Cold related injuries

Most individuals have the luxury of working in an office or some other type of edifice, so cold related injuries wouldcold rarely, if ever, be a concern. However, there are organizations and industries in which people work outside on a frequent or regular basis. Parks employees, road workers, construction, military, for example, have duties that involve braving the elements to earn a paycheck. While working outdoors, especially during winter weather, it’s important to take precautions to avoid injuries related to the cold.

Though apathy and lack of awareness may contribute to risk, there are other contributing factors to cold related injuries.

  • Inadequate or wet clothing
  • Consuming substances that inhibit the body’s response to cold, or that impair judgment.
  • Poor physical fitness
  • Illness, such as a cold or the flu
  • Becoming fatigued, restrained, injured, lost or entrapped out in the elements
  • Also, men have a notable higher rate of cold related injury than do women.

Damage can occur through the following conditions:

Cold stress: When the body struggles to maintain its normal temperature, the body will begin to shift blood flow from the extremities and outer skin to the chest and abdomen. Exposed skin and the extremities will cool more rapidly and increase the risk of more serious cold related injuries, such as frostbite and hypothermia. First indication is shivering.

Rewarm an individual suffering from cold stress by wrapping their body in blankets, finding shelter, and providing a radiant heat source. Encourage him or her to stay in motion to generate body heat.

Hypothermia: When the body is unable to replace heat lost to the elements, body temperature will become abnormally low.

Symptoms include:

  • Shivering
  • Fatigue
  • Loss of coordination
  • Slurred speech
  • Disorientation

More advanced indicators may involve:

  • The lack of shivering
  • Blue skin
  • Dilated pupils
  • Shallow breathing
  • Irregular heartbeat

In the late stages, the victim might feel so hot they may want to remove clothing. If left untreated hypothermia can result in unconsciousness and eventually death.

Helping someone with hypothermia:

  • Request immediate medical assistance.
  • Move the person to a warm, dry room or shelter
  • Remove wet clothing, including shoes and socks
  • Keep the person in a horizontal position.
  • Cover him or her with layers of blankets or towels and a vapor barrier for example a tarp or garbage bag.
  • Cover the head and neck but not the face
  • If alert, offer a warm, sweetened, nonalcoholic beverage.
  • Place warm bottles or hot packs in armpits, the groin area and along sides of the chest.
  • Ask emergency technicians for additional rewarming instructions.

 

A person in late stage hypothermia and unconscious is in a lethal situation. Wrap him or her in blankets and quickly transport them to where they can receive medical attention. Do not attempt to rewarm them.  If they stop breathing or don’t have a pulse for the period of one minute, CPR should be started. However, don’t apply chest compressions without the direction of an emergency medical technician (EMT).

Immersion Hypothermia: This condition is when exposure to cold water results in hypothermia. Damage occurs more quickly when a person is wet as water conducts heat away from the body 25 times faster than air. Don’t let warmer water fool you. Immersion hypothermia can occur in water temperatures below 70°F.

Helping someone with this type of hypothermia is similar to nonimmersion hypothermia.

 Frostnip and Frostbite:  Frostnip is a mild freezing of the top layers of skin tissue and is reversible. Frostbite is irreversible and occurs when the skin freezes, causing ice crystals to form between cells. Toes, fingers, ears, cheeks and the nose are particularly prone to frostbite. In serious cases, tissue, muscle and bone may be affected and amputation may be required.

Symptoms of Frostbite:

  • Numbness, tingling, stinging or aching,
  • Bluish or pale, waxy skin.

If caught early, recovery from frostbite is possible.  If there is no danger of freezing, mildly frozen tissue may be rewarmed and insulated until medical attention is received.

In case of frostbite:

  • Get indoors immediately.
  • Seek medical attention.
  • Remove constrictive clothing and jewelry that could impair circulation.
  • Place dry, sterile gauze between toes and fingers to absorb moisture and keep them from sticking together
  • Elevate the affected area to reduce pain and swelling

Immediate care recommendations for deep frostbite:

  • Follow guidelines for the treatment of hypothermia.
  • Do not rub or massage the affected area to warm it.
  • Do not apply snow or water, or break blisters.
  • Loosely cover and protect the area from contact.
  • Do not try to rewarm the frostbitten area without professional medical assistance. For example, do not place in warm water. Rewarmed tissue sustains further damage if it refreezes.
  • Warm with radiant heat. Do not use a heating pad, heat lamp or the heat of a stove, fireplace or radiator. Numb extremities can be easily burned.

Trench/Immersion Foot:  This happens when the body, to reduce heat loss, constricts blood vessels to cut down circulation in the feet. Without circulation, the skin tissue will die. This can occur in temperatures as high as 60°F if the feet are constantly wet.

Symptoms include:

  • Numbness, a tingling and/or itching sensation accompanied by,
  • Redness, swelling, leg cramps, blisters or ulcers, and bleeding under the skin.
  • In some cases, gangrene may turn feet dark purple, blue or gray.

 For immediate care:

  • Avoid walking
  • Remove footwear and socks, and dry the feet.
  • Moving to a warm, dry area and using rewarming techniques is usually only minimally effective.
  • Seek medical treatment.

Chilblains: These are damaged capillary beds (groups of small blood vessels) in the skin. They are caused by repeated exposure to temperatures just above freezing and up to as high as 60°F. Damage is permanent.

Symptoms:

  • Redness and itching—usually on cheeks, ears, fingers and toes
  • Blistering, inflammation and, in severe cases, ulceration.

Caring of chilblains:

  • Avoid scratching.
  • Slowly warm the skin.
  • Use corticosteroid creams to relieve itching and swelling.working outdoors
  • Keep blisters and ulcers clean and covered.
  • Seek medical advice.

 How to prevent these cold related injuries:

  • Use your head:
    • Check the weather forecast and be prepared for changing conditions.
    • If working on ice, be sure it’s thick enough to safely support applied weight.
    • Take extra precautions if you are unaccustomed to the cold or exerting yourself at higher elevations.
  • Clothing:
    • Wear layers of cold weather clothing retain body heat and repel water.
    • Wool, silk and most synthetics retain their insulating properties when they are wet.
    • Pack extra clothing in case you get wet.
    • Wear goggles or sunglasses to protect your eyes and sunscreen to protect your skin, even when it’s overcast.
    • The Army Medical Department website states to remember the acronym COLD.
      • C: Keep it Clean; O: Avoid Overheating; L: Wear clothing Loose and in layers; D: Keep clothing Dry
    • Follow the rules:
      • Stay on paths and trails and out of restricted areas.
      • Use your phones for emergencies and do not use it while engaging in a work or recreation activity.
    • Avoid fatigue:
      • Staying fit year-round is one of the best ways to manage fatigue and prevent serious injuries.
      • Follow an exercise regimen that helps build strength, stamina and flexibility.
      • Always stretch before and after your activity.
      • Take a break in a warm place if you are in pain or feel exhausted.
      • Keep your body fueled and well-hydrated. Drink plenty of water, eat nutritious meals and carry snacks to boost your energy.
      • Cold-weather workers who wear heavy, protective clothing require 10-15 percent more calories a day compared to those working in temperate climates.

Much of this advice is common sense. Don’t put yourself in peril by not being prepared for being in cold weather. This information isn’t only for those who work in the cold, but those who play in it as well – skiers, snowboarders, snowmobilers, etc. Whether at work or play, use your head, wear appropriate clothing and bring extra, and stay out of restricted areas and you should be able to avoid cold related injuries.

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