Preventing frostbite


January 2019
Article by Patrick Sura, MD, Chief Medical Officer and Emergency Medicine physician (pictured right)

It happens every winter: dangerously cold temperatures will grip the Midwest and bring along threat of frostbite.

As a family medicine and emergency physician for over 30 years, I’ve seen my share of patients with frostbite injuries and hypothermia related to cold exposure. But for now, let’s focus on frostbite – specifically what it is, what it looks like and what to do if you have it.

Frostbite is defined as an injury or destruction of skin and underlying tissue. It results from prolonged exposure to freezing or subfreezing temperatures. And it most often happens to the nose, ears, fingers or toes. Frostbitten skin is usually painful or numb and may look pale or blue/black. The skin may feel stiff or rubbery to the touch.

What should you do if you’re exposed to the extreme cold and are concerned you may have frostbite?

  • Remain calm. Fear or too much activity causes sweating. Sweating cools the body and can make you feel chilled.
  • Find shelter so you can get out of the cold, the wind or the water.
  • Remove cold, wet clothes.
  • Put on dry clothing, especially wool clothing or a synthetic fabric that insulates well, such as polypropylene. Make sure your head is covered.
  • If dry clothing is not immediately available, you can try to get warm by making skin-to-skin contact. But, do not rub or massage frozen skin.
  • After removing wet clothes, wrap a blanket or sleeping bag around you and another person and allow body heat to rewarm you. Use a heated blanket, if available.
  • Move around. Whirl your arms around like a windmill. Activity gets your blood moving and makes body heat – but don't be so active that you sweat.
  • Avoid putting your whole body in warm water. As a last resort, use a warm-water bath [100.4°F (38°C) to 105°F (41°C)] to rewarm if help is not available and other home treatments are not working to warm you up. Small body parts, such as a hand or foot, can be rewarmed by putting them in warm water. Do not put anyone who is not fully awake and alert into a warm bath.
  • Drink warm fluids that do not contain caffeine or alcohol.
  • Eat high-energy foods like apples, bananas, oranges, almonds, eggs and yogurt.
  • Do not give food or drink to a person who is acting confused or responding slowly.
  • Avoid using tobacco because it can decrease blood flow to extremities like the finger and toes.
Most minor cold injuries will heal on their own, and home treatment is usually all that is needed to relieve your symptoms and promote healing. But if you think you may have a more severe cold injury, call 911 or use first aid measures while you arrange for an evaluation by your doctor. If you don’t have a physician or provider, call Amery Hospital & Clinic at 715-268-8000 for an appointment. Amery Hospital & Clinic is open 24 hours a day to help serve your health care needs.

Preventing frostbite and other cold exposure injuries

  • Safety first. Before walking or driving on lakes or ponds, be sure the ice is thick enough. Be very wary of rivers or areas with flowing water.
  • Bring an emergency kit so you are prepared for cold, wet or windy weather conditions that might arise.
  • Head for shelter that will protect you from wind and rain. 
  • Avoid doing too much activity and sweating when you’re outdoors in the cold. Sweating increases heat loss through evaporation, so you will feel even colder.
  • Avoid touching metal, especially with wet hands. Doing this makes you feel colder and may cause frostbite.
  • Eat plenty of food to help maintain your body heat. Carry high-calorie foods, such as candy bars and trail mix, when going out in cold weather.
  • Drink plenty of water. Carry extra water with you and drink it hourly. Your urine should be clear, not yellow or orange. If you are not urinating every 2 to 3 hours, you probably are not drinking enough fluids.
  • Avoid drinking caffeinated beverages or alcohol as it contributes to dehydration and loss of body heat. Alcohol can also impair judgement and the body’s ability to regulate its temperature.
  • Avoid using tobacco.
  • Wear proper clothing and shoes. Keep extra protective clothing and blankets in your car in case of a breakdown in an isolated area.
  • Keep your hands and feet dry. Wear mittens instead of gloves. Wear moisture-wicking socks that retain warmth and keep moisture away from your skin like merino wool.

These tips can help you and your family prevent frostbite while enjoying the outdoors. Best wishes for a safe and warm winter.

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