedged free, they are not sharp enough to cause a deep, penetrating cut," says Wint.
6. HELP FOR AN INJURY Should you cut your finger or hand, bleeding from minor cuts will often stop on its own by applying direct pressure to the wound with a clean cloth. If continuous pressure does not slow or stop the bleeding after 15 minutes, an emergency room visit may be required.

SNOW BLOWER SAFETY

Wrong and dangerous handling of snow blowers can cause finger and hand injuries. A number of these injuries are amputations to the tips of the fingers, so we'd really want to prevent snow blower hand injuries.

What happens is that usually, injuries happen when the snow is either

• heavy
• wet
• accumulated a few inches

Then what happens is that the thick, wet or heavy snow may get stuck, clogging the exit chute of the machine...and then the person using the machine tries to unclog it using their hands or fingers. 

PROBLEM: the blades can still rotate when the snow blower machine is switched off, and unfortunately will cut whatever comes into contact with these spinning blades.

Here's some snow blower safety tips:

Stay safe this season with these snow blower safety tips:

HOW TO KEEP YOUR SNOW BLOWER FROM CLOGGING

• Work at a brisk pace. The faster the blades and pace, the less likely the snow will stick.
• If heavy, wet snow is anticipated, consider snow blowing several times during the snowfall. Heavy snow is more likely to clog.
• Some people spray the blades and chute with cooking oil spray. This may help.

IF YOUR SNOW BLOWER CLOGS

• Turn it OFF!
• Disengage the clutch.
• Wait five seconds after shutting the machine off to allow the impeller blades to stop rotating.
• ALWAYS use a stick or broom handle to clear the impacted snow. DO NOT assume that you are safe just because the power switch is off.
• NEVER put your hand down the chute or around the blades.
• Keep all shields in place. DO NOT REMOVE the safety devices on the machine.
• Keep your hands and feet away from all moving parts.

REMEMBER:

• Protect your eyes from flying debris by wearing goggles or glasses, especially if you are unclogging the machine.
• Stay focused while snow blowing.
• Wear boots with traction to avoid slipping.
• Do not drink alcohol or use narcotics before using your snow blower!
• When being moved or picked up, snow blower should be turned off, spark plug disconnected, and unplugged. Do not try to lift the machine from the bottom, even if it’s not running. The blades are sharp enough to cause serious injury.
• Never allow children to operate or be near the machine while in use.

If you suffer a snow blower injury, seek medical attention immediately, even for seemingly small injuries. Even small cuts can be infected and may need antibiotics. Before you seek treatment, clean a cut well with soap and water and cover with a bandage. More severe injuries can lead to multiple finger amputations. 

Save any amputated body part in a sealed plastic bag wrapped in moist gauze or cloth and place that bag in another bag of ice. Go immediately to the closest emergency room. It may not always be possible to reattach an amputated part. The further the injury is toward the fingertip, the less likely it could or should be reattached.

If you amputate a hand or finger, your function will likely never return to normal.  Patients who smoke, have diabetes, and have other medical conditions may have worse outcomes if they sustain these injuries. Prevention is still the best treatment. Ensure that you are doing everything in your power to stay healthy and safe!

TABLE SAW SAFETY

Table saws are very useful tools used to cut and shape all types of materials; however, they can cause serious hand injuries. The hands are vulnerable because they are used to guide pieces into the saw. Most often, injuries are lacerations due to direct contact of fingers and hand with the saw blade. Kickback injuries can also cause serious problems, as can burns.

The degree of injury can vary widely. The severity depends on the location of the injury (finger, hand, or forearm). Also, the depth of the injury is important (skin only vs. deeper tissues such as tendons, nerves, arteries, and bone). Qualities of the saw change the injury, as well. Differences in the kerf (the width of the cut made by the saw blade), tooth pattern, type, and force of the saw can change the injury.

Anything that contacts the saw blade can be injured. Nerve injuries cause a loss of feeling or loss of ability to control certain muscles. Circulation may be lost if the arteries are injured. Saws can also break bones. Sometimes, you can lose part of the bone, which would lead to amputation. Electric shocks and burns can also occur while operating a table saw.

Large population studies have shown that time off work due to a table saw injury can range from 24-125 days. Medical costs range from $2,906-$40,121, depending on the severity of the injury. Lost wages range from $2,731-$14,220 [Hoxie 2009].

CAUSES

Many table saw injuries are caused by failing to follow safety precautions. Other contributing factors include awkward cuts and untidy working spaces. Distractions and doing the job in a hurry are also dangerous. Finally, alcohol is often a factor with major injuries. Avoid alcohol and drugs while using this equipment.

Recommendations for safe use

• Follow all the safety instructions provided for your table saw
• Read the owner’s manual
• Do not override safety guards; they are there for your protection. Specifically, make sure the following are in place: Riving knife, Blade guard and Anti-kickback pawls
• Take your time and plan ahead
• Keep your workspace clean
• If a planned cut seems awkward or unsafe, find a better way to perform itConsider using a jig or an assistant, depending on the job
• Consult trusted websites online, where professionals demonstrate how to make unique cuts
• Never look away from your work
• Never use your hands to clear the scraps from a sawing worktable; instead, use a push stick
• Do not wear loose clothing, gloves, or jewelry; avoid long sleeves, neckties, and hoodie strings
• Keep your finger off the trigger when carrying a portable saw
• Do not use the saw to perform a task for which it was not designed
• Use the correct blade for the application and set it for the correct depth to minimize the amount of exposed blade and reduce the potential for binding
• Use sharp blades because dull blades cause binding, stalling, and possible kickback
• Avoid cutting nails, screws, and staples
• Use a rip fence whenever possible
• When starting, let the saw reach full speed before cutting and support the work firmly so it does not shift
• If the saw stalls, switch off the power and unplug the tool before trying to restart it
• When working with metal, secure the metal materials with clamps or in a vise to keep it from moving
• Check for proper blade guard operation before each cut
• When starting or stopping the saw, make sure the work is not touching the blade
• Lower a table saw blade below the tabletop when finished
• Keep a clear head, concentrate, take your time, and DO NOT DRINK ALCOHOL before using a table saw!
• Take extra time and care when supervising students and adolescents (e.g., shop class)

There are now commercial table saw products available to decrease injury. The technology works quickly to stop the blade from cutting if it senses you have touched the blade.

Though this technology is good, it does not prevent all types of injury; in fact, it does not help with kickback. If you use blade-stopping technology, be careful not to become complacent. Continue to use the safety recommendations listed above.

TREATMENT

Some treatment options include:

• Stitches or bandages for cuts
• Skin grafts for larger skin injuries
• Casts for broken bones
• Surgery to repair tendons, blood vessels, nerves, and bones
• Amputation (removal) or replantation (reattachment) of the finger, hand, or arm

Not all these treatment options are possible. Consult your hand surgeon for the best option. Side effects such as weakness, stiffness, or numbness are common after table saw injuries.

TURKEY CARVING SAFETY

Nothing says “Thanksgiving” like football, family and the enticing aroma of turkey. But every year, too many people severely cut their hand while carving a turkey. Luckily, these injuries are avoidable. Here's how to carve a turkey safely to enjoying your Thanksgiving feast: 

• Never cut toward yourself. Your free hand should be placed opposite the side you are carving toward. Don’t place your hand underneath the blade to catch the slice of meat.
• Keep your knife handles and cutting area dry to avoid slips. Good lighting around the cutting area is also important.
• Keep all cutting utensils sharp. Having a sharp knife will avoid the need to use a lot of force when cutting, which can be dangerous. Dull knives are more likely to cause slips and are still sharp enough to cause an injury. If possible, use an electric knife.
• Use kitchen shears to tackle the job of cutting bones.

If you cut your finger or hand, bleeding from minor cuts will often stop by applying direct pressure to the wound with a clean cloth.

WHEN TO SEEK MEDICAL HELP

Visit the emergency room if you’ve cut yourself and:

• Continuous pressure does not stop the bleeding after 15 minutes
• You are unsure of your tetanus immunization status
• You are unable to thoroughly cleanse the wound by rinsing with a mild soap and plenty of clean water

Visit a hand surgeon within a few days if you’ve cut yourself and:

• You notice persistent numbness or tingling in the fingertip
• You have difficulty moving or bending your fingers