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Sub zero tolerance

Learn how to protect yourself from cold weather-related injuries

Learn how to protect yourself from cold weather-related injuries

Winnipeg Health Region
Wave, November / December 2009

What are some of the more serious weather-related injuries that people suffer during the winter?

Low temperatures, especially combined with strong winds, can lead to frostnip, frostbite, and hypothermia.

What is frostnip?

Frostnip is a thermal injury to tissue caused by cold. The injury may occur with or without freezing of the tissue. Frostnip most commonly affects the hands and feet. It happens when ice crystals form under the skin; it's usually not painful and is easy to treat. Frostnip initially causes cold, burning pain, with the area affected becoming blanched. With rewarming, the area becomes reddened.

What is frostbite?

Frostbite occurs when soft tissue freezes. It is a particular danger on days with a high wind-chill factor. If not properly treated, frostbite can lead to the loss of tissues or even limbs. Symptoms include:

  • Cold, burning pain that progresses to tingling
  • Later, numbness or heavy sensation
  • Area becomes pale or white
  • Rewarming causes pain

Other physical findings for both frostbite and frostnip may include:

  • Reduced body temperature
  • Affected area may be red or white
  • Swelling may be present
  • Blisters may be present
  • Area is initially cold, hard to the touch
  • Sensation is reduced
  • If rewarming has occurred, area will be warm and tender

How are frostnip and frostbite treated?

Treatment for both injuries includes:

  • Rapidly rewarm the area by immersing in warm water at approximately 42 C for 30 minutes.
  • If water is not available, hold area between two warm hands.
  • Do not rub and do not use hot water bottes or hot stoves.
  • Rest affected limb, avoid irritation to the skin.
  • Continue rewarming until skin is warm, soft, pliable and flushed red.
  • Elevate limb once it is rewarmed.
  • Do not break blisters.
  • Wrap loosely in soft material, protect from injury and further cold exposure.
  • Give the person warm fluids to drink.
  • Offer Tylenol or ibuprofen for pain if needed.

Seek medical attention for frostnip and frostbite if:

  • The skin is pale, feels unusually firm and is insensitive to touch, even after re-warming.
  • There are large areas of blistering, bluish discolouration that does not resolve with re-warming, or severe pain.

What is hypothermia?

Hypothermia is a potentially fatal condition that occurs when the body's temperature drops below 35 C (95 F). A person can develop hypothermia if they have been exposed to cold temperatures for a long period of time (e.g., being stranded outside in winter because your automobile gets stuck or breaks down) or if they are immersed in cold water for a short period time (e.g., falling through ice on a river or pond during the winter). Alcohol is a major risk factor for hypothermia. A person who drinks too much and then spends time outside in sub-zero temperatures can misjudge how their body is reacting to the cold.

Warning signs of hypothermia include:

  • Drowsiness
  • Slurred speech
  • Irritability and combativeness
  • Impaired co-ordination
  • Weakness and lethargy
  • Cool skin

How is hypothermia treated?

If you suspect someone is suffering from hypothermia, call 911 immediately or transport them to the nearest Emergency Department. If you cannot take a person to an Emergency Department and must wait for medical help, you can treat a person suffering from hypothermia by bringing the person in question indoors and wrapping them up with blankets to increase body temperature. Replace wet clothes if necessary. While reflected heat from a stove can help raise body temperature, do not use direct heat, electric blankets or hot water bottles to rewarm. It is also important to not rub the skin as this increases the damage to the skin and underlying tissue.

If the person is conscious, give them warm, sweet, non-alcoholic drinks. Do not give medication, alcohol or allow them to smoke.

How can I guard against cold weather-related injuries?

Cold weather-related injuries usually occur when we fail to treat the cold with the respect it deserves. When going outside to cross-country ski or toboggan, remember to dress in layers with appropriate cold-weather gear. Be sure to wear a warm hat that covers your ears and a pair of loose-fitting gloves or mitts - up to 40 per cent of our body heat is lost through the head and hands. Likewise, one should always prepare for car trips, especially if you are driving through remote areas. When travelling by car, monitor weather conditions carefully and adhere to travel advisories. Keep a winter storm survival kit in your car. This should include extra clothing, blankets, food, flares, chains, gloves and first-aid supplies. Keep your gas tank full, and to the extent possible, avoid travelling alone.

Linda Coote is a registered nurse and manager with the Winnipeg Health Region's Health Links - Info Santé.

About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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