Cold-related Illnesses

Introduction

Frostbite and hypothermia are possible risks when traveling in cold environments. Hypothermia can even occur on relatively warm days when it is very wet or windy. High altitude increases your risk of cold-related injuries and illnesses as well.

Frostbite, like other burns, can range from superficial to full thickness. Superficial frostbite causes numbness, tingling, and a white appearance to the area that turns very pink when warmed.

Partial thickness frostbite causes large, painful blisters that can be filled with either clear fluid or blood. You may not notice any blisters until you begin warming the affected area.

Full thickness frostbite causes damage to all layers of the skin and deeper structure and can cause a black or waxy and pale appearance to the affected areas and numbness.

Hypothermia occurs when your core body temperature gets too low. Mild hypothermia causes shivering, mild confusion, mild clumsiness, slurred speech and fatigue. More severe hypothermia causes altered mental status and lethargy. Shivering may stop. This can progress to heart rhythm disturbances, coma, and death.

Treatment

Frostbite

Anyone with frostbite should evacuate and seek emergency medical care. Do not warm up frostbitten areas if you think there is a high chance that they will freeze again. In that case, it is better to leave them cold until they can be warmed and stay warm. Do not remove shoes if walking will be required to get to medical care as swelling may make it hard to put shoes back on after they are removed.

Once you are in a good position to rewarm the affected areas, the best way is to warm in circulating water that is a comfortable temperature (bathtub or hot tub temperature). Never rub any frostbitten areas and handle them very gently. Once the areas are warm, apply bulky, dry gauze bandages to protect the areas from further harm. Rewarming can be painful, so over-the-counter pain medications like ibuprofen may be needed. Ibuprofen can also help reduce inflammation and swelling.

Hypothermia

For all hypothermia, the best treatment is prevention. Bring proper clothing and waterproof or windproof layers if needed. Choose fabrics that help wick moisture away from skin and stay warm when wet such as wool or synthetic fabrics. Cotton should be avoided in wet and cold conditions.

If early signs of hypothermia develop, move to a warm, sheltered area. Remove any wet or sweaty clothes and add additional layers of clothing or blankets when available. If the victim is awake, sipping warm fluids with some sugar in them can help with rewarming. Warm compresses such as a water bottle filled with hot water and wrapped in a cloth can be applied to the neck, armpits, and groin.

For severe hypothermia, immediately evacuate to seek medical attention. Keep the patient lying down and avoid excessive motion or jostling, which can cause heart rhythm problems. Make a warm wrap by placing the patient on a tarp or waterproof layer with a sleeping bag or other layers of insulation on it. You may include some warm compresses or water bottles, but make sure they are not directly touching the skin. Wrap the patient in several warm layers of sleeping bags, clothes, or blankets, with an insulating layer like a tarp or tent fly on the outside.

When To Worry

Frostbite and hypothermia are medical emergencies. Immediately seek a warm, sheltered setting and emergency medical care.

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