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Cold: signs and symptoms to watch for

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Prepare for the worst! Have a cold weather kit (space blanket, matches or lighter at a minimum)

 

Dress in layers, drink water, eat, now your limits and rest when you need to. Dehydration is easier in cold then hot because you don't feel like drinking..

 

 

This is not an all inclusive article but I hope this gets the conversation going and awareness up, we need to prepare for the worst.

 

SOME COLD WEATHER INJURY INFO:

  • Cold weather-related injuries occur with and without freezing of body tissues.
  • Cold weather-related injuries include chilblains, trench foot, frostnip, and frostbite.
  • Signs and symptoms may include tingling, numbness, and changes in the color and texture of the skin.
  • Treatment generally includes moving out of the cold environment, removing wet clothing, and re-warming the affected area.
  • Frostbite is a serious cold weather-related injury that requires immediate medical attention and rapid re-warming. Do not thaw the affected area if there is the risk of refreezing.
  • Certain individuals, such as the elderly, children, alcoholics, and the homeless, are at increased risk of developing cold weather-related injuries.
  • Prevention of cold weather-related injuries is best accomplished through proper planning and preparation for cold weather.

Introduction to frostbite and cold weather-related injuries

Winter cold and snow provide a number of opportunities to get outside and participate in activities such as skiing, sledding, and snowmobiling. However, without proper protection, cold weather-related injuries can occur even when temperatures are above freezing (32 F, 0 C). This is especially true if there are high winds or if clothing is wet. In general, however, it is both the temperature and the duration of exposure that play a role in determining the extent and severity of cold weather-related injuries. This information describes the different types of cold weather-related injuries, as well as what to do to prevent and treat them prior to reaching a health care practitioner

What type of injuries can be caused by cold weather?

Cold weather-related injuries can be divided into two general categories. There are those injuries that occur without the freezing of body tissue, such as chilblains, trench foot, and frostnip, and those injuries that occur with the freezing of body tissue, such as frostbite. Hypothermia is a medical condition characterized by a core body temperature that is abnormally low.

Chilblains

Chilblains (also known as pernio) are a common type of cold weather-related injury that can develop in predisposed individuals after exposure to nonfreezing temperatures and humid conditions. Chilblains typically develop because of an abnormal vascular response several hours after the area exposed to cold is re-warmed. Chilblains are itchy, painful, reddish, or purplish areas of swelling that usually affect the fingers, toes, nose, or ears. In some individuals, blisters or small open sores may also form, increasing the risk for developing an infection. Chilblains usually last for several days, and the affected area usually heals after several weeks. Though the affected area may remain sensitive to the cold in the future, there is usually no permanent damage. It is not uncommon for chilblains to recur in susceptible individuals.

Trench foot

Trench foot was named after the condition suffered by many soldiers in the trenches during World War I, though it is a condition still encountered today, often found in homeless individuals. Trench foot develops after feet have a prolonged exposure to a wet, cold, environment and is typically a more serious condition than chilblains. Tight-fitting, constricting boots and footwear serve to exacerbate the condition. Trench foot does not require freezing temperatures, and can occur with temperatures of up to 60 F (15.5 C).

The symptoms of trench foot may include pain, itching, numbness, and swelling. The affected foot may appear red, or blotchy (red and pale areas mixed together) or even bluish-black with advanced injury.

As with chilblains, blisters and open sores can develop. With severe trench foot, the tissue dies and sloughs off, and the development of gangrene can occur, sometimes requiring amputation. The usual recovery period for uncomplicated trench foot can be several weeks.

Frostnip

Frostnip is a mild cold weather-related injury that typically affects the face, ears, toes, and fingers. After exposure to cold weather, the affected area may appear pale, and may be accompanied by burning, itching or pain. Tingling or numbness are frequently present. Simple re-warming restores normal color and sensation, and there is no subsequent permanent tissue damage.

Frostbite

Frostbite occurs when there is freezing of body tissue, and it is the most serious of the cold weather-related injuries. Frostbite usually affects the hands, feet, nose, ears, and cheeks, though other areas of the body may also be affected. This type of injury results from decreased blood flow and heat delivery to body tissues resulting in damaging ice crystal formation, which ultimately leads to cell death. Upon re-warming of the affected tissue, vascular damage and complex cellular metabolic abnormalities lead to tissue death. Damage to tissue is most pronounced when there is prolonged cold weather exposure, the affected area slowly freezes, and the subsequent re-warming process is slow. Repeated thawing and refreezing of the affected tissue is particularly damaging, and should be avoided.

Frostbite injuries can be classified as either superficial or deep, depending on the tissue depth of injury. Superficial frostbite injuries involve the skin and subcutaneous tissues, while deep frostbite injuries extend beyond the subcutaneous tissues and involve the tendons, muscles, nerves, and even bone. Superficial frostbite injuries have a better prognosis than deep frostbite injuries.

What are the signs and symptoms of frostbite?

The signs and symptoms of frostbite depend on the extent and depth of tissue injury. Individuals with superficial frostbite may experience the following signs and symptoms to the affected area:

  • pain,
  • burning,
  • tingling,
  • numbness,
  • pale colored skin,
  • clear-colored skin blisters may develop, and
  • firm-feeling skin with soft underlying tissue which can move over bony ridges.

As the degree of injury progresses (1st to 3rd) to involve deeper tissue structures, the signs and symptoms of deep frostbite can develop, which may include the following:

  • complete loss of sensation,
  • pale, yellowish, bluish, gray, or mottled skin color,
  • formation of blood-filled skin blisters, and
  • firm-feeling skin and underlying tissue, with the affected area feeling hard and solid.

With advanced frostbite injuries, the affected area can subsequently appear blackened and gangrene can develop, placing the affected individual at high-risk for infection.

Who is most likely to get a cold weather-related injury and what can be done to prevent it?

Anybody can develop a cold weather-related injury.

  • The young and the elderly are more prone to these types of injuries due to vascular compromise or inability to effectively redistribute body heat. In addition, individuals who work outdoors, the homeless, and those who engage in outdoor activities are more likely to develop cold weather-related injuries due to their increased chance and time of of exposure to the cold conditions.
  • Alcohol and illicit drug use also make it more likely that individuals will develop a cold weather-related injury because these individuals have impaired judgment and they may not sense that they are in danger.
  • Patients with certain medical conditions including psychiatric illness, circulatory problems, diabetes, scleroderma, dehydration, and smoking can develop a cold weather-related injury more quickly than other individuals.

The prevention of cold weather-related injuries is best achieved through careful pre-planning and preparation for the cold, when possible.

  • Travel with another person in case an emergency occurs. Take along an emergency kit and blankets in your car in case of a breakdown or accident.
  • Dress warmly using multiple layers and adequately cover body areas prone to injury.
  • Try to have an extra change of dry clothing so you can remove any wet clothing if necessary.
  • Always keep your hands and feet dry and avoid wearing tight fitting clothing on these areas as it may decrease the circulation. Use waterproof shoes.
  • Drink plenty of water and avoid alcohol, caffeinated drinks, and smoking. Carry high-calorie snacks to provide adequate nutrition.
  • Most importantly, however, move indoors to a warmer environment when you begin to feel cold.

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  • Certain individuals, such as the elderly, children, alcoholics, and the homeless, are at increased risk of developing cold weather-related injuries.

Damn it...

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