Preventing Slips, Trips, & Falls Slips, trips and falls consistently rank in AEP’s top three in terms of accidents and injuries. Foot, ankle, knee, back, hip, elbow, hand and head injuries are possible from a slip, trip or fall. These events range from no injury to serious injuries, so it’s important to focus on ways to prevent them from occurring before they happen. Welcome to our HPI presentation and training on slip/trip/fall prevention. An HPI Moment

Winter months can produce all kinds of slick surfaces. If you are walking across a potentially slippery surface: • Wear shoes with non-slip soles and good ankle support. Use boots or ice cleats to ensure good traction. • Leave your hands and arms free for better balance. Carrying large loads can affect your balance and block your vision. • If the ground is icy, walk like a penguin to maintain your footing and balance. Take short steps with slightly bent knees, shuffle your feet, and walk at a slower pace, so you can react quickly to a change in traction. • Always use designated paths and crosswalks. Don’t take short cuts over snow drifts or plowed snow. • Turn off electronic devices and prevent other distractions while you walk. • In general, avoid walking on unqualified, unproven and unseen paths.

SLIPS, TRIPS, & FALLS You notice that with a Slip, your body goes backwards. You notice with a Trip, you fall forward. And of course a Fall is a Fall, either at the same level or from one level to another.

Types of Falls Slip and Fall Trip and Fall Step and Fall Now let’s discuss the three different types of common falls. Slip and fall Slip and fall usually occurs when a slippery surface and improper footwear are combined. The heel of the foot will slide forward propelling the body backwards or the heel of the foot will slide backwards causing the person to fall. Trip and fall Occurs when the front foot is suddenly stopped, the upper body is propelled forward and the fall occurs. A rise in a sidewalk as small as 3/8 inch can cause a person to stub his/her toe resulting in a fall. The same thing can happen going up a flight of stairs with the height being the only difference. Step and fall This type of fall occurs when the front foot lands on a surface lower than expected such as unexpectedly stepping off a curb. This type can also occur when a person steps forward and either the inside or outside of the person’s foot lands on an object either higher or lower than the other side. This can cause a person’s ankle to roll or twist and the person to fall forward or sideways.

SLIPS, TRIPS, & FALLS Expect The Unexpected Falls happen because people don’t expect them The more falls you anticipate and guard against, the fewer you’ll have

Changes in Environment: The 3 U’s Unqualified Unproven Unseen As we go through our day, each of us crosses dozens perhaps hundreds of walkways. A walkway is quite simply a path we choose to cross to reach our destination. Some walkways pose special hazards we need to identify and respond accordingly. Let’s start by discussing how we identify those hazards by using the three U’s. The three U’s stands for unqualified, unproven and unseen walkways. For Slip/Trip/Fall injury cases: 45% are related to unqualified walkways 86% are related to unproven walkways 25% are related to unseen walkways (NOTE: Incidents may involve more than one 3 U) The following slides will define the 3 U’s and give examples. 6

Definition of “Unqualified Walkway” An “unqualified” walkway is a path not designed to be a walkway. An “unqualified” walkway is a path not designed to be a walkway. Walkways designed to be a path are sidewalks, parking lots, driveways, designated paths, etc. They are specifically designed or qualified by someone (city, county, or resident) to be a walkway. So examples of unqualified walkway are lawns, fields, so called “short cuts”, and some construction zones. Not paved No signs of foot traffic Landscaping not maintained Ice or snow on a sloping surface 7

Definition of an “Unproven Walkway” An "unproven" walkway is a path that can be taken to reach a desired location… However, because of changes in conditions and/or no evidence of use, it is questionable. No footprints No signs of being taken care of Construction sites Ice/snow paths in the shade One “U” down, two more to go. The next “U” is for unproven walkways. An "unproven" walkway is a path that can be taken to reach a desired location. However, because of changes in conditions and/or no evidence of use, it is questionable. So an unproven walkway is simply a walkway, qualified or not, that we’re not sure has been crossed recently by another person. 8

Definition of an “Unseen Walkway” "Unseen" walkways are paths where the solid surface is not seen. Excessive Vegetation Snow Poor light conditions Tree leaves Debris Water And now the last “U” – unseen. "Unseen" walkways are paths where the solid surface is not seen. This sounds technical but it’s not. Simply stated, if you can’t see what your walking on, then it’s an unseen walkway. You may say, “I don’t ever walk on surfaces I can’t see.”. Good for you, but let’s talk about some examples on the next slide. 9

How do I act on the 3 U’s? Not designed as walkway No signs of use Surface not seen Unqualified Walkways Unproven Walkways Unseen Walkways Now that we can identify the three U’s we need to know how to respond to these potential hazards as we come across them. The best defense is a good offense. If you see walkways that fall into the three U’s then consider avoiding them first. Find a safer walkway even if it takes you a little out of the way. If you must cross a ‘U’ walkway then proceed with cautious defensive strides, taking shorter steps, evaluating the surface. It is PII’s conclusion that training on the 3 U’s and defensive strides would reduce slip/trip/fall injuries by a factor of five or more. On slippery surfaces, point your toes out to more equally distribute your weight across your feet. Also, consider putting on your friction footwear (Yak-Trak’s, Grip-X). Unproven Walkways You should always proceed with caution using defensive strides. Unqualified Walkways Use defensive strides Consider wearing friction footwear Unseen Walkways Try to avoid whenever possible Consider using a sweeping motion as you step through tall grass. Defensive Strides Friction Footwear Avoidance Friction Footwear Caution 10

Additional Recommendations Maintain a safety focused attitude. Slow down – be deliberate and aware Wear approved footwear or traction aids Watch where you are going Keep your hands out of your pockets when walking Consider wearing boots or shoes with aggressive soles into the office and change into a regular pair of shoes 3-point contact for entering and departing vehicles Walk like a penguin Here are some additional recommendations to help reduce the chance of you falling. Maintain a safety focused attitude. Safety is a mindset that we can achieve zero harm. Slow down – be deliberate and aware. Watch where you are stepping and … GO S-L-O-W-L-Y !! Wear approved footwear designed to help prevent slips, trips and falls. Shoes with a defined heal and keep laces tied. During bad weather, avoid boots or shoes with smooth soles and heels. Instead, wear shoes or boots that provide traction on snow and ice; boots made of non-slip rubber or neoprene with grooved soles are best. Watch where you are going. Don’t assume a walkway is clear and look for unexpected changes in the surface level. Keep your hands out of your pockets when walking to allow you to help catch your balance if you should begin to fall. You can help break your fall with your hands free if you do start to slip. Try not to carry too much – make multiple trips when necessary.

Falling Tips Wear a heavy, bulky coat that will cushion you if you should fall. Try to avoid landing on your knees, wrists, or spine. Try to relax your muscles if you fall. Naturally, the goal is not to slip, trip and fall; however, the possibility of a fall still exists. Wear a heavy, bulky coat that will cushion you if you should fall. Try to avoid landing on your knees, wrists, or spine. Try to fall on a fleshy part of your body, such as your side. Try to relax your muscles if you fall. You’ll injure yourself less if you are relaxed.

Expect the Unexpected. Identify-potential hazards Use the 5 Rules for Defensive Walking:   Scan-environment Identify-potential hazards Predict-how you could get hurt Decide-how to reduce the risk Act-use controls to stay safe Pay attention to your surroundings, look where you are going, and use designated pathways and crosswalks. Wear the proper footwear. Walk, don’t run – take your time. Don’t read, write, talk on the cell phone, or work while walking. Wear gloves so you can keep your hands out of your pockets and at least have one hand free. Use handrails while ascending and descending stairs, take your time, and don’t skip steps. Use 3 points of contact entering / exiting vehicles. Walk like a penguin . . . . . . . .

When it comes to Preventing falls --- it’s the state of mind with which you approach a situation that counts!