The polar vortex bearing down on a majority of U.S. has plunged even Southern states into a deep freeze! Many unfamiliar with these icy temperatures may not be aware of the deadly danger the cold poses. Emergency doctors know all too well the potentially serious health risks and injuries associated with these extreme cold weather conditions.
With some areas of the country seeing temperatures and wind chill in the negative numbers, frostbite becomes a real risk. Frostbite can occur in exposed skin within 5 to 10 minutes when the temperature dips below 0° F. Your tissue literally freezes, with ice crystals forming in the cells. Early warning signs occur when your skin gets red and stings and prickling and numbness occur. This is called frostnip. With continued exposure, it can progress to initially freeze just the top layer of your skin, which becomes whitish-gray. If treated at this stage, good recovery is usually expected. However, if you continue to be exposed to the elements and the tissue freezes all the way through, it can cause permanent damage to muscles, nerves and blood vessels. This is known as third-degree or deep frostbite. It can behave similarly to a full thickness, third-degree burn. If your skin turns blotchy and bluish-black with blisters it can indicate gangrene has set in and amputation may occur.
Common mistakes people make that actually cause more harm is rubbing or massaging the area with snow or ice. Even massaging alone can damage the tissue further. The most important thing you can do is get out of the cold and remove any wet, constricting clothing, especially around the affected area. Then get to an emergency room as soon as possible. One caveat: If you are out in the wilderness and it will take a while to get to civilization for help, don’t warm up the affected frostbitten area if there is a chance of re-freezing. Believe it or not, it is better to leave the part frozen, since worse damage may occur to the tissue if it thaws and then freezes again!
Being out in cold too long puts you at risk for hypothermia. Hypothermia is defined as a core body temperature less than 95° F. Those highest at risk for developing hypothermia include the elderly, who often have problems regulating their body temperature, infants and very young kids who lose body heat faster than adults and may not be able to tell you they are cold. Anyone drinking too much alcohol is also at increased risk! Drinking alcohol to warm up is a common mistake people make when they get cold. It may feel warm going down, but alcohol actually dilates the blood vessels in your skin, causing you to lose more body heat. It can also impair your judgment so you may not have enough sense to get yourself out of the cold. Getting wet also causes you to lose body heat faster, which increases your risk of becoming hypothermic.
If you do not escape the elements and treat your hypothermia, it can become rapidly fatal. In the emergency room we describe the progressive symptoms of hypothermia as the “umbles”: fumbles and stumbles, then mumbles and grumbles. First you can loose your coordination, fumbling and stumbling around. Second, you may start to loose consciousness, exhibiting slurred speech, mumbling and grumbling. Eventually, you can become completely unconsciousness and go into cardiac arrest.
There have been multiple cases of children who have fallen through the ice and are revived, sometimes more than 40 minutes after their cardiac arrest from hypothermia. This is why in the ER we say, “You are not dead until you are warm and dead.” We do resuscitations on victims of hypothermia sometimes for over an hour, never declaring the resuscitation code blue over until their core temperature is back to normal because there is a chance they can be saved!
Some important tips for cold weather survival
If you get stranded in your car, it’s recommended to not leave your vehicle to look for help, especially in isolated areas. Staying in the your car even without the engine running does provide some shelter from the elements. However, if you do run your engine, make sure the tail pipe is not blocked with snow, as dangerous carbon monoxide can then leak into the car. Also tie a colored scarf to the car to signal your need for help.
Keep an emergency kit in your car at all times during the cold weather. It should include: a shovel and windshield scraper, warm blankets with a dry hat, gloves and outerwear, booster cables, sand or kitty litter, tow rope and flashlight, battery-powered radio, some high-protein food, water and a basic first-aid kit.
The acronym COLD can help you to remember how to AVOID hypothermia in the first place:
- Cover – yourself and all exposed areas including hands, face and neck
- Overexertion – try to avoid overexertion that causes you to sweat, which can make you damp and lose more heat
- Layers – wear loose layers that trap air and insulate you; your outer layer should be tightly woven and water-repellent
- Dry – stay as dry as possible and make sure that no snow can enter into your clothing and get you damp and wet
First aid tips if you find a victim of hypothermia
If come upon someone who is out in the elements and appears to be suffering from hypothermia, here are some things you can do:
- Start CPR if they have no pulse or are not breathing.
- Call 911.
- Move the victim to a warm area and remove any wet clothing.
- Do not apply direct heat to extremities, which causes a further drop in core temperature.
- If they are awake and conscious, give them warm non-alcoholic beverages.
Remember being prepared for an emergency is the best way to avoid one, so stay warm and stay safe!