Cold weather safety

By Stu Willis, MD and Pete Cassidy, RN

Boundary Community Hospital Emergency Department

Brrrrrrrrrrrr! It’s cold out there!

The weather outside may be frightful, after all, we live in North Idaho and six months out of the year it’s cold and wet, windy and sometimes miserable. Did you know that the most common cold weather injuries in our area are hypothermia, frostbite, chilblains (sometimes called frost nip) and “trench foot?”

HYPOTHERMIA occurs when the body core temperature drops significantly below normal. It can be a life-threatening emergency and should be treated immediately. It is more common in children and the elderly because they sometimes do not recognize the signs – frostbite and hypothermia can come on within minutes.

Conditions leading to hypothermia, even in only mildly chilly weather, include improper clothing and equipment, wetness, fatigue/exhaustion, dehydration, and poor food intake. And, alcohol use may “numb you to the danger.”

Signs/Symptoms of hypothermia:

Watch for the “umbles” ­— stumbles, mumbles, fumbles, and grumbles which indicate changes in coordination and levels of alertness

Mild hypothermia signs:

1) Shivering out of control

2) Unable to do complex tasks, but can still walk and talk

3) Reduced blood flow to the limbs and skin

Moderate hypothermia symptoms include:

1) Dazed consciousness

2) Loss of fine coordination

3) Slurred speech

4) Violent shivering

5) Irrational behavior — “I don’t care” attitude

Severe symptoms include:

1) Shivering in waves

2) Falling to the ground; can’t walk; curling into a fetal position

3) Pale skin, dilated pupils, decreased pulse rate

4) Muscle rigidity develops

If you suspect someone has hypothermia, call 9-1-1 and try to reduce heat loss by changing them to dry clothes and adding more clothes. Increase their physical activity, find shelter, and be sure they eat and drink – carbs, proteins, fats and hot liquids help bring the temperature up.

FROSTBITE occurs as fluid in the cells freeze with exposure to cold temperatures. The crystals damage the tissues. The most common locations for frostbite are the hands and feet, and exposed superficial skin such as the nose, lips, and ears.

Signs/symptoms of frostbite include:

· Numbness in affected areas

· Tingling, blistered, swollen, or tender areas

· Pale, yellowish, waxy-looking skin

· Frozen tissue feels wooden to the touch

· Significant pain after rewarming

Recommended treatment for mild frostbite is placing the affected part in “warm” water, 98-104 F. Do not allow the affected part to refreeze!!! And avoid excessive heat, or rubbing the area. Moderate to severe frostbite should be treated by medical professionals. Always SUSPECT HYPOTHERMIA if frostbite has occurred.

Some “Be Safe” precautions:

Supervise children when they are out in the cold

Older children/teens and others participating in outside winter activities should be encouraged to use the “buddy system” to look for early signs of cold injury

Be sure to wear gloves or mittens and hats

Keep feet dry and avoid tight socks and boots

Remember C-O-L-D:

· Keep it Clean

· Avoid Overheating

· Wear it Loose and in Layers

· Keep it Dry

Avoid alcohol, caffeine, and tobacco/nicotine

So, when the temperature drops and snow starts falling, watch for the signs and know when you need to go see your doctor or come to the emergency department for treatment. We live in a beautiful place, with all kinds of weather, so be safe and enjoy those cold weather activities.