- - Monday, February 23, 2015

More blasts of arctic air are expected throughout much of the U.S. into the end of the month … with cold into first week of March (sigh). Not only is the cold bitter, but it is also dangerous and deadly. So far, hypothermia has resulted in the deaths of at least 20 people. And although Oscar Wilde stated that “Conversation about the weather is the last refuge of the unimaginative,” discussing cold weather safety can be lifesaving.

Dr. Nina’s What You Need To Know: To Brave and Survive the Extreme Cold Temperatures

What is frostbite? This term describes injury caused by freezing of the skin and underlying tissues. Exposure to cold weather conditions — especially when there is a wind chill factor — is the most likely cause. However, frostbite can also result from direct contact with ice, freezing metals and very cold liquids.
• Symptoms: The affected area first becomes very cold and red, then numb, hard and pale. Because of skin numbness, we may not realize we have frostbite until someone else points it out.
• The most commonly affected areas are those that are exposed. They include: fingers, toes, nose, ears, cheeks, and chin. However, frostbite can occur anywhere on our body especially when snow or other precipitation gets under our sleeves or into our boots.
• Treatment depends on the severity. Frost nip — the first stage of frostbite — does not cause permanent skin damage. As a result, it can often be treated by gently rewarming our skin. However, all other frostbite requires medical attention due to damage to the skin and underlying tissue, which may include muscle and bone. Complications include infection and nerve damage.

What is hypothermia? The term describes when our body loses heat faster than it produces it, resulting in dangerously low body temperatures. Normally, our body maintains a temperature of 98.6oF (37oC). Hypothermia is typically seen when the temperature is less than 95oF (35oC).

This is a medical emergency and here is why: Our body responds to the drop in temperature by constricting its blood vessels in order to redirect blood flow to its vital organs — the heart, lung and brain. This results in an increase in blood pressure and heart rate. As temperatures continue to drop, our organ function becomes affected. This can lead to heart and lung failure and possibly death.
• Symptoms depend on the severity. For example, mild hypothermia involves shivering, lethargy, cold/pale skin, and an increased breathing rate. Moderate hypothermia is marked by confusion and impaired judgment, as well as slurred speech and loss of coordination. In severe hypothermia, the shivering stops, breathing rate decreases, and there is a loss of consciousness.
• Treatment involves seeking medical attention immediately. Call 9-1-1! While waiting for help, experts recommend: moving the person to a warm place (e.g. indoors); removing any wet clothing and drying them; and wrapping them in warm attire (blankets, towels).
• Avoid the following: placing the person in a hot bath, massaging their limbs, or using heating pads. These can cause the constricted blood vessels to suddenly open up and our blood pressure can plummet. Low blood pressure can lead to poor perfusion of our organs, cardiac arrest and possibly death.

How do we prevent cold-related injuries?
• Limit time outdoors to less than 10 minutes, whenever possible (cabin fever may warm us up in this cold).
• When traveling, keep the gas tank more than half-full; have extra blankets and clothes in the event of being stranded or the car battery will not start; and have a backup battery charger for our mobile phone.
• Walk slowly and carefully on snowy, icy walkways. I have taken care of one too many patients with broken bones and bleeding into their brain due to slips and falls from ice.
• Avoid overexertion such as shoveling snow. Heart attacks are more likely to occur during the winter months.
• Warm our body from the inside with hot liquids (e.g. soups, tea, coffee).
• Dress appropriately. Wear multiple layers of loose clothing; cover ears, head, face, hands and feet; keep dry with water repellant items and remove wet clothing immediately.

Who is at an increased risk of cold weather health injuries?
• Elderly: Decreased body temperature regulation and sensation to cold. In addition, they are more likely to have multiple medical conditions or be on several medications.
• Very young: Large surface area to weight ratio and more likely to ignore cold conditions (after all, who wants to come indoors when you can make snowmen like Olaf or Frosty?)
• Mental problems: Interferes with judgment to dress properly or retreat to warm areas.
• Certain medical conditions: Heart and lung diseases; hypothyroidism; Parkinson’s disease; and diabetes.
• Medications: Certain antidepressants, antipsychotics, narcotics and sedatives may change the body’s ability to regulate its temperature.

The cold weather reminds me of the nursery rhyme: “Rain rain go away. Come again another day.” I would like to impose my literary license with some important edits. First, I want to substitute “snow snow,” “hail hail,” “sleet sleet,” and “cold cold” for rain. Second, I would like to make a special request that it does not return until next year. Like most of us who live in or have loved ones who live in cold areas of our country, I am ready for spring. December is a winter wonderland but by the time February rolls around, I am not alone when I say “enough already.” It’s time to thaw. Be safe!

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