Thursday, November 22, 2012

Frostbite

For those who believe Mother Nature is warm and fuzzy, I have some troubling news to share. She’s a killer.

Well, maybe that’s a little harsh. But nature plays by some very strict rules, with severe consequences for violators. Play by the rules, and everything’s fine. But keep in mind that the real outdoors is no soft and cuddly Disney movie.

Every season has its challenges, but the cold-weather months are among the most daunting and dangerous. The trouble is that human beings are warm-blooded, and we have to take measures to protect our soft, warm flesh from the chilly elements. To neglect this is to sacrifice our flesh to frostbite.


Frostbite

Flesh exposed to extreme cold will freeze, and the result is frostbite. Depending upon conditions, this can sometimes happen very quickly — like in a matter of minutes. For example, you grasp a frozen bit of metal with a bare hand, or worse yet, you splash some intensely cold gasoline (which won’t freeze until far below zero) on your hands or feet while refueling a vehicle — instant severe frostbite injury.

Slower frostbite sneaks up on you over a span of time during which your raw skin is exposed to the cold elements, or circulation is restricted to your hands and feet due to boots and gloves that are too tight.

Under normal slow-frostbite conditions, the initial process isn’t particularly painful. Other than mild tingling, you might not even notice, because the flesh becomes numb as it freezes. And because you can’t feel it happening to yourself, it's important to be vigilant to guard against the onset of frostbite. If you're with friends, watch each other for signs of freezing tissue. If you're alone, use a signal mirror or other reflective surface to do the best you can to detect the telltale signs of frostbite. Check hands and feet to make sure they still have warmth and feeling.

So what does frostbite look like and feel like?

As skin freezes, the affected spot loses sensation and turns gray/white or yellow/white in color. The flesh becomes stiff, resilient, crispy to the touch. Mildly frostbitten flesh still yields under moderate pressure, but as the freezing deepens, the flesh becomes solid and wooden feeling.

Frostbite is most likely to happen to exposed flesh where the wind and cold have direct access to the skin (cheeks, nose, chin, forehead, ears, etc.). Also vulnerable are hands and feet, where circulation is restricted by tight clothing and is relatively distant from the warmth of the body core.

How Serious Is It?

Mild frostbite, if caught and treated early, does not pose a serious health threat. But it can be painful during recover. If the freezing is allowed to deepen, the flesh may be terminally damaged, resulting in eventual loss. Gangrene in injured flesh, leading to eventual amputation, is not uncommon among expedition climbers who suffer extreme frostbite and can’t get treatment soon enough. But you don’t have to be an expedition mountaineer to fall victim. All you have to do is fail to prevent frostbite, then neglect immediate treatment.

Prevention

The first line of defense is your clothing, protecting the flesh from exposure to the cold and wind. Dress in layers, with a breathable wind/waterproof shell covering effective insulation layers. A neoprene face mask, full coverage headgear to protect the neck and ears, adequate footgear and mittens will go a long way toward fending off the surface damage caused by bitter cold. Keep boots and socks dry and loose enough to permit the free flow of blood circulating to your toes. Mittens are more effective than gloves because they don’t isolate fingers and they’re roomy enough to not restrict blood flow.

Next, eat high energy foods and warm drinks often during the times of peak exposure. Stay away from alcohol, because it not only numbs the brain and results in poor judgement, but it also causes the circulatory system to dilate, which can speed you on your way to an even bigger problem — hypothermia.

Check your skin often, inspecting for telltale spots. Check your buddy. Check fingers and toes.

To increase circulation, wriggle your face, move fingers and toes, mildly exercise those areas most vulnerable. Periodically, hold a warm hand over cheeks, nose, ears, etc., to share the warmth. If your hands are affected, pull off your gloves and insert hands under bare armpits. If your buddy has cold feet, you may have to take shelter, pull off his boots and hold his chilled feet against your warm stomach. This is where you learn who your true friends are.

Get out of the cold as soon as possible. Then get out of cold clothing and into something warmer. Frozen boots are like an icebox, and feet will just get colder if you leave them inside. Start working on creating a warmer environment.

Treatment

When it comes to treatment of deeply frozen flesh, you should get to a medical facility as quickly as possible. If a seriously frozen area is thawed and then allowed to freeze again, extreme damage will result. Treatment of profound frostbite is best left to professionals. In cases of solidly frozen feet or hands, do not attempt to remove boots or gloves. Just transport the victim to an emergency medical facility as fast and safely as you can.

But if the injury is only mild and you can’t get real medical help in a reasonable amount of time, the recommended procedure is to immerse the frostbitten area in warm (not hot) water. A temperature between 102 and 105 is generally safe. Expect some excruciating pain, as the flesh thaws. After thawing, take all precautions to ensure against re-freezing that part of the body. It will be vulnerable, so you must be careful.

Do’s 

• Do — Periodically check yourself and your buddy for frostbite

• Do — Eat and drink hot stuff

• Do — Stay dry

• Do — Use gentle warming techniques to thaw mild frostbite

• Do — Prevent re-freezing of the injured area

Don'ts

• Don’t — Rub the injured area with snow (very dangerous)

• Don’t — Drink alcohol

• Don’t — Smoke

• Don’t — Attempt to thaw a deeply frozen injury. Transport the victim as quickly as safely possible to a medical facility.

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