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FROSTBITE AND HYPOTHERMIA
Winter doesn't slow outdoor activity for most Minnesotans. Whether at work or play, frostbite and hypothermia are a risk. Consider the following tips to prevent and treat these common problems:

How to dress for winter success:
  The most important preventive measure when fighting the cold is how you dress. Staying dry is as important as staying warm. Dress in light layers. Long underwear made of polypropylene wicks moisture away from the body. Inner layers of wool or waffle weave synthetics provide insulation. The outer layer should be made of wind and moisture resistant fabrics.
  Wearing a hat cuts body heat loss. Cover as much skin as possible. Take extra care with fingers and toes. Wear an extra pair of socks and wear boots. Choosing mittens over gloves will keep your fingers warmer.

Other preventive measures include:
  Eat well, at least one hot meal a day. Drink hot liquids such as broth, cider or soup. Avoid drinks containing caffeine, such as coffee or tea, and alcoholic beverages; these can make you more susceptible to the cold.
  Find out if any medications you are taking will make you more vulnerable to cold. Take extra precautions if they do.
  Use a "buddy system" to monitor physical reaction to cold when engaging in extended outdoor activities.
  Keep your home adequately heated or wear layers indoors. The elderly are more susceptible to cold-related stress; Frequently check on those living alone during colder weather.

Hypothermia
People may think hypothermia occurs only in extreme cold. Actually, hypothermia can occur in all types of weather and can even result from inadequate heating indoors. Hypothermia occurs when the body's temperature drops below 95 degrees Fahrenheit. Symptoms of this condition include change in mental status, uncontrollable shivering, cool abdomen and a low core body temperature. Severe hypothermia may produce rigid muscles, dark and puffy skin, irregular heart and respiratory rates, and unconsciousness.

Treat hypothermia by protecting the victim from further heat loss and calling for immediate medical attention. Get the victim out of the cold. Add insulation such as blankets, pillows, towels or newspapers beneath and around the victim. Be sure to cover the victim's head. Replace wet clothing with dry clothing. Handle the victim gently because rough handling can cause cardiac arrest. Keep the victim in a horizontal (flat) position. Give artificial respiration or CPR (if you are trained) as necessary.

Frostbite
Frostbite occurs when exposed flesh becomes frozen. Ice crystals form in the soft tissues due to over-exposure to cold. These ice crystals cause the skin to rupture, killing the cells. The most common areas affected by frostbite are the nose, cheeks, ears, toes and fingers. Like hypothermia, frostbite goes through several stages of severity. Symptoms of the first stage, called frostnip, are numbness and changes in the color of the skin, which turns first red, then white. Frostnip causes no permanent damage because only the surface of the skin is involved; however, the affected area may develop long-term sensitivity to cold.

Superficial frostbite occurs if exposure continues. The skin becomes white and waxy, and grayish-yellow patches may appear on the affected areas. The skin feels cold and numb. The skin surface feels stiff but underlying tissue feels soft and pliable when depressed. Treat superficial frostbite by taking the victim inside immediately. Remove any constrictive clothing items and jewelry that could impair circulation. If you notice signs of frostbite, immediately seek medical attention. Place sterile gauze between the toes and fingers to absorb moisture and to keep them from sticking together. Slightly elevate the affected part to reduce pain and swelling. If you are more than one hour from a medical facility and you have warm water, place the frostbitten part in the water (100 to 105 degrees Fahrenheit). If you do not have a thermometer, test the water first to see if it is warm, not hot. Rewarming usually takes 20 to 45 minutes or until tissues soften.

Deep frostbite usually affects the feet or the hands and is characterized by waxy, pale, solid skin. Blisters may appear. Treat deep frostbite by moving the victim indoors and immediately seek medical attention.


Acknowledgments:
Geisinger Wyoming Valley Medical Center
Boston Univ. Medical Center Community Outreach
Hennepin County Medical Center Burn Center
The Cheshire Medical Center


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