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)
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 Viral Swab Instructional Video

Viral Swab Instructional Videos

These instructional videos were created to help explain the viral swab procedure to patients presenting with coronavirus symptoms at Harborview Medical Center. The videos were created with interpreters and hospital staff who walk the patients through the nose-swab testing, and offer post-visit information. The videos are available in 7 languages: English interpreted into Amharic, Arabic, Cantonese, Oromo, Somali, Spanish and Vietnamese.

Each video has an accompanying easy-to-scan QR code. If the patient wants to review the video once they are back home, they can scan the QR code which will automatically take them to the video on YouTube. QR code pdfs are available for download under each video, and are also found in the sidebar.

Download Amharic QR code PDF
Download Arabic QR code PDF
Download Cantonese QR code PDF
Download Oromo QR code PDF
Download Somali QR code PDF
Download Spanish QR code PDF
Download Vietnamese QR code PDF

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.