Food, family, gifts and much more bring us joy. The holiday season in the U.S. is upon us, and unfortunately, so are some of the unique challenges that accompany these special days.

In a recent survey of 1,000 Americans, a quarter of respondents said they have needed to call EMS for themselves or family during the holidays for a variety of injuries and incidents. Perhaps even more revealing, a third of respondents said they are less likely to call an ambulance or visit an ER during the holidays, primarily for fear of long wait times.


That tells us emergencies are relatively common during the Thanksgiving and Christmas season, even if they aren’t always being reported. First responders, therefore, must be on their toes at this time of year. Read on for a rundown of some of the major concerns during the holidays.




Between the hundreds (even thousands) of lights decoratively strung along homes, countless trees displayed indoors and large amount of cooking, the risk of home fires increases during the holidays. 


According to the National Fire Protection Association, from 2015 to 2019, U.S. fire departments responded to an average of 790 home structure fires that began with holiday decorations, 160 home fires that began with Christmas trees and 7,400 fires that started with candles (with candles fires occurring 2.5 times the daily average on Christmas Day). Home cooking fires, meanwhile, peak on Thanksgiving, followed by Christmas and Christmas Eve.


For EMS personnel that respond to these incidents, burns are common and the most evident injuries from fires, but smoke inhalation also creates serious and potentially fatal damage to victims. Acute respiratory distress and respiratory failure are a significant consideration, meaning intubation may be immediately required, with suctioning used to prepare the airway and clear any mucus or particles.




Over 100,000 people visit ERs because of choking each year. Unsurprisingly there are more of those visits during Thanksgiving and other holidays that traditionally include large meals, as well as the prevalence of more loose objects (decorations, tree ornaments, toys) that children may swallow. While many sufferers or their families may be able to dislodge the hazard before responders arrive, choking can cause other dangers that must be quickly addressed.


A lodged object may cause airway bleeding that makes it harder to visualize the airway. Pieces of the object may remain in the airway, hindering breathing. Providers must be ready to provide effective suctioning and be aware of the type of patient, as pediatric or geriatric patients typically require less powerful suctioning and more delicate care.




Many people in colder climates dream of a white Christmas, but when snow starts to fall on roads or ice begins to form on sidewalks, that dream might turn into a nightmare. Frequently, winter weather results in vehicle accidents and the associated variety of injuries.


Upon arrival at the scene, responders must assess the situation and coordinate triage, with the most serious injuries receiving top priority for treatment. The most serious injuries include those to the spinal cord, head/brain and chest. Each of these injuries can have airway challenges, either from physical damage or neural damage that affects breathing, and require unique treatment techniques.


For example, those with spinal cord injuries must be immobilized to prevent further damage and have the jaw thrust maneuver used to open their airway. Intubation using the SALAD (Suction Assisted Laryngoscopy and Airway Decontamination) technique may also be necessary.


Another major medical emergency in wintry conditions is hypothermia caused by exposure to cold weather. Those with extreme cases will have a slower heart rate, which decreases the ability to oxygenate the body.


Mental health


It is no longer news that mental health diseases like depression are at an epidemic level in the U.S., and these conditions can intensify during the holidays, when people may be more stressed, separated from family, or feeling lonely without friends and family to celebrate the occasion.


In the worst-case scenario, these people may attempt suicide, potentially by overdosing on drugs. Airway compromise is among the greatest risks for these patients, as vomiting and aspiration are often side effects during an overdose. Breathing may also slow, creating a lack of oxygen to the body. Again, suctioning and intubation are likely to be required.


Ready for the season?


As we enter the holiday season, the best hope is for celebrations to remain joyous, but emergency professionals understand that won’t be the case for all. In those unfortunate situations, they must be prepared with knowledge, skills and equipment that can help prevent tragedy.