Cold Injuries-Recognizing and Treating the 3 Most Common Cold Related Injuries

In part 2 of our series on Cold Injuries we will look at three (3) of the most common cold related injuries and how to recognize their causes, symptoms, and how to treat them in a survival/SHTF scenario.

 

Frostbite

Visual signs of minor frostbite

Visual signs of minor frostbite

Visual signs of moderate frostbite

Visual signs of moderate frostbite

Visual signs of severe frostbite

Visual signs of severe frostbite

Frostbite accounts for the largest number of Cold Weather Injuries each year and occurs when tissue temperature falls below 28-30°F. Frostbite can occur suddenly due to contact to cold metal or super-cooled liquids such as alcohol, fuel or antifreeze or it can develop over time due to prolonged exposure to cold. Frostbite is the most common in exposed skin such as the nose, ears, and cheeks, but also occurs in the hands and feet due to reduced skin blood flow.

Cause

  • Exposure to below freezing temperatures (<32°F) causing freezing of skin, fingers, toes, ears and facial parts.
  • Exposure of skin to metal, super cold fuel, oil, and lubricants, wind-chill, and tight clothing, particularly boots.
  • Riding in open vehicles, exposure to wind, running or skiing, and altitude exposure where there is little tree cover can all contribute to greater wind-chill.

Symptoms

  • Numbness in affected area.
  • Tingling, blistered, swollen, or tender areas.
  • Pale, yellowish, waxy-looking skin (grayish in dark-skinned soldiers).
  • Frozen tissue that feels wooden to the touch.
  • Significant pain after rewarming

Prevention

  • Monitoring air temperature and wind speed and using the wind-chill index is the only way to find the relative risk of frostbite.
  • Use contact gloves to handle all equipment; never use bare hands.
  • Use approved gloves to handle all fuel, oil, and lubricants.
  • Avoid cotton clothing, which holds perspiration in cold-weather environments.
  • Keep face and ears covered and dry.
  • Keep socks clean and dry.
  • Avoid tight socks and boots.

Treatment

  • Immersion of the affected part in warm (98-104 ° F) water is very effective; however most minor cases of frostbite can be re-warmed at room temperature or against skin.
  • Once a tissue is thawed, IT MUST NOT BE ALLOWED TO FREEZE AGAIN! If there is the possibility of tissue refreezing, it is better not to thaw it to avoid further tissue damage.
  • Avoid exposure to excessive heat (open flame, stove tops, steam, and heat packs) or rubbing affected tissue.
  • Anyone with a peripheral freezing injury must be suspected of being hypothermic and treated appropriately. In a survival/SHTF situation, it is more important to prevent hypothermia than to rewarm frostbite rapidly.
  • Do not give alcohol to any victim of a cold injury.

NON-FREEZING COLD INJURIES                                                                                                                   

The most common non-freezing cold injuries are chilblains and trench foot. Trench foot occurs when tissues are exposed to temperatures from 32-60°F for prolonged periods of time (12 hrs. or more), whereas chilblains, which is a more superficial injury, can occur after just a few hours of exposure. A non-freezing cold injury is classified by the symptoms and stages of recovery.

CHILBLAIN

Chilblains is a non-freezing Cold Weather Injury that can occur after 1-5 hours in cold-wet conditions when skin temperature is below 32°F/0°C. The most commonly affected areas are the back side of the fingers, but the ears, face, and other exposed skin are also areas chilblains can occur. There are no lasting effects from chilblains.

Cause

  • Continuous or repeated exposure of skin to cold/wet weather conditions at temperatures below 50 °F for more than 1-5 hours.

Symptoms

  • Chilblain lesions are swollen, tender, itchy and painful.
  • With re-warming, the skin becomes swollen, red (or darkening of the skin in dark-skinned people) and hot to the touch. An itching or burning sensation may continue for several hours after exposure.
  • Early diagnosis of chilblains becomes clear when symptoms do not resolve with re-warming.

Prevention

  • Use contact gloves to handle all equipment; never use bare hands.
  • Use approved gloves to handle all fuel, petroleum, oil, and lubricants.
  • In extreme cold environments, do not remove clothing immediately after heavy exertion (long hikes, running, etc.); wait until you are in a warmer place.
  • Avoid cotton clothing, which holds perspiration, in cold-weather environments.

Treatment

  • Re-warm affected area, keep warm and dry.

IMMERSION FOOT (TRENCH FOOT) 

WW II Poster about trenchfoot

WW II Poster about trench foot

The term "trenchfoot" originated during WW I In this picture from WW I soldiers are being examined for trenchfoot.

The term “trench foot” originated during WW I In this picture from WW I soldiers are being examined for trench foot.

the visual signs of trenchfoot after 12+ hours of exposure to cold/wet conditions.

The visual signs of trench foot after 12+ hours of exposure to cold/wet conditions.

Cause

  • Prolonged (12 hrs. or more) exposure of tissue, especially the feet, to wet cold and conditions at 32°F to 60°F. Inactivity and damp socks and boots/shoes (or tightly laced boots/shoes that impair circulation) speed the onset and severity of trench foot.

Symptoms

  • Cold, numb feet that may progress to hot with shooting pains.
  • Swelling, redness, and bleeding, feet may become pale and blue.
  • Accompanied by aches, increased pain sensitivity and infection.

Prevention

  • Keep feet clean and dry; change wet or damp socks as soon as possible.
  • Wipe dry the inside of Vapor Barrier boots dry at least once per day, or more often as feet sweat.
  • Dry leather boots by stuffing with paper towels, dry grass, newspaper, etc.

Treatment

  • Remove wet or constrictive clothing, gently wash and dry affected extremities.
  • Elevate affected limbs and cover with layers of loose, warm, dry clothing.
  • Do not pop blisters, apply lotions or creams, massage, expose to extreme heat or let someone with trench foot to walk, which can increase tissue damage and worsen the injury.

Knowing the most common cold related injuries and their causes you are better equipped to avoid them.  By knowing how to treat them, if they occur, you greatly increase your chances that you will survive a cold related injury.

I look forward to seeing your comments and as always, Train to Survive!

Tom

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