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Respect the Cold
(Frostbite & Hypothermia)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 25 in the January 29, 2014 issue of
The Mississauga News under the feature: Health, Wellness & Beauty, Medicine Matters
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

When winter starts with a roar, it seems to catch our attention pretty quickly and we may let our guard down about the true perils of being cold. The airwaves are full of fanfare and excitement with approaching snowstorms. It seems that the cell phone age has made us complacent to hazards. At one time, the family Chevy carried essentials of winter survival buried deep in the crevices of the large trunk: chains, shovel, blanket, light, salt, flares, gloves, tool kit and assorted other things. Many people now seem to feel that the cell phone is able to replace all that. I gaze at people stopped on the 400 series highways in wind chills of 20 C dangerously sitting in stalled vehicles without even bare essentials such as a hat or gloves. Remaining in a disabled vehicle on a multi-lane highway in adverse weather is an extremely high-risk behavior. If you drive these roads, then be prepared to move well away from your car if you experience trouble. These situations define a Coroner's nightmares.

Frostbite and hypothermia are serious health problems that are associated with cold weather. Frostbite is the term applied when tissue begins to freeze. The skin begins to turn white or grayish and feels firm, hard or even waxy. It is a painless process beginning with numbness. This is why it is usually someone else who first spots it on you. The treatment is to immediately warm up the area. Rubbing frostbite with snow is an old myth that should be avoided. Human cells tend to burst when completely frozen. Severe frostbite can produce enough damage to an area that it is unable to recover. The damaged dead tissue becomes infected and turns black. Often, amputation is the only option.

Hypothermia is a much more severe scenario. As the body loses heat to the surrounding environment, it burns energy stored in your body to replenish it. If the pace cannot be maintained, then the core temperature starts to fall to dangerous levels. Initially, you have no idea that this is happening. Your brain is most affected and has trouble functioning. To an outside observer, you appear confused and disoriented. Hypothermia can strike under mild conditions such as being drenched by rain. Older persons and those with low body masses or fighting chronic diseases are more affected. An interesting feature of hypothermia is that it slows down metabolism, therefore, people who are found unconscious and seemingly cold should be vigorously resuscitated. They stand a chance of making a recovery if appropriately and quickly assessed, warmed and treated. Learn to respect extreme weather, especially while driving. You would be surprised at how easy it is to become a victim in cold weather. Better to stay indoors and play some "pong" or monopoly.

Related resources:

How to Survive the Freezing Cold by Charles W. Bryant, How Stuff Works.

Cold Injuries Hypothermia and Frostbite by Tim W. Allari, M.D. Columbus, GA

Hypothermia and Frostbite - Condition Factsheet from Canoe.ca. The Facts on Hypothermia and Frostbite, Causes of Hypothermia and Frostbite, Symptoms and Complications of Hypothermia and Frostbite, Diagnosing Hypothermia and Frostbite, Treating and Preventing Hypothermia and Frostbite.

Frostbite and Hypothermia: What to Do When Winter Has You in Its Icy Grip from National Safety Council. Cold weather can be dangerous for anyone who enjoys outdoor winter sports, and people who work outdoors during winter must be particularly mindful of the risks.

Frostbite vs Hypothermia Symptoms and Stages from eMedicine Health. What is the difference between frostbite and hypothermia? What is paradoxical undressing? What is hypothermia? What are the symptoms of hypothermia? What are the symptoms and stages of frostbite? What are the risk factors for frostbite and hypothermia?

Winter Storms and Extreme Cold from FEMA. Chart: Here's How Long You Can Stay Outside In Extreme Cold Temperatures Before Getting Frostbite by Christina Sterbenz, Business Insider.

Physical Hazards: Thermal Stress from Seattle University.

Cold Stress Guide from United States Department of Labor.

Cold Stress from Construction Safety Association of Ontario. Describes risks of cold stress, symptoms of hypothermia and other cold stress issues and methods to avoid them. "Cold stress or hypothermia can affect construction workers who are not protected against cold. The cold may result naturally from weather conditions or be created artificially, as in refrigerated environments.

Cold is a physical hazard in many construction workplaces. When the body is unable to warm itself, serious cold-related illnesses and injuries may occur, leading to permanent tissue damage and even death."

Hypothermia from Wikipedia, the free encyclopedia.

Hypothermia: A Fact Sheet from Allegheny County Health Department (ACHD).

How to Recognize and Treat Hypothermia from About.com.

Frostbite from Wikipedia, the free encyclopedia.

How to Treat Frostbite from wikiHow.

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