Extremely cold weather is dangerous. In fact, according to the Centers for Disease Control and Prevention, more people die from cold temperatures than during heat waves.

As with heat-related illness, older people and those with chronic medical conditions are at higher risk during cold snaps. Cold weather can make chronic heart and lung problems worse. But even young or healthy people may develop hypothermia or frostbite.

The best way to protect yourself from the cold is to stay inside. If you have to go outside, these tips can help you stay safe:

Dress Appropriately

Wear the right clothing. Dressing in layers is ideal, because the air between them traps body heat and acts as insulation. Be sure clothing is dry (damp or wet clothing will make you feel much colder) and cover all exposed skin, especially fingertips, your nose, and earlobes (because metal also conducts cold, consider removing jewelry, especially earrings). Frostbite can happen quickly, especially on extremities. Your outer layer should be windproof, and be sure to wear a hat to limit heat loss. A scarf that covers your nose and mouth can prevent airways from constricting if you have trouble breathing in cold weather.

Footwear is also important. Boots or shoes should be warm (consider insulating insoles) and waterproof. They should have rubber soles for traction and provide arch support.

Clear Sidewalks and Paths Carefully

When you’re out in cold weather, your body has to work harder to maintain its temperature of 98.6°F. Your heart works harder, even when you’re standing still. And you may not realize just how hard your body works when shoveling snow.  Shoveling is an intense cardiovascular workout—for example, a 180-pound person can burn about 250 calories in a half hour, which is about the same as jogging or using a stair climbing machine! If you have heart disease, or if you’re at all out of shape, take frequent breaks when you shovel. Tip: If you have trouble talking, you should rest. Try shoveling for five to ten minutes at a time, and avoid lifting a heavy shovel full of snow.

If your parents or elderly neighbors are responsible for keeping public sidewalks clear and easy to navigate, be sure there is a plan in place so that they won’t have to clear snow. Even if there’s no snow in the forecast, remember than when the temperature goes below 32°F, any standing water will freeze, so sidewalks may become icy. Keep ice melt on hand to keep walkways safe.

Keep Stairs Safe

As with sidewalks, any steps or stairs leading to the front door should be completely free of ice and snow. In addition, be sure there is a sturdy banister or railing for everyone to hold.

Install Proper Outdoor Lighting

Increase nighttime visibility by making sure pathways are adequately lit with soft, well-placed lighting. Avoid halogen or other bright bulbs, which can create glare. If possible, aim lights so they illuminate the ground rather than shining in faces.

Know the Signs of Frostbite and Hypothermia

• Frostbite occurs when your skin freezes. It’s most common on extremities and exposed skin like cheeks. The first sign is redness and pain.
• Hypothermia happens when your body’s core temperature is too low. Because your temperature drops gradually, symptoms start slowly. You might not realize how much danger you are in. The first sign of hypothermia is shivering; other signs include dizziness, confusion, shallow breathing, and trouble speaking.

If possible, go inside when you start to shiver, but at the very least put on another layer, and be sure your clothes (especially socks and mittens or gloves) are dry.