Cold Weather Injuries, article 1

When engaging in winter sports or any time you are outdoors in below freezing temperatures, you must take care to prevent cold weather injuries, such as frostbite. Simply put, frostbite is the freezing of body tissue. Any part of your body that is exposed to temperatures below the freezing point for water could be at risk for frostbite.

A study that appeared in the British Journal of Sportsmedicine identified frostbite as the leading cold weather injury among mountaineers. The results of this study suggest that adequate training or knowledge of cold-weather injury combined with appropriate clothing and gear is the best prevention for frostbite.

In particular, the study noticed a difference in injury occurrence between recreational mountaineers and scientific researchers working in cold climates. The latter group would have received training about preventing frostbite and other cold-weather injuries. The researchers would also have been provided gear and clothing by their employers.

With this in mind, be sure to remember the following:

Symptoms of frostbite:

The first symptoms include burning, itching, extreme tingling and numbness. As frostbite becomes worse, there may be the presence of blisters, severely chapped skin, bruising, and discoloration. It is painful to rewarm the area.

Stages of frostbite:

Stage 1: you would experience some itching, burning, numbness or tingling. The affected area will actually begin to look frozen, often pale or white.

Stage 2: The skin has frozen all the way through. The area has definite swelling and has formed blisters. There is total numbness in the aflicted area.

Stage 3: The tissue below is actually frozen as well. The skin has a blue-grey discoloration. There is extreme pain when rewarming the body. It is critical to get medical attention for this level of frostbite.

Prevention: Wear good, warm, layered clothing when outdoors! The parts of the body most likely to get frostite include the hands, feet, nose and ears. Keep these areas protected with items like warm, waterproof boots, good mittens, hats, hoods, and balaclavas. This will keep your body temperature up and consistent in your extremities.

Avoid anything that will cause your blood vessels to dilate and any diuretics. This means avoiding alcohol and caffeine. Alcohol and other drugs are particularly dangerous as they interfere with your brains ability to recognize when you are cold. Save that hot toddy for when you are indoors and warm for the evening. Instead of a hot cup of coffee to warm up, try tea.

Treatment: The first thing to do is to seek medical help. Next, remember that the amount of final damage done is determined by how long the area stays frozen, NOT how cold it is. Do not rub the area as that will damage the tissue even further. If the feet are frostbit, do not have the person walk on their feet. place clean bandages between frostbit fingers or toes to prevent rubbing.

Give the person warm and hydrating liquids in order to get their body temperature up. While waiting for medical help, try to slowly rewarm the area, but be sure to avoid a thaw and refreeze cycle. The thaw and refreeze cycle will lead to much greater damage!
Remove any wet or restrictive clothing so that the person will not freeze any further.

There are two articles still to follow on cold weather injuries. Watch for the articles on hypothermia and trenchfoot so that you can be prepared and prevent unnecessary injury.

Sources: Harirchi, I, Arvin, A, Vash, J, & Zafarmand, V. (2005). Frostbite: incidence and predisposing factors in mountaineers. British Journal of Sportsmedicine, 39, 898-901.