First aid for cold injuries

It’s the time of year when those of us in the Northern hemisphere start having cold weather, and even here in Tucson nighttime temperatures are low enough to warrant consideration for hypothermia. With that in mind, let’s go over some First Aid basics for cold injuries.

There are two basic types of cold injuries: low body temperature (hypothermia), which affects the entire body; and frostbite, which affects only a small part of the body (usually, the toes, fingertips, nose, and/or ears).

If a person is outside in weather colder than about 50° F (about 10 ° C) and is not clothed to protect themselves, their body will eventually be unable to generate enough heat to maintain constant normal body temperature. The core temperature of their body will fall, resulting in hypothermia. Mild symptoms of hypothermia include being apathetic or lethargic, shivering, having pale & cool or cold skin, and poor muscle coordination. A person in a more severe hypothermia will often have symptoms like being unconscious, having very shallow & slow breathing, skin that feels ice cold to the touch, and may have a weak pulse (or may not have a detectable pulse). Anyone who has signs or symptoms of hypothermia should be removed from the cold immediately, and re-warmed with an external source of heat (their own body heat is not enough!). Any wet clothing should be removed. Call 9-1-1 or your local emergency response number for anyone who is thought to be suffering from hypothermia and is not acting like themselves or is unconscious, if you cannot rewarm the person, or if you are unsure about what to do.

Frostbite happens when an exposed part of a person’s body is subjected to cold temperatures long enough for the tissue to become damaged and sometimes frozen. This can happen as a result of working in cold temperatures without gloves for example, or can also happen to people who are exposed to sudden bursts of cold such as if a liquid nitrogen or oxygen line ruptures and injures them. Frostbitten tissue may appear white, grey, or yellow and waxy, and the person will complain about the body part being numb (before it becomes numb, and fully frostbitten, they may complain about that part of their body feeling itchy and painfully cold). The person may lose the ability to use the body part; for example, if their finger becomes frostbitten they may be unable to bend it. Frostbitten body parts must be kept protected from re-freezing; if there is any chance that a person may suffer frostbite again after warming up the injured body part, it is better to not rewarm it until after that chance has been removed. Rewarm the body part slowly, and do not rub the injured part as rubbing it can cause the tissue to be even more severely damaged. Remove any jewelry on or near the injured part, in case the area swells.

Preventing the injury from occurring initially will help the most, so make sure that anyone who will be exposed to low temperatures is appropriately dressed and protected, including covering face, ears, and hands, and limiting exposure to cold temperatures when possible. Anyone who develops, or is treated for either frostbite or hypothermia should be examined by a physician.

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