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Recognizing and Treating Hypothermia and Frostbite

Working outside often entails risks of its own, and this time of year many outside workers need to take precautions against two additional occupational hazards: hypothermia and frostbite.

Hypothermia occurs when your internal body temperature drops lower than normal as a result of being in a cold environment indoors or out. Infants, people in poor health and the elderly can easily become hypothermic.

Frostbite occurs when the skin freezes as a result of low temperatures, wet clothes or even forceful winds. Fingers, toes, earlobes, cheeks and nose have the greatest exposure to cold and are most likely to be affected.

Workers, managers and safety professionals should follow these suggestions from the American College of Emergency Physicians (ACEP) on how to recognize, treat and avoid hypothermia and frostbite.

Warning Signs

Signs of hypothermia can include constant shivering; confusion; sleepiness; irrational behavior; slurred speech; memory loss; slow and shallow breathing; slow or weakening pulse; and cold, pale, dry skin. In infants, hypothermia may cause signs and symptoms such as cold skin; limpness; refusal to feed; and unusual quietness.

Signs of frostbite might at first include skin having a "pins and needles" feeling followed by the area turning pale or white and becoming numb. Severe frostbite symptoms include blistering and hardened skin that eventually turns black.

What to Do

You can help a victim of hypothermia by getting the person out of the cold and to a dry, warm place. Remove wet clothing and warm the person gradually with dry clothes, blankets, towels or your own body heat. Keep the victim still because too much movement may cause cardiac arrest, especially in the elderly. Keep the victim in a horizontal (flat) position. If the person becomes unconscious, check their breathing and pulse and be prepared to resuscitate if necessary.

Frostbite is often accompanied by hypothermia. Very gently remove gloves, rings and other restrictive clothing. Warm the affected part with your hands, in your lap or in the person's armpit. Do not rub frostbitten areas or apply direct heat. Place the affected part in warm water (104 F/ 40 C). Dry carefully and apply a dressing of dry gauze bandage. Raise and support the affected area to reduce swelling.

With both hypothermia and frostbite, medical attention should be sought as soon as possible.

How to Avoid Frostbite and Hypothermia

  • Limit your exposure to cold and go indoors if there is any doubt you are too cold.
  • Eat plenty of food and stay as active as possible.
  • Be careful of things that restrict your circulation such as smoking, tight clothing and fatigue.
  • Ask your doctor if the medication you are taking can affect your circulation.
  • Limit your alcoholic intake. Alcohol affects your circulation and ability to feel "cold."
  • Dress in multiple layers of clothing to trap warm air between layers.
  • Wear a hat outside. It helps to maintain body heat.
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