Keep The Cold At Bay: Preventing Frostbite

November 20, 2007
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Frostbite Warnings

Exposed skin is most vulnerable to freezing from a cold wind and frigid temperature, but even tissue that is protected inside mittens or sturdy boots can eventually fall victim. Frostbite can happen whenever the body is exposed to temperature below 32 degrees Fahrenheit. When the body begins to feel the impact of the cold, it automatically shuts down some blood flow to the extremities, in an effort to preserve core temperature (a survival strategy to avoid hypothermia). But cutting off the flow of warm blood leaves the extremities without the very thing needed for protection against frostbite. Unable to stay warm, these parts of the body gradually chill and loose sensation. The fluid in the cells starts to freeze, and that causes damage.

The first stage of frostbite is sometimes referred to as frostnip, and it affects the outermost layer of tissue. Many have suffered mild frostnip and felt the pinpricks and numbing of the skin as it becomes slightly stiff. At this stage, evidence of freezing is the appearance of white or gray areas on the skin, but the deeper tissue is still warm and pliable. This degree of frostbite is not extremely serious, as long as it is recognized early and steps are taken to reverse the situation.
To help prevent frostbite in its earliest stage, you can establish a buddy system where you and your hiking partner(s) watch each other for signs of frostnip – patches of white or yellowish-gray on exposed skin. If you’re by yourself, use a small mirror to check the condition of your cheeks, chin, forehead, nose and ears. Flex fingers and toes, and wriggle your face to encourage blood flow, and periodically place a warm hand over those parts of your face to warm them and feel for frozen spots or stiff flesh. If any problems are detected, immediately cover the affected areas to protect against exposure to cold and wind and get to a warmer environment. Then gently re-warm the injured area by applying warm (not hot), moist compresses or submerging in warm water.

The second frostbite stage is called superficial frostbite. The freezing reaches deeper tissue, the skin feels waxy or leathery, and the flesh becomes more rigid. Discoloration ranges from white to yellowish-gray, or even slightly blue. Blisters are likely to form. This is a serious medical problem, and the victim should be taken as quickly as possible to a medical facility for professional treatment.

If exposure continues, or treatment is not obtained, superficial frostbite can advance to the third stage – deep frostbite. In this stage, the skin appears blotchy white or gray-blue. The deeper flesh becomes hard and cold to the touch. Permanent injury, blood clots, gangrene or loss of the limb can occur. Professional medical attention must be sought as quickly as possible.

Preventing Frostbite

Be prepared and you’ll have won half the battle. Here are some suggestions on how to be ready for the cold.
o Dress in layers that trap air inside. Wear clothing that is waterproof and breathable (to allow perspiration to escape). Keep your head, neck and wrists covered to preserve you core temperature. Mittens are often better than gloves, because fingers can keep each other warm. Make sure mittens, socks and boots are not so tight they restrict blood flow to fingers and toes. Wear gators to keep snow out of boots. In extreme cold, wear a neoprene facemask.
o Stay dry. Pace activities to avoid perspiration and exhaustion. Becoming wet or exhausted is asking for trouble.
o Limit exposure to wind and cold. Take breaks from exposure by periodically coming indoors or getting inside your vehicle. If no building or vehicle is available, find or improvise a shelter to protect yourself.
o Avoid use of alcohol and tobacco. Alcohol dilates blood vessels, resulting in loss of body core temperature. Tobacco constricts blood flow to extremities, increasing risk of frostbite.

Treating Frostbite

If the victim needs immediate medical attention, there are some things you can do while waiting for help to arrive or transporting the victim to a medical facility.
o Move the victim out of the cold and into a warm, protected place.
o Do not thaw frostbite unless you can guarantee that the flesh will not be refrozen.
o To thaw the flesh, either immerse the affected part of the body in warm (not hot) water or soak a cloth in warm (not hot) water and gently lay it on the affected area. Do not massage, or rub the frozen flesh. Leave blisters intact.
o Avoid exposing the affected area to sharp objects or dry heat (fire, hot pads, etc.) because the flesh is numb and might unknowingly get burned or otherwise injured.
o Expect the thawing process to be painful – continue with treatment in spite of anguished protest. After thawing, carefully wrap the affected area with clean bandaging material. Keep fingers and toes separated. Caregivers might need to feed and clothe the victim to prevent use of the injured limb.
o Keep the injury clean.

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