Most people have a mental picture of rugged mountaineers climbing Mount Everest when they hear about hypothermia and frostbite. Hypothermia and frostbite are more likely to affect the homeless and the elderly under unspectacular circumstances like lowering or turning off heating inside your own home. More than 1000 people die of hypothermia in the United States every year. The good news is that hypothermia and frostbite are preventable conditions.
Hypothermia and frostbite are common cold-related injuries in the winter months. In extreme cases, frostbite can result in a loss of limb, and hypothermia can result in the loss of life. Milder cold injuries are commonplace and can occur in unexpected places such as inside your home. Both conditions are the result of prolonged exposure to the cold. Often, other factors that compound the problem, such as advanced age or medical conditions that affect the victim’s ability to fight the cold.
Hypothermia occurs when the body’s temperature drops below the normal core temperature of 37°C (98.6°F) to 35°C (95°F) or colder. The human body operates within a narrow range of temperatures. If the body is cooling down faster than it can warm itself up, it will eventually become hypothermic. The early symptoms include vigorous shivering, but as it progresses, clumsiness, exhaustion, decreased movement, and slurred speech begin to appear. Loss of control and confusion are signs that hypothermia has become advanced.
Frostbite is an injury caused by freezing skin tissue, but the damage can go deeper in severe cases. Frostbite most commonly affects the fingers and toes, but other common sites include the nose, ears, cheeks, and chin area. Complications include increased sensitivity to cold, nerve damage, nail damage, skin colour change at the affected site, or infection.
Many of these dangers of cold exposure are due to accidents, but that doesn’t mean that they aren’t preventable. Preparation, foresight, and knowledge about the cold can prevent most accidents, and even in the worst-case scenarios, limit the severity of the damage.
Factors – Vulnerable Populations
Several factors can influence an individual’s susceptibility to hypothermia and frostbite. Vulnerable populations can be in danger of becoming hypothermic in circumstances that wouldn’t endanger those who are healthy. Some factors affect the body’s ability to withstand the cold, while others affect the person’s judgment, and increase the likelihood of the person exposing themselves to the cold, like mental health problems, alcohol, or certain drugs. Those who are vulnerable or caretakers need to understand the additional risks.
- Age is a critical factor. The elderly are particularly vulnerable as the ability to regulate temperature weakens. The statistics bear this out clearly. Babies can also be susceptible to the cold as they are unable to generate heat efficiently.
- Alcohol impairs judgment and losing consciousness outdoors is a common way to get hypothermia and frostbite. Alcohol may help make you feel warm, but it worsens hypothermia.
- Certain medical conditions like diabetes, arthritis, hypothyroidism, and Parkinson’s disease can affect thermoregulation. Certain medications can also affect thermoregulation.
- General health matters. Malnutrition or vitamin deficiencies can affect the body’s ability to tolerate cold. Exhaustion can also exacerbate the effects of the cold.
Frostbite leaves the affected site more vulnerable to future cold injuries.
Most cases of frostbite and hypothermia are preventable with education and foresight. Outside Magazine has a chilling story on how a series of small and understandable misjudgments and unpreparedness can turn fatal. The main factors that increase the risk for frostbite and hypothermia are cold, wind, moisture, and length of exposure. Prevention is simply about reducing these factors.
- Keep yourself warm with appropriate clothing
- Keep your environment warm
- Plan for unforeseen events when traveling
Scenario 1: Outdoors
- Check the weather forecast before you leave the house. Should you stay at home tonight? If it’s windy and cold, you need to dress accordingly.
- Layer up – layering keeps the body warmer by trapping air between the clothes, which act as insulation.
- Have spare socks if you expect cold weather. Wet socks can quickly become a problem in the cold, leading to frostbite and Trench foot.
- Wear a hat that covers your ears, a wool one if possible. It can also help protect your skin from winter sun exposure during the day as well as protect you from the cold.
- Opt for mittens (one pocket) over gloves (covers fingers individually) if possible. Your body generates more heat if they aren’t separated by fabric.
- Stay away from alcohol if you are going to be exposed to the cold for long. It may feel warm, but it is counterproductive, removing heat from the vital organs faster. Losing consciousness outdoors is also a common cause of hypothermia.
- Keep hydrated. Dehydration can accelerate the effects of hypothermia.
Scenario 2: Indoors
- Chronic hypothermia, where body temperature slowly drops over time, is common among the elderly and can occur indoors. Low-income people or homeless people who may not have access to adequate clothing or heating are particularly vulnerable to this type of hypothermia.
- People in poor health or those that are too exhausted are more vulnerable to hypothermia.
- Babies are particularly vulnerable as they can’t generate heat efficiently. Babies need to be dressed appropriately for the room temperature.
- The ideal indoor temperature is between 18°C (64.5°F) and 23°C (73.5°F), depending on the person’s preferences. Slightly cooler temperatures tend to be preferred for sleep.
- If an older person is living alone, be aware of slippery surfaces. Falling from a slip is a danger itself, but exposure to the cold floor can cause hypothermia if they cannot move or lose consciousness.
Scenario 3: Long-distance Driving
- Use your common sense. Check the weather forecast, and make sensible decisions.
Tell people where you are going, and bring a cellphone.
- Always keep your gas tank full when the weather is subzero.
- Have emergency supplies in your car in case of emergency: Blanket, coat, first-aid kit, flashlight, rope, jumper cable, a bag of sand (for traction in the snow), dry food, water, and dry towels.
Scenario 4: Outdoor Adventures
- Hiking in the winter is not for beginners and is much more dangerous.
- Check the weather forecast, and postponing or cancelling the trip is always an option if the weather is too extreme.
- Footwear must be waterproof and well insulated.
- Layer up. A close-fitting layer of wool or synthetic material will remove the sweat away from your body. Wear a second layer of a lightweight sweater or light jacket. Finally, a heavy waterproof jacket should be worn to protect you from the cold.
- Be prepared for terrain with appropriate equipment like crampons and hiking poles.
- Hydrate well and carry more water than necessary. Yes, water is heavy, but the cold, dry air will dehydrate you quickly.
Prevention is all about planning and foreseeing potential problems that could arise in the future, even if it seems unlikely. Prevention is about being aware of the dangers of the cold. Having practical and realistic ways to protect yourself is essential.
If you come across someone with moderate hypothermia, call for medical help. If the victim is cold or mildly hypothermic, they may recover without any intervention once they are out of the cold. However, any sign of confusion, slowness, or lack of mobility is cause for concern. While you are waiting for medical help, you may be able to provide some first aid:
- Move yourself or the patient to a warm and safe environment, if possible.
- If the person is wet, dry them off.
- Cover the person with dry blankets.
- Don’t apply excessive heat directly (hot water, pad, lamp). Handle the person gently. Avoid rubbing, massaging, or other excessive movements as it increases the risk of cardiac arrest.
- Warm drinks can help warm the body. Avoid caffeinated or alcoholic beverages.