Winter Is Coming

While the calendar tells us that fall just started, cold weather is already arriving, especially here in the high country. It's not bad enough to keep folks out of the hills, but it is definitely bad enough to punish improper choices. With the cold weather comes cold weather injuries. While a bit of forethought can prevent the vast majority of these, things sometimes go wrong. When that happens, you need to be able to recognize and treat the resulting injuries.

The two major cold weather injuries are frostbite and hypothermia. Frostbite results from flesh being exposed to extreme or prolonged cold, while hypothermia is a lowering of the body's core temperature to a dangerous level. They often run hand in hand, and can cripple or kill a victim.

Frostbite: Frostbite is a progression of injury caused by the exposure of skin to extreme cold, or prolonged exposure to more moderate cold. Early stages start by the skin becoming red, cold, and swollen. This progresses to numbness, and the skin becoming hard to the touch in the more severe stages. The redness progresses to a bluish or gray tone as well. There may be a tingling sensation as well as pain associated with swelling.

Treatment involves warming the affected area gradually. Soaking affected areas in warm water is ideal. A loose wrap with warm towels or blankets can help, as well as sheltering in a warm building or car. Do not rub frostbitten skin. While it does provide heat, vigorous rubbing can damage tissues already weakened by frostbite. Severe cases require medical attention. These cases are ones involving gray or hardened skin, as well as persistent numbness and swelling.

Hypothermia: Hypothermia is a very dangerous condition where the body's core temperature drops to a dangerous level, usually defined as 95 degrees Fahrenheit. This frequently occurs from exposure to winter conditions or immersion in cold waters. When the body temperature falls to these levels, the brain and organs begin to malfunction and shut down, and can lead to permanent damage or death.

Early-stage hypothermia patents will be shivering, and possibly dizzy and confused, and show a lack of coordination. They may be both hungry and nauseated, as well as fatigued. As their condition worsens, shivering stops, and fatigue progresses to drowsiness and unconsciousness.

The first step in treatment is moving the patient out of the cold, and removing any wet clothing they're wearing. Wrap them in warm, dry blankets if they're available. If necessary, wrap a healthy person in the blankets with the patient to share body heat. As with frostbite, gradual warming is safer and better than severe, sudden heating. Be gentle when moving all cold-injury patients, both due to their possible confusion and sluggishness, and to prevent injury to weakened tissues. Severe hypothermia cases need professional care, where advanced techniques can be used to warm the patient inside and out.

Prevention of cold injury is the best course of action. Unfortunately, no plan survives first contact with reality. Know how to recognize cold-related injuries before they become severe, and how to treat them when they occur.

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