First Aid Care for Cold Emergencies

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Cold Emergencies

When people are exposed to extreme cold weather environments and conditions, the human body can only tolerate so much and when prolonged exposure to such punishing conditions are not mitigated permanent disability and possibly death can occur.

Extreme and prolonged cold exposure may cause several disabilities and injuries to the body namely frostbite or to the entire body as a whole such as hypothermia, a severe life-threatening condition which results to death if not properly managed.

Frostbite

Frostbite occurs when temperatures drop below the freezing point of water (below zero degrees Celsius) which freezes mostly the extremities and parts of the face (hands, feet, nose and ears). When skin tissue dies gangrene normally follows from frostbite in which the affected part may need to be amputated to prevent further damage to surrounding tissues.  The signs of frostbite include the following:

1. Cold and numb waxy-looking skin (pain at first followed by numbness).
2. Development of paraesthesia (tingling sensation) following deep cold exposure.
3. Chilblain occurs, a localized tissue inflammation that appears as swollen purplish or reddish skin.
4. The victim with frostbite will experience significant pain and discomfort when blood flow is reestablished. Blisters may also appear upon re-warming.
5. A dull continuous ache progress into throbbing sensation 1-3 days following the injury and may last until several months until final separation of tissue is complete.

First aid care for Frostbite

To care for frostbite:

1. Move the victim to a safe and warm place.
2. Remove wet/cold clothing and jewelry from the injured part or extremity. (Earrings, rings etc.).
3. Keep the affected body part elevated to reduce swelling and edema.
4. If victim is not nauseated and able to drink, give the person warm non-alcoholic and non-caffeinated fluids to drink.
5. Seek medical care for further evaluation and management.

Care for frostbite in a remote and desolate location 

If the victim is in a remote region where medical rescue will most likely be delayed (more than 1 hour) and rescuers need to re-warm the affected body part, do the following:

1. Place the frostbitten part in warm (100 degrees Fahrenheit) water for 20-40 minutes or until tissue becomes soft. For ear or facial frostbite, apply moist cloths and change them regularly.
2. Following thawing:

• Position dry dressings between fingers or toes.
• Slightly raise the affected part to reduce swelling and alleviate pain.

Recognizing Hypothermia

Hypothermia occurs when the body’s core temperature drops below 95 degrees Fahrenheit. Hypothermia is an extremely life-threatening cold related injury which can happen quickly or gradually. The temperature does not necessarily have to be below the freezing point for hypothermia to happen. The signs of hypothermia include the following:

1. Uncontrollable shivering
2. Cold skin even under clothing
3. Confusion and sluggishness

Emergency Care for Hypothermia

To care for hypothermia:

1. Get the victim out of the cold and into a warm and dry place.
2. Prevent further heat loss by doing the following:

• Cover the victim’s head.
• Replace the victim’s wet clothes with dray clothing.
• Place additional insulation such as blankets, towels and coats beneath and over the victim.

3. Let the victim rest in a comfortable position.
4. If the victim is conscious and alert, give him/her warm fluids to drink.

Immediately seek medical care for severe hypothermia (rigid muscles, cold skin on chest and abdomen, delirium and lethargy).