Dealing With Extreme Cold, Hypothermia, and Frostbite

Dealing With Extreme Cold, Hypothermia, and Frostbite

2014 is coming in COLD. Across the U.S., temperatures are plummeting and wind chills arecolder than we've seen for a long time.

The Centers for Disease Control and Prevention (CDC) [source] remind us that extreme cold weather is a dangerous situation that can bring on health emergencies in susceptible people, such as those without shelter, outdoor workers, and those who work in an area that is poorly insulated or without heat. What constitutes cold stress and its effects can vary across different areas of the country. In regions relatively unaccustomed to winter weather, near freezing temperatures are considered factors for “cold stress.” Whenever temperatures drop decidedly below normal and as wind speed increases, heat can more rapidly leave your body.

Today's blog post shares some emergency care techniques and video clips from our programs concerning two of the most common emergencies that can occur in cold weather.

Cold, wet temperatures can result in a lowering of the internal body temperature. Hypothermia, a generalized cooling of the body, occurs when the internal core body temperature has decreased to 95° F or less. It is a life-threatening condition.

Without early recognition and active care, surviving severe hypothermia is unlikely.

As the body temperature gets lower, body processes become impaired and eventually fail. Cardiac arrest may occur.

To help recognize hypothermia, look for pale, cold skin, uncontrollable shivering, loss of coordination, difficulty speaking, and an altered mental status.

Severe hypothermia can result in the loss of shivering and a slowing of the breathing and heart rate.

To care for someone experiencing hypothermia, carefully and gently move him or her to a warmer place. Remove wet clothing and cover the person with something dry and warm. Cover the head and neck to retain body heat.

If available, activate EMS and get an AED if one is available. Be prepared to perform CPR and use the AED.

If you are far from professional medical care, begin actively re-warming the person. Place that person near a heat source. Put containers of warm, but not hot, water in contact with the person’s skin.

It is best to recognize and treat hypothermia early. The chance for survival decreases as the condition progresses.

Frostbite develops when skin freezes. Body parts that are exposed to extreme cold, such as fingers, toes, earlobes, cheeks, and nose, are the most likely to be affected.

Early recognition and care for frostbite can reduce or eliminate later complications. Early signs of developing frostbite include a pins-and-needles sensation and throbbing. Later signs include a loss of feeling in the affected part and firm, pale, cold, numb skin.

Minor frostbite can be treated with simple rewarming using skin-to-skin contact, such as a warm hand.

If more serious, quickly get the person to a warmer place. Remove wet clothing. If available, activate EMS.

When EMS is available, or there is any chance that the part may refreeze, do not try to re-warm the frostbitten area. Remove any jewelry from the affected areas. Place clean pads between frostbitten fingers and toes. Wrap the affected part with a clean towel or pad. Calm, comfort, and reassure the person until EMS providers arrive.

Do not rub or massage the affected area or disturb blisters on frostbitten skin. Never give the victim alcoholic beverages. They do not help and may be harmful.

If you are far from professional medical care, and there is no chance refreezing will occur, re-warm the affected part yourself. Immerse the frostbitten area in warm water for 20–30 minutes. The water should be warm, not hot – just above normal body temperature. Check and maintain the water temperature often. Severe burning pain, swelling, blistering, and color changes may occur.

Do not let the person use the affected part after it is thawed. Get the person to professional medical care as soon as you are able to.

Other Types of Cold Stress to be aware of include:

Cold Water Immersion - Cold water immersion creates a specific condition known as immersion hypothermia. It develops much more quickly than standard hypothermia because water conducts heat away from the body 25 times faster than air. Typically people in temperate climates don’t consider themselves at risk from hypothermia in the water, but hypothermia can occur in any water temperature below 70°F.

Survival times can be lengthened by wearing proper clothing (wool and synthetics and not cotton), using a personal flotation device (PFD, life vest, immersion suit, dry suit), and having a means of both signaling rescuers (strobe lights, personal locator beacon, whistles, flares, waterproof radio) and having a means of being retrieved from the water.

Trench Foot - Trench foot, also known as immersion foot, is an injury of the feet resulting from prolonged exposure to wet and cold conditions. Trench foot can occur at temperatures as high as 60 degrees F if the feet are constantly wet. Injury occurs because wet feet lose heat 25-times faster than dry feet. Therefore, to prevent heat loss, the body constricts blood vessels to shut down circulation in the feet. Skin tissue begins to die because of lack of oxygen and nutrients and due to the buildup of toxic products.

Chilblains - Chilblains are caused by the repeated exposure of skin to temperatures just above freezing to as high as 60 degrees F. The cold exposure causes damage to the capillary beds (groups of small blood vessels) in the skin. This damage is permanent and the redness and itching will return with additional exposure. The redness and itching typically occurs on cheeks, ears, fingers, and toes.

This winter, please keep it safe by dressing appropriately and limiting your exposure to these brutally cold conditions!

Special note for our safety professional readers: Summit Training Source offers a cold weather prevention course to help you keep your employees safe during challenging winter conditions.

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