Cold Weather First Aid

While the temperature outside isn't quite as cold as recent winters, I thought this blog would still be appropriate for the last few weeks of the season. Despite the fact that temperatures may be warming slightly, it is still very cold outside! Park visitors are not always prepared for the cold, especially if a sudden change in temperature occurs or if they are traveling from other parts of the state where it is warmer. For those of you who are Emergency Medical Responders this should serve as a good review. For those of you who are not, I hope you find this information valuable in caring for yourself or your family members.

Frostbite

Frostbite can result when parts of the body are exposed to a cold environment. Exposed body parts can actually freeze. The most vulnerable body parts are your face, ears, fingers and toes. Adding wind to cold temperatures, known as wind chill, can speed the rate in which frostbite occurs.

Types

Superficial Frostbite (Frost Nip) - The affected body part becomes numb and bright red in color. Eventually the skin becomes white in color, and there may be a loss of feeling and sensation in the area. Rewarming may cause the patient to experience a tingling feeling.

• Treatment: Rewarm by placing affected areas next to warm body parts. Do not rub the body parts that have suspected frost nip as you can make things worse, especially if you rub them with snow. A quick rewarm for frost nip on your fingers would be to place them in your armpits. Treat these patients for shock.

Deep Frostbite - The patient's skin will be white, waxy, and it may be firm or frozen. Swelling and blisters may be present. If skin has thawed it may appear flushed with areas of purple and white.

• Treatment: Rewarming needs to take place under controlled conditions so prompt transport to a medical facility is needed. If possible, remove any jewelry and cover the area with dry clothing or dry dressings. Treat these patients for shock.

MedWild Videos - I have shared a couple of these short videos on prevention etc. These short videos have some excellent tips. I did not share the treatment videos, because they go beyond what MPS EMRs are trained to do.

Hypothermia

If a person has been exposed to extreme cold, we should be looking for signs and symptoms of hypothermia. When the body temperature falls to subnormal range of below 95 degrees Fahrenheit (F), hypothermia can occur. This happens because a person's body is not able to produce enough energy to keep the internal (core) body temperature at a satisfactory level.

Signs and Symptoms

Core Temperature of 93 to 95 degrees F - Shivering, foot stamping, constricted blood vessels, rapid breathing, generally withdrawn.
Core Temperature of 89 to 92 degrees F - Loss of coordination, muscle stiffness, slowing respirations, slow pulse, confused, lethargic and sleepy.
Core Temperature of 80-88 degrees F - Coma, Weak pulse, arrhythmia, very slow respirations, unresponsive.
Core Temperature of less than 80 degrees F - Apparent death, cardiac arrest, unresponsive.

• Treatment: Move the patient to a warm environment, such as a building or a warm vehicle. If this is not possible keep patient dry, wrap blankets around yourself and the patient or get into a sleeping bag with patient to share your body heat and begin the rewarming process. Handle patients gently, treat for shock, and transport to a medical facility. You can also use heat packs to help generate heat, but do not place heat packs directly on the skin.

MedWild Videos - I have again shared a couple of these short videos on prevention etc. These short videos have some excellent tips. I did not share the treatment videos, because they go beyond what MPS EMRs are trained to do.

Let's think about a situation:

You are called to assist an elderly hiker who has collapsed along the trail. Your initial assessment reveals violent shivers, a shallow and thready pulse, and slow respirations.  His skin temperature is slightly cool to touch. Although he seems a bit withdrawn, the man knows his name and the date and is aware of his surroundings. However, he cannot remember what happened to him. What is your initial treatment for this patient?

Post your answer in the comment section below.

Information for this blog came from:
Schottke, D., Emergency Medical Responder, Your First Response in Emergency Care, Sudbury, Jones and Bartlett Learning.

*This is a revised version of a blog post written by Robin Melton in 2014.*