Sep 02 2010
Cold Weather Injuries
Working in a cold weather environment presents many new challenges as well as more dangers. Understanding and recognizing these dangers may save your life or the life of a family member or comrade.
Here are some Injuries and Conditions associated with working/living in a cold weather environment.
Types of Injuries
Chilblain
Definition:
Chilblain is a medical condition that is often confused with frostbite and trench foot. Chilblains are acral ulcers (that is, ulcers affecting the extremities) that occur when a predisposed individual is exposed to cold and humidity. The cold exposure damages capillary beds in the skin, which in turn can cause redness, itching, blisters, and inflammation. Chilblains are often idiopathic in origin but can be manifestations of serious medical conditions that need to be investigated. Chilblains can be prevented by keeping the feet and hands warm in cold weather. A history of chilblains is suggestive of a connective tissue disease.
Symptoms:
- Ulceration of the digits and toes
- Red nose
- Skin redness
- Toe skin inflammation
- Finger skin inflammation
- Earlobe inflammation
Treatment:
- Keep area warm.
- Seek medical attention.
Prevention:
- Avoid rapid changes in temperature.
- Wear gloves and socks.
- Use warm footwear.
- Keep hands and feet warm.
- Avoid tight fitting socks/shoes.
- Place cotton wool between the toes to improve circulation.
- Healthy diet.
- Exercise to improve circulation
- Avoid alcohol before going out in snow.
Immersion syndrome
Definition:
Commonly refered to as trench or immersion foot. Trench foot develops when a person’s feet are exposed with wet conditions for long periods of time.
Symptoms:
When infected with trench foot, a person’s feet may feel itch or tingling sensations. If left untreated, swellings of blisters may appear along with the feel of numbness and pain. Skin upon infected areas may turn red when exposed to warm conditions. Dead skin cells presented in infected areas will soon peel off. Pain developed from leg cramps is also common with the infections of trench foot.
Trench foot occurs when feet are cold and damp while wearing constricting footwear. Unlike frostbite, trench foot does not require freezing temperatures and can occur in temperatures up to 60° F.
Prevention:
Trench foot is easily prevented by keeping the feet warm and dry, and changing socks frequently when the feet cannot be kept dry. Using the buddy method is a preferred method since the inspection would be more thorough and unbiased.
Frostbite
At 32°F, the blood vessels near the surface of the skin will start to constrict. Medical conditions such as Diabetes and the use of alcohol, tobacco and caffeinated beverages will also affect the flow of blood to the exterminites as well.
Symptoms:
The areas most likely to be affected by frostbite are your hands, feet, nose and ears. If your skin looks white or grayish-yellow, is very cold and has a hard or waxy feel, you may have frostbite. Your skin may also itch, burn or feel numb. Severe frostbite can cause blistering and hardening. As the area thaws, the flesh becomes red and painful.
Treatments:
Gradually warming the affected skin is key to treating frostbite. To do so:
- Protect your skin from further exposure. If you’re outside, warm frostbitten hands by tucking them into your armpits. Protect your face, nose or ears by covering the area with dry, gloved hands. Don’t rub the affected area and never rub snow on frostbitten skin.
- Get out of the cold. Once you’re indoors, remove wet clothes.
- Gradually warm frostbitten areas. Put frostbitten hands or feet in warm water — 104 to 107.6 F (40 to 42 C). Wrap or cover other areas in a warm blanket. Don’t use direct heat, such as a stove, heat lamp, fireplace or heating pad, because these can cause burns.
- Don’t walk on frostbitten feet or toes if possible. This further damages the tissue.
- If there’s any chance the affected areas will freeze again, don’t thaw them out. If they’re already thawed out, wrap them up so that they don’t become frozen again.
- Get emergency medical help. If the skin turns red and there’s a tingling and burning sensation as it warms, circulation is returning. But if numbness or sustained pain remains during warming or if blisters develop, seek medical attention.
Snow Blindness
Exposure to reflected sunlight from snow, ice, or water, even on grey overcast days, can result in sunburn of the tissues comprising the surface of the eye, as well as the retina, producing snow blindness.
Symptoms.
Symptoms may not be apparent until up to 12 hours after exposure. The eyes initially feel irritated and dry; then, as time passes, eyes feel as though they are full of sand. Blinking and moving the eyes may be extremely painful. The eyelids are usually red, swollen, and difficult to open.
Treatment.
A mild case will heal spontaneously in a few days, but you can obtain some relief by applying cold compresses and a lightproof bandage. Over the counter pain medication may be used to help in pain management.
WARNING Do not rub your eyes. Seek medical attention.
Prevention.
Snow blindness may be prevented by using sunglasses or goggles. If the glasses are lost, an emergency set of goggles can be made from a thin piece of leather, cardboard, or other lightproof material. Cut the material the width of the face with horizontal slits over the eyes. These improvised goggles can be held in place with string or para/550 cord attached to the sides and tied at the back of the head.
Dehydration
Working in cold weather environments is difficult, and a person can dehydrate without feeling “thirsty”. Continue to hydrate as you would based on your work load and monitor urination for discoloration, the clearer the better.
Hypothermia
“You only get so cold….then you die.”
The worst case scenario. Just a 3 degree drop in your body core temperature can start the symptoms of Hypothermia. Your body core temperature has dropped and the body begins shivering to try and warm itself. Mental confusion is another symptom as well. Sudden immersion into freezing water is commonly associated with hypothermia However, prolonged immersion in water as warm as 70degrees can start hypothermia.
Many divide hypothermia into different categories Mild, Moderate and Severe. Obviously each stage progressively worse and in it’s advanced stages, patients will become movements will become labored, speech will be slurred, and the patient will even have a false sense of warming and begin to remove clothing. Oddly enough, in the final stages of Severe Hypothermia, the patient may demonstrate a behavior called “Terminal Burrowing” which is seeking small places to sleep, similar to a hibernating animal.
Symptoms
- shivering
- changes in consciousness
- stumbling, mumbling or fumbling
- slurred speech or confusion
- slow rate of breathing
- cold, pale skin
- fatigue, lethargy or apathy
- lack of motor coordination
Treatment
- prevent further heat loss – move person out of the cold
- carefully remove wet clothing and replace it with dry – covering head
- insulate the body from cold ground – placing on warm dry blanket, etc.
- monitor breathing until help arrives – prepare for CPR if needed
- share body heat with skin to skin contact where possible
- provide warm non-alcoholic beverage (to a conscious, alert person) to drink
Gradual warming of the patient is paramount. Remove any wet or restrictive clothing and begin to warm the patient, hot liquids (if conscious), sharing of body heat, massaging the extremities increasing the heart rate and circulating the blood and of course, seeking medical attention.
CLOSING
Some things that help prevent injuries:
- Use the buddy system. Monitor and check on each other.
- Dress in layers. Wear loose fitting clean clothing. Wool and synthetic clothing work best, cotton fabrics will retain moisture and will hasten many conditions. Remove layers based on physical activity and prevent overheating.
- Stay hydrated. Continue to drink water even though you don’t feel thirsty.
- Wear a hat and gloves. Sounds like something your mom might say, but it’s true. Much of the body’s heat is lost through the head and hands.
- Conductivity…when resting or sleeping, put something between you and the ground. A lot of the body’s heat is lost through sitting or sleeping on the cold ground.
- Eat. Sounds odd, but your body’s caloric requirement will increase during cold weather to maintain the core temperature.
Hope this helps…..good luck and stay safe.
Sources for material:
http://en.wikipedia.org
http://coloradoouting.com
http://www.mayoclinic.com/
