Winter Safety

Outdoor enjoyment doesn't have to end just because the weather turns cold. But winter does mean taking a few extra precautions. The two leading causes of cold injury, hypothermia and frostbite, can have serious consequences - even death. But they are both preventable and treatable.

The Hypothermia Hazard

The dangers of exposure to extremely cold temperatures are well known, but the thermometer doesn't have to fall below freezing before cold can cause trouble.

When the body's "core temperature" drops below 98.6, a condition known as Hypothermia exists. "Core temperature" is the temperature of internal organs, particularly the heart, lungs, and brain. The body needs to maintain its normal core temperature for normal chemical reactions to take place.

Mild hypothermia can occur even in warm weather, particularly in elderly people or people with circulation problems.

In weather as warm as 60°, enough wind and rain can make hypothermia a real possibility for anyone.

Other contributing factors are:

• Inappropriate clothing
• Wetness
• Fatigue or exhaustion
• Dehydration
• Poor food intake
• Alcohol intake (causes increased blood flow near the skin's surface, losing heat)

Signs of Hypothermia

"The Umbles:" The victim stumbles, mumbles, fumbles and grumbles, showing loss of coordination and mental alertness.

Mild hypothermia (core temperature 98.6° - 96°F)

• Shivering - not under voluntary control
• Can't do complex functions (like skiing), but can still walk & talk

Moderate hypothermia (core temperature 95° - 93°F)

• Dazed consciousness
• Loss of coordination in hands
• Slurred speech
• Violent shivering
• Irrational behavior
• "I don't care" attitude

Severe hypothermia (core temperature 92° - 86°F)

• Shivering occurs in waves - pauses between episodes becomes longer until shivering ceases
• Victim can't walk; curls up on ground in fetal position Muscle rigidity
• Pale skin
• Dilated pupils
• Reduced breathing and heart rate

Treating Mild and Moderate Hypothermia

Basically, the idea is to conserve the heat the victim already has and replace the body fuel they have spent trying to keep warm.

Reduce heat loss

• Add layers of clothing
• Replace wet clothing with dry clothing
• Increase physical activity
• Find shelter from cold and wet weather

Add Fuel and fluids:

• Carbohydrates (warm sugar water or liquid Jello™ for heat and quick energy)
• Protein (protein bars for slower-burning fuel)
• Fats (even longer-burning, but require more energy and water to break down). Granola trail mix (GORP) is a source of carbohydrates, proteins and fats.
• Avoid alcohol (increases heat loss)
• Avoid caffeine (diuretic - causes water loss, increasing dehydration)
• Avoid tobacco (constricts blood vessels, increasing risk of frostbite)

Treating Severe Hypothermia

 

Wrap patient in multiple layers of wool blankets or sleeping bags, with a final layer of plastic sheeting to protect from moisture.

Feed patient only warm sugar water every 15 minutes. Diluted (not full-strength) liquid Jello™ works best because of its protein content.

Help patient urinate. Heat is lost to a full bladder, so urination will help conserve heat. You will need to help by opening up the wrap to do this, then re-covering the patient as soon as possible.

Add heat. Hot water bottles, heat packs - even warm rocks or towels - can be applied to major arteries - neck (carotid), armpits (brachial), groin (femoral), and palms of hands (arterial arch).

Rescue breathing can increase oxygen and provide internal heat.

Watch out for "Afterdrop," where the core temperature decreases during re-warming. This dangerous effect happens as the result of the skin layer warming too fast, sending cold stagnant blood from the surface to the internal organs. Avoid afterdrop by re-warming the core only. Do not expose a severely hypothermic patient to extremes of heat.

Frostbite

Frostbite is the actual freezing of body tissue. When this happens cells rupture due to increased water or from tearing by ice crystals.
That's why you should never rub frostbitten skin. Rubbing only increases the damage.

Like hypothermia, there are degrees of frostbite, depending on temperature and duration of exposure.

Before frostbite begins, a condition known as Cold Response occurs, where the area may be painful, may be pale or red, is resilient but cold to the touch.

In Mild Frostbite, skin may have sensation, but appears white and waxy. The top layers of skin have begun to freeze and feel hard, but deeper tissue is still soft. It usually occurs on cheeks, earlobes, fingers and toes. Damage is usually reversible.

Treatment for Cold Response and Mild Frostbite is simple: Rewarm gently. Blowing warm air or placing the area against a warm body part is usually sufficient. Do not rub the area!

Frostbite is more serious and can cause permanent damage. You should seek medical attention as soon as possible.

In frostbite, the skin is white, feels "wooden" and numb, or has no sensation at all.

If only a small area is frostbitten, it can be rewarmed as frostnip.

Deeper frostbite requires special care, as muscle and bone may be at risk.

• First of all, don't attempt rewarming unless you are sure there is no danger of the body part refreezing. Until you are sure the skin will stay warm, do not rewarm it. Re-freezing and rewarming causes further damage.
• Don't use dry heat to rewarm. It is too difficult to maintain an even, constant temperature.
• To rewarm, use a bath of continuously circulating warm water, 105° to 110° F. NO HOTTER, or additional damage will result.
• Remove constricting clothing from the area and immerse. Once the affected part enters the warm water bath, additional warm water should be added to keep the temperature constant. Don't add this additional water directly to the injured area.
• Monitor the temperature constantly with a thermometer.
• Keep the affected part in the bath for 25 - 40 minutes. Thawing is complete when the part is pliable and color and sensation have returned. There can be significant pain.
• Once thawing is complete, wrap the injured area in sterile gauze and protect it from movement and further cold.
• Do not use the rewarmed area. Until the area has healed. Joint and muscle activity of any kind can cause significant damage.

Prevention of cold injuries is simple:

• Dress appropriately. Add or subtract layers as activities and weather conditions apply.
• Don't stay in wet clothing. Stop and change as soon as possible..
• Avoid alcohol, tobacco and caffeine, as these can adversely affect the body's natural ability to control heat loss.
• Use the Buddy System to check on each other's faces, cheeks and ears for signs of frostbite.
• When you do find evidence of cold injury, stop and rewarm the area.
• Don't become overtired. When you feel fatigued, find a warm place to rest.
• Eat well. Your body needs extra fuel to keep warm.

People in reasonably good health should be able to participate in a variety of outdoor activities in cold weather by taking these common sense precautions.

Don't let winter get you down. Bundle up and enjoy it!