Winter – Cold Weather and Power Outage Safety

Winter brings cold temperatures, snow, freezing rain, and high winds. When rain freezes, ice weighs down trees and power lines, this can lead to power outages (see below for multi-language fact sheets).

Photo by Brett Sayles (cc license)

During a winter storm

Washington Department of Health tips:

  • Wear several layers of loose-fitting, lightweight, warm clothing rather than one layer of heavy clothing. Wear mittens rather than gloves. Wear a warm, woolen cap.
  • Do not drive unnecessarily.
  • Reduce the temperature in your home to conserve fuel.
  • Heat only the areas of your home you are using. Close doors and curtains or cover windows and doors with blankets.
  • Use alternative heat methods safely. Never use a gas or charcoal grill, hibachi or portable propane heater to cook indoors or heat your home.
  • Never use a generator indoors or in a garage or carport.
  • Be careful when shoveling snow. Do not overexert yourself.
  • Be sure to eat regularly. Food provides calories that maintain body heat.
  • Watch for signs of frostbite and hypothermia — slurred speech, disorientation, uncontrollable shivering, stumbling, drowsiness and body temperature of 95 degrees Fahrenheit or less.
  • If you become trapped outside, get out of the wind and stay dry. Build a lean-to or snow cave if nothing else is available. Do not eat snow; it will make you too cold.

If in your vehicle

  • Make sure someone knows where you are going. Stay on the main roads.
  • If you must stop, remain inside the vehicle. Use a bright distress flag or your hazard lights to draw attention to your vehicle.
  • If trapped in a blizzard, clear your tail pipe and run your engine and heater for 10 minutes every hour. Open your window slightly.
  • During night hours, keep the dome light on in the car so rescue crews can see your vehicle.
  • Keep an emergency kit in your vehicle. Include a three-day supply of water and non-perishable food that can be eaten without being cooked. Include a blanket or sleeping bag for each passenger, a flashlight, cell phone, shovel, sack of sand or kitty litter, booster cables, flare, coffee can with lid, and toilet paper.

PDF tip sheets in other languages: Spanish, Chinese, Korean, Russian, Somali, Ukrainian, Vietnamese

What should I do if I see damaged or downed power lines?

Department of Health Seattle & King County:

  • Don’t get near any fallen or sagging power line!
  • Call the utility company about the line
    (Seattle area residents: 206-684-7400, other King County residents: 1-888-225-5773).

If you have a power outage, safe ways to stay warm

  • Find places where you can go to get warm, such as the home of friends and family whose homes have power.
  • Wear several layers of light weight, warm clothing rather than one layer of heavy clothing. Wear hats, mittens, and blankets indoors.
  • Close curtains and cover windows and doors with blankets. Everyone should try to stay together in one room, with the door closed, to keep in body heat.

Prevent poisoning from carbon monoxide

  • If you don’t have electricity, only use a generator outdoors and far from open windows and vents.
  • NEVER use a generator indoors, in garages or carports
  • NEVER cook or heat indoors with a charcoal or gas grill 

Help Others

Q&A RSV, flu and COVID in King County: What should I know?

In the Fall and Winter months there is often a rise in respiratory viruses. This Fall (2022) there have been many RSV and flu cases requiring emergency room visits – especially for young children. Health clinics might also see more COVID cases and hospitalizations in the winter as people gather indoors and new COVID variants spread. These diseases can make young children, older adults, and other vulnerable people very sick, and overload hospitals and clinics.

RSV is a common respiratory virus that spreads every winter. Anyone can get RSV, but in 2022 we’re seeing a lot of cases in young children. For healthy adults and older children RSV can feel like a cold, with symptoms like runny nose, less appetite, coughing, and fever. But it can be a very serious illness for babies, older adults, and others.

The Seattle and King County Department of Public Health has put together an informative slide deck in eighteen languages. The deck Includes information about RSV, flu and COVID in King County, what to look for and how to prevent illness.

These slides can be shared in waiting rooms, at community centers, and in other places where people gather. Slides are available in the following languages:
• አማርኛ (Amharic)
• العربية (Arabic)
• 简体字 (Chinese – Simplified)
繁體字 (Chinese – Traditional)
• دری (Dari)
• English
• Français (French)
• 日本語 (Japanese)
• ភាសាខ្មែរ (Khmer)
• 한국어 (Korean)
• KajinM̧ajeļ (Marshallese)
• ਪੰਜਾਬੀ (Punjabi)
• Русский (Russian)
• Af Soomaali (Somali)
• Español (Spanish)
• Wikang Tagalog/Filipino (Tagalog/Filipino)
• ትግርኛ (Tigrinya)
• Українська (Ukrainian)
• Tiếng Việt (Vietnamese)

How Does the American Health System Work

The American Health System is complicated. This fact sheet was produced to guide patients to where they can see a doctor. It describes the differences between a Primary Care Clinic, a Specialty Clinic, the Emergency Room, and In-Patient Care and when it is appropriate to use each service. The goal of this resource is to help improve health literacy for English, Spanish, Chinese, and Vietnamese speaking patients.

photo by Online Marketing (cc license)

Infant Formula Shortage Resources

Washington State Department of Health Resources

Photo by: Jaye Haych (cc license)

The Washington State Department of Health (DOH) has compiled the following resources to assist families and caregivers trying to find nutritionally appropriate food for their babies. The below information comes from the American Academy of Pediatrics (AAP), the U.S. Department of Health and Human Services, the Washington WIC program, the Centers for Disease Control and Prevention, and the U.S. Food and Drug Administration. For the full news release, please see here.

  • Baby Formula Shortage Partner Toolkit – in English and Spanish, download here.
  • Resources for Families Impacted by the Infant Formula Shortage  in English, Spanish and 14 different languages (FAQs)
  • If you still have concerns about your child’s health, contact your child’s primary care provider’s office and ask to speak with a nurse, medical assistant, or health educator on your child’s care team.
  • For people needing a connection to health care providers, call the Help Me Grow WA hotline at 1-800-322-2588 for referrals and to apply for food and health resources in Washington. Additional support and resources are also available to participants in federal and state nutrition programs.
  • For WIC participants and families, contact your local WIC clinic to get infant formula benefits replaced or change baby formulas. WIC has expanded the types of formula they provide to offer more choices for families participating in the program. They can often tell you which stores have formula in stock. If you can’t reach your local clinic, call the state WIC office at 1-800-841-1410 Monday to Friday, 8:00 am – 5:00 pm. Check the Washington WIC web page for more information on approved replacement infant formulas.
  • For participants in Basic Food (SNAP), visit the Parenthelp123 web page or call 1-800-322-2588.

Some additional tips to help with your infant formula search:

  • Check smaller stores and drug stores or buy online from reputable distributors and pharmacies.
  • Gerber’s MyGerber Baby Expert: reach a certified nutrition or lactation consultant by phone, text, Facebook Messenger, web chat, or video call, who can help you identify a similar formula that may be more readily available
  • Abbott’s Consumer Hotline: call 1-800-986-8540; Abbott’s urgent product request line: ask your OBGYN or your infant’s pediatrician to submit an urgent product request by downloading and completing the form – PDF 
  • Mead Johnson/Reckitt’s Customer Service line: call 1-800 BABY-123 (222-9123)

Community Resources

  • Locate your nearest Community Action Agency (CAA). Your neighborhood CAA may be able to provide you with formula or connect you with local agencies that have formula in stock.
  • United Way’s 2-1-1: dial 2–1-1 to be connected to a community resource specialist affiliated with United Way who may be able to help you identify food pantries and other charitable sources of local infant formula and baby food.
  • Feeding America: call your local food bank to ask whether they have infant formula and other supplies in stock.
  • Human Milk Banking Association of North America (HMBANA): certain HMBANA-accredited milk banks are distributing donated breast milk to mothers in need; please note that some may require a prescription from a medical professional. Find an HMBANA-accredited milk bank.
  • Relactation or induced lactation is also possible and can be an alternative to using formula. La Leche League International has resources on how to stimulate milk supply.
Sscreenshot from FIT Instructional Video

FIT Instructional Videos

Colon cancer is a leading cause of cancer-related deaths, but it is preventable with screening. The fecal immunochemical test (FIT) is the most used stool test for colon cancer screening. These videos demonstrate how to properly use a FIT kit to collect a stool sample for colon cancer screening. They are available in Arabic, Cantonese, English, Khmer (Cambodian), Russian, Somali, Spanish and Vietnamese.
* It is recommended that adults begin screening for colon cancer age 45 (previously age 50).

A PDF document containing QR Codes that link directly to each video is provided in the sidebar.

Demonstration: Dr. Rachel Issaka
Videography: Dr. Carey Jackson
Arabic Interpreter: Joseph Tawadros
Cantonese & Vietnamese Interpreter: Lien T. La
Khmer Interpreter: Jeniffer Huong
Russian Interpreter: Oleg Gouts
Somali Interpreter: Mohamed Hashi
Spanish Interpreter: Araceli Gonzalez-Medel


Screenshot from video

Live Better with Kidney Disease & Learn About Dialysis

Background

Increasingly, dialysis, a treatment for severe kidney disease, is of concern among Cambodian patients with diabetes. This tool was developed to help educate Cambodian patients and community members about dialysis, also known as renal replacement therapy. It is tailored to reflect common concerns and questions some Cambodians may have when learning about and considering dialysis.

There are two videos (see below and in sidebar), one in Khmer and one in English.

Methods/ Acknowledgements

The project was initiated by Cambodian Caseworker/Cultural Mediator Jeniffer Huong and Renal & Transplant Clinical Nurse Specialist, Nancy Colobong Smith, MN, ARNP, CNN. They aimed to create a product that is both culturally sensitive and clinically applicable. The project was facilitated by EthnoMed Program Coordinator, Rekha Ravindran, MPH. Advanced practice nursing student Megan Jane Melvin, DNP, ARNP, was recruited to lead the development of this tool, in collaboration with the project team. A literature review was conducted about barriers and knowledge gaps about dialysis among Cambodian patients with diabetes, and interviews and focus groups were conducted with a Cambodian patient, Cambodian community advocates and medical providers who work in refugee health. Information was synthesized to determine key educational messages for the script and images. EthnoMed Program Supervisor Christine Wilson Owens and Community House Calls Program Nurse Manager Lea Ann Miyagawa, MN, RN participated in project meetings. Special thanks to Tessavan Ros who played the role of the patient in the photos and narration. Original photos were taken by UW Medicine Photographer Clare McLean. Northwest Kidney Centers gave permission to use several photos by C. B. Bell, III, Scott Areman and Ben Jenkins. Illustrations are credited to University of Washington and UWMC Health Online. EthnoMed Program Coordinator Anna Cowan, MPH, produced the final media product. Special thanks to all others who supported and contributed to this work: Dr. Bernadette Thompson, Dr. Carey Jackson, Physician Assistant Phalla Kith, Taing Bun Nam, James Heng, Keo Soth, Sorphon Sim, Channdara Sos, Sothea Thong, Jenny Ap, Phon Som, Sophearom Lim, Sokha San, Thy Savu, Sambath Soung and Kimnay Siev. UWMC generously shared their clinic for photography.

Funding

This project was funded in part through an American Nephrology Nurses Association (ANNA) and Gloria Scharf Beedie Memorial Grant.

Steering Wheel of Self-Management

In my role as a cultural mediator and diabetes navigator over the last five years, I have recognized the need for simple messaging of abstract concepts for patients from all socio-economic backgrounds in order to be meaningful. There are Western concepts that, as a system, we may take for granted. These include “chronic disease”, “prevention”, and “primary care”. In addition, we have a non-trivial number of illiterate and/or indigenous language speakers that also have low numeracy and a completely different concept of time and scheduled appointments.

The idea behind the “Steering Wheel of Self-Management” is to have a visual tool to be used by providers and patients alike. Providers/ educators can teach patients, patients can teach other patients.

Concept of Self

Perhaps the most basic concept I share with patients is the notion of SELF within the patient-centered care model in a clinical setting. Many of our patients come from countries or health systems that discourage patient participation, questions, or self-empowerment. They come to clinic for a “cure” or “fix” from an educated expert. Once they learn there is no “cure” for a chronic condition like diabetes, they may quickly lose interest or feel that it is not within their rights to express misgivings to a doctor. Hence, I developed the idea of the steering wheel as a central metaphor for illustrating control over one’s chronic disease, instead of being a passive recipient of it.

Prevention: Know how to avoid complications by managing YOUR own personal steering wheel according to YOUR life situations.

Concepts of Journey and Time

For many immigrants and refugees, the concept of a long journey or travel is a familiar one. This implies both distance and time in a way that our patients can more easily connect with.

  • Conceptual Message: TIME, something managed over time
  • Implicit message: Drive your diabetes so it doesn’t drive you

Chronic = continuous: Recognize that your highway and terrain will change over time. Learn to navigate the curves keeping both hands on the your steering wheel.

Steering Wheel Metaphor

Through trial and error during clinical visits and discussions in the lobby, I developed a series of images relating to the one central metaphor that seemed to easily illustrate chronic disease as a tangible concept. Originally I used a stock clip art wheel (later, we developed this original illustration, below) with three spokes to signify the three basic impacts on blood glucose: medication, food and exercise. The two hands on the steering wheel indicating patient empowerment.


  • Steering Wheel of Self-Management, the tool to keep a handle on things (your health).
  • Steering wheel has 3 spokes or points: Exercise, Food, Medicines, all three used in combination,
  • to keep on the road and not drive over the edge or off a cliff.
  • Emphasizing it is not just one thing.

Highway Metaphor

Then over time I began to deepen the metaphor to include the “highway of life” and its curves and roadblocks encountered that can affect diabetes management.

Highway is your diabetes or your health in general, there are many curves and stops on the highway.

Practical Uses

Practical uses of the steering wheel include a version with text and a pictorial-only version for patients with illiteracy or low literacy. The wheel can be printed out and notes written for patients identifying short term goals in the areas of exercise, nutrition and medication management, and for visualizing a care plan. The wheel image can be sent in mailer reminders, as motivator, to patients.

Steering Wheel with Words

Steering Wheel with Spanish words for Exercise, Food, Medicines, and “Driving (Managing) the Course of Your Diabetes”

Steering Wheel – Pictures only

Steering Wheel with images (no words) for Exercise, Food, Medicines

Patient Feedback

Patient feedback has been very positive both in clinic and in community health worker settings. Through the teach-back method, patients have demonstrated a strong grasp of the concept of chronic disease, despite education level. Patients have been able to individualize care plans and select small tangible goals to work on for behavior change.

Copyright

The Steering Wheel of Self-Management operates under the Creative Commons License Attribution-Noncommercial-No Derivative Works 3.0 United States. You are free to copy, distribute, display this work under the following conditions:

  • Attribution: You must attribute the work to EthnoMed, and author Rose Cano.
  • Noncommercial: You may not use this work for commercial or for-profit purposes
  • Alterations: You may not alter, transform, or build upon this work.

For any reuse or distribution, you must make clear to others the license of this work. Any of these conditions can be waived if you get permission from the copyright holder.

The Brain

Brain Death: What It Means

This handout offers information for families and loved ones of patients. It explains how doctors determine that a person is dead based on their brain function.

Handout PDFs are available at UW Medicine Health Online in English, Arabic, Tigrinya, Russian, Chinese, Vietnamese, Amharic and Spanish languages.

For information for providers, see Determination of Brain Death/Death by Neurologic Criteria – The World Brain Death Project (article accessible with JAMA subscription).

The Brain
Photo by Francisco Bengoa (cc license).
The FITO Museum of Traditional Vietnamese Medicine

Using Traditional Medicines

This handout created by Harborview Medical Center addresses the use of traditional medicines, encouraging patients to discuss them with their doctor and pharmacist. It goes on to explain reasons why this is important.

The handout translated into a number of languages and each PDF includes both target language and English. Languages include: Arabic, Khmer (Cambodian), Somali, Spanish and Vietnamese. Audio narration is also available in each language.

PDFs and audio files are accessible in the sidebar.

These materials were funded by .

The FITO Museum of Traditional Vietnamese Medicine
The FITO Museum of Traditional Vietnamese Medicine. Photo by Anthony Tong Lee (cc license).
Young woman wearing mask

Sick Days and Diabetes

These materials were developed at Harborview Medical Center (Seattle, WA) for use in a multicultural diabetes class for patients and family members. The materials were translated into a number of languages and each PDF includes both target language and English. Several of the handouts have audio narration (about 3 min).

Audio and PDFs are available in the sidebar.

Updates to materials were funded by .

Young woman wearing mask
Photo by Nikki (cc license).
Vietnamese Health Board COVID-19 PSA Video

COVID-19 PSA Video – Vietnamese Health Board

Dear Vietnamese Leaders and Public Officials:

Vietnamese Health Board – Ban Y Tế Cộng Đồng  would like to share a COVID-19 public service announcement. Please watch and share with your networks. The video can be found on YouTube and FaceBook. While you’re on FaceBook, like us! 

For more information about the video and VHB, please see the attached press releases in English and Vietnamese (in sidebar).

Washing your hands, wearing a mask, and staying six feet away from people are some of the ways we can slow the spread of COVID-19. Learn how to follow these basic tips by watching this public service announcement.

See also: Vietnamese Health Board – Ban Y Tế Cộng Đồng Facebook – videos and information in Vietnamese

Photo of feet with happy and sad faces drawn on big toes.

Learning About Diabetes: Tips for Foot Care

These diabetes patient education handouts provide tips for good foot care. They are available in Amharic, English, Khmer (Cambodian), Somali, Spanish and Vietnamese (see resources in sidebar).

The handouts were created by Learning About Diabetes, Inc., a non-profit charity providing easy-to-understand diabetes-care information in a number of languages. They were translated by EthnoMed, and shared with permission.

Visit the Learning About Diabetes website for additional languages (Arabic, Bengali, Chinese, Creole, Hindi and Russian).

Photo of feet with happy and sad faces drawn on big toes.
Photo by Vinoth Chandar (cc license).