PROVIDENCE, R.I. (WPRI) — As temperatures continue to plummet and many are trying to clean up after Thursday’s winter storm, the Rhode Island Department of Health (RIDOH) is stressing the importance of bundling up to prevent cold weather injuries.

RIDOH spokesperson Joseph Wendelken said the rule of thumb is to wear at least three layers of clothing and protect yourself from head to toe.

“These are serious health conditions that are a reality,” Wendelken said.

Anyone going outside in these temperatures should take precautions to avoid illness and injuries such as hypothermia and frostbite.

Wendelken said there are multiple signs of concern to look to determine if someone is suffering from frostbite:

  • Extremities become cold and blisters begin to form
  • Skin begins to turn white, or become darker and turn black
  • Extremities become numb and tingly

When it comes to warming back up, there are important measures to take:

  • Find a warm environment and get out of the cold
  • Gently rewarm extremities and do not use direct heat
  • Use warm water to soak your extremities

“Your body spends a lot of energy, trying to keep your core warm and what happens over time is, blood shifts out your legs and your arms and your feet,” Wendelken said. “It leaves those parts of your body more susceptible to frostbite.”

Wendelken said hypothermia symptoms are often seen by others and not the person suffering from it:

  • Confusion or lack of coordination
  • Shivering
  • Slow and shallow breathing
  • Drowsiness or fatigue
  • Loss of consciousness
  • Dilated pupils

There is no distinct answer to how long is too long to be outside, but RIDOH said if you are experiencing any of these symptoms, you should go inside and call a doctor.

RIDOH also said it is important to keep in mind safe shoveling practices while outside trying to clean up. According to RIDOH, shoveling can cause sudden increases in blood pressure and heart rate, which could lead to heart attacks.

A spokesperson for Lifespan said between 1 a.m. Thursday and 10 a.m. Friday, emergency personnel across Rhode Island responded to 16 heart attacks. Lifespan also said during this time they saw 13 back injuries from shoveling, 11 snow blower injuries, 10 slips or falls, one case of hypothermia/frostbite, eight injuries from motor vehicle accidents and 14 other snow-related injuries.

Before picking up the shovel, RIDOH suggests taking these measures to prevent cold weather emergencies:

  • Talk to a doctor if you have history of heart trouble to make sure it is safe to shovel snow
  • Keep hydrated
  • Dress warm with several layers
  • Avoid alcohol, caffeine and nicotine
  • Warm up muscles by walking around for a few minutes to stretch your arms and legs

RIDOH also said while shoveling it is important to take it slow and take multiple breaks, along with these tips:

  • Don’t pick up too much snow at once
  • Bend from the knees and life with legs bent to prevent back injuries.
  • Stand with your feet about hip-width apart for good balance
  • Keep the shovel close to your body
  • Try not to twist your body while shoveling
  • Stop if you feel tired or feel tightness in your chest