Winter is here! Anyone out and about in the cold, wet weather is at risk for some temperature-related injury if they do not follow some basic common sense precautions. Understanding what things make you at risk can help prevent mild and severe cold-related problems.
The biggest danger in winter weather is the actual temperature and the length of time of exposure to the cold. Wet clothing and wind can greatly enhance the dangerous effects of the cold temperatures – even 50 degree weather can be problematic with some wet clothes and wind.
The metabolism of your own body is your only source of heat. Fortunately it is very good at producing heat and regulating body temperature with an elegant thermostat mechanism. The brain initiates sweating to cool your body, and induces shivering and increased hormone production to maintain adequate heat in response to external cold temperatures.
This can be very mild or very severe. In the mildest form, the heart rate increases and breathing gets faster. When you are too cold, shivering and other involuntary movements to stay warm start happening without even thinking about it. Poor coordination and not thinking clearly are common, which can impact your immediate safety and outcome. If the hypothermia progresses, the senses and mental status are even more dulled, and even the shivering or willingness to move diminish.
Serious heart, lung and other vital organ complications ensue due to decreased blood flow. Children are more prone to hypothermia due to their small size and smaller reserves for heat production and energy storage compared to adults. Young infants do not have the ability to shiver, and being unable to express themselves are more vulnerable to prolonged cold temperatures without any obvious warning signs. Elderly adults may also have less capacity or resistance to cold temperatures being unable to respond quickly to environmental changes, decreased metabolic reserves, chronic illness, or some medications. It is well known that certain medications such as antidepressants, narcotics, general anesthesia, some blood pressure meds, and alcohol consumption all impair the ability of the body to regulate temperature.
True frostbite is when exposed tissues actually freeze and form ice crystals in the cells of the respective tissue. This leads to severe tissue damage and even death; however, most of us will only encounter mild forms of this process, which starts with swelling, turning pale, and numbness of the skin. Hands, feet and face are the most common areas involved because of their exposure and because they are farthest from the heart and warmer core temperatures.
Blisters that are clear or blood-filled, discoloration of the skin, swelling and redness indicate more advanced problems. Getting to medical care is paramount if clues suggest serious complications.
Frostbite occurs in the workplace in industries using cold storage of common refrigerated and frozen food products. Overzealous use of an ice pack on an injured knee or sprained ankle can cause accidental frostbite, especially when in direct contact with the skin without some dry cloth to mediate the effect on bare skin. Ice packs should be applied intermittently for only a few minutes at a time.
Re-warming the body part or individual is the most important treatment for the consequences of cold exposure. It is important to avoid re-freezing if this is a risk. In fact, re-warming a truly frozen part should be delayed until you reach some place where re-freezing is no longer a risk. Warm, dry clothes and blankets do wonders to eliminate the continued loss of heat.
If possible, get to a warm, dry location. Any external heat source could be beneficial. Placing cold hands or feet in warm, not very hot, water is helpful. In extreme situations, body-to-body contact with warm dry blankets can help the person suffering from hypothermia in a remote location.
It’s crucial to be prepared, which doesn’t need to be expensive.
• Proper clothing and supplies are important whether it is a trip downtown, day hike, or wilderness trip. Plan for the unexpected. Weather conditions in remote areas can change abruptly in the fall or winter. Bring some options with you. The best way to avoid cold related injury is to dress in layers that can be removed as conditions dictate.
• Limit the time in the cold as much as possible.
• Stay dry. Waterproof footwear and suitable covering for head and hands is a must.
• Stay well hydrated. Drugs, alcohol and tobacco can seriously impair your judgment and the ability to tolerate prolonged exposure to the cold.
A small amount of planning can help avoid problems and keep you a lot more comfortable – and healthy – when out in the cold weather.
– Dr. Bruce Kaler