Hypothermia occurs when your body temperature drops below 96° F. It can easily happen in cold winds or wetness, and anyone who is exposed to severe cold without enough protection can develop hypothermia. Older people may not notice the cold as easily and can develop hypothermia even after exposure to mild cold. Certain medications, medical conditions or the consumption of alcohol can also make people more susceptible to the cold, and therefore hypothermia. You can avoid hypothermia if you guard against dehydration, fatigue, cold winds, wet clothes, and are aware of the symptoms. Your body automatically begins to shiver to rewarm itself. As your energy is used up to keep warm, you may reach a point where your body will be unable to rewarm itself. If left untreated, your body will gradually shut down and you can die.

1. Hypothermia can occur rapidly during cold-water immersion (one hour or less when water temperature is below 45° F). Because water has a tremendous capacity to drain heat from the body, immersion in water considered even slightly cool (e.g., 60° F) can cause hypothermia, if the immersion is prolonged for several hours.
2. Generally, deep-body temperature will not fall until after many hours of continuous exposure to cold air, if the individual is healthy, physically active, and reasonably dressed. However, since wet skin and wind accelerate body heat loss, and the body produces less heat during inactive periods, body temperature can fall even when air temperatures are above freezing if conditions are windy, clothing is wet, and/or the individual is inactive.
3. Hypothermia may be difficult to recognize in its early stages of development. Things to watch for include unusually withdrawn or bizarre behavior, irritability, confusion, slowed or slurred speech, altered vision, uncoordinated movements, and unconsciousness.
4. Even mild hypothermia can cause victims to make poor decisions or act drunk (e.g., removing clothing when it is clearly inappropriate).
5. Hypothermia victims may show no heart beat, breathing, or response to touch or pain when in fact they are still alive. Sometimes, the heart beat and breathing of hypothermia victims will be so faint that it can go undetected. If hypothermia has resulted from submersion in cold water, cardiopulmonary resuscitation (CPR) should be initiated without delay. However, when hypothermia victims are found on land, it is important to take a little extra time searching for vital signs to determine whether CPR is really required. Hypothermia victims should be treated as gently as possible during treatment and evacuation, since the function of the heart can be seriously impaired in hypothermia victims. Rough handling can cause life-threatening disruptions in heart rate.

SYMPTOMS OF HYPOTHERMIA

• Slow or irregular speech
• Shallow or very slow breathing
• Fatigue
• Confusion
• Slow pulse
• Weakness or drowsiness
• Shivering
• Cold, pale skin

TREATMENT

If you recognize hypothermia in someone, move the victim to shelter, remove their wet clothes, and replace them with warm, dry garments. If the victim is alert enough to hold a cup, give warm liquids to drink. Never give food or drink to an unconscious victim--he or she may choke. To help speed rewarming, place the victim in a pre-warmed sleeping bag. If the victim is unconscious, seek medical help immediately, before re-warming. Hypothermia is a medical emergency; untreated, it results in death.

COLD WEATHER PRECAUTIONS

• Dress warmly even when indoors
• Wear a warm hat and shoes
• Protect yourself from wind. (This can be done most effectively by wearing clothes that block wind and moisture.)
• Eat plenty of food
• Stay as active as possible
• Avoid drinking alcoholic beverages
• Keep warm in bed with enough clothing and blankets
• If you're taking medications for treatment of anxiety, nervousness or nausea, ask your doctor if it might affect your body temperature
• Ask friends and neighbors to look in on you once or twice a week. Your community may have a telephone check-in service for the elderly or housebound

FROSTBITE

Frostbite is a cold weather injury where the skin and underlying tissue freezes. Frostbite rarely occurs in still air below -10° C but may do so at higher temperatures in high winds (Wind chill Effect). Frost nip usually affects the cheeks, nose, ears, fingers, and toes, leaving them white and numb. Frost nip can be treated at home.

Frostbite need not occur, even in the extremist of altitude,temperature and fatigue. Frostbite frequently occurs as a result of carelessness.

Recognition

Below -107deg; C any tissue which feels numb for more than a few minutes may become frost-bitten. In early or superficial frostbite in the unthawed state the skin is yellowy-grey, painless, numb and leathery to the touch. Pain occurs as rewarming takes place. In deep frostbite the tissue is hard, white and obviously frozen, like a piece of chicken from a freezer.

Emergency Treatment

For all but trivial frostbite (e.g. a cheek, a fingertip) evacuation to a place of safety is essential. Once safe, rewarming should begin without delay. Avoid smoking (nicotine contracts blood vessels). Warm fluids should be provided if the individual does not show signs of altered consciousness. If possible immerse the frost-bitten area in a saucepan of hand hot water. 39-42° C (100° F) is optimal. Immerse for periods of 20 minutes, moving fingers and toes if possible. Do not knock or rub the frozen tissue. Thawing may be extremely painful, but is not always so. Thereafter wrap gently in clean bandages, separating fingers and toes. If a hot water container is not available, warm the parts in a warm sleeping bag (or on the abdomen, in the groins or armpits) for several hours.

Further Progress of Frostbite

A few hours after thawing the tissue swells and during the first two days giant blisters form. Try not to break them. Much the most important emergency treatment after rewarming is to keep the skin as clean as possible to avoid any infection.

Summary

Frostbite may become a major emergency and should be treated by competent medical providers. Frostbite can frequently be avoided, but when it occurs it is important to get into a safe environment. Rapid rewarming is recommended and strict adherence to hygiene is necessary.