New England winters - Cold injuries
With the different seasons and ever-changing weather in New
England it is important to be prepared for any weather-related event that can
happen. Currently, in the middle of winter,
New England continues to experience frigid temperatures and snowy, icy
conditions.
As Tactical Athletes are required to work in any and every weather condition, they are both particularly susceptible to sustaining cold injuries themselves, if not treating the general public suffering from these conditions. There are four general classifications of cold injuries:
- Immersion foot (also known as “trench foot”
- A non-freezing injury to the extremities
- Occurs with extended exposure to cold, wet conditions
- Symptoms
- Blueish or blotchy skin
- Blisters
- Skin maceration
- Pain
- Burning
- Tingling or itching
- Loss of sensation
- Swelling
- Open wounds
- Treatment
- Remove footwear
- Gently clean the skin
- Soak the affected extremity in warm water for 5-10 minutes
- Thoroughly dry the skin
- Put clean, dry socks on
- Footwear should be completely dry before donning
- Chilblain
- A non-freezing injury to the extremities
- Occurs with extended exposure to cold, wet conditions
- Symptoms
- Itching
- Tenderness
- Pain
- Swelling
- Small, red bumps
- Treatment
- Remove clothing
- Gently clean the affected area
- Elevate the affected extremity
- Cover the area with warm, dry clothing or blankets
- Do not use any lotions, creams, or extreme heat
- Limit weight bearing through the affected area until no longer negatively affected
- Frostbite
- Freezing injury to body tissues
- Often occurs in a localized area as a result of exposure to extreme cold
- Symptoms of mild frostbite
- Burning
- Redness or mottled gray skin appearance
- Stiffness
- Swelling
- Tingling
- Symptoms of deep frostbite
- Blisters
- Mottled gray skin appearance
- Numbness
- Loss of sensation
- Swelling
- Body tissue that feels hard and is non-rebounding
- Treatment
- Rule out hypothermia
- Remove any clothing
- Rewarm the tissue by immersing the affected area into a warm bath for 15-30 minutes
- Rewarming should be completed slowly, and water temperature should not exceed 98 degrees
- Continue to rewarm the area until the tissue is pliable and color and sensation have returned
- Hypothermia
- Occurs when the core body temperature is 95 degrees or less
- Symptoms of mild hypothermia
- Apathy
- Decreased fine motor control
- Hypertension
- Lethargy
- Mild amnesia
- Vigorous shivering
- Symptoms of moderate or severe hypothermia
- Depressed vital signs
- Gross motor skill impairment
- Impaired mental function
- Shivering has stopped
- Slurred speech
- Very cold skin
- Unconsciousness
- Treatment
- Move the individual to a warm shelter, out of the wind and rain/snow
- Remove clothing
- Insulate the body and head with warm, dry clothing and blankets
- Apply direct heat only to the trunk
- Do not rewarm the extremities, as this could send cold blood to the core and cause a decrease in core temperature, ultimately causing cardiac arrhythmias and death
- Provide warm fluids
Ways to prevent cold injury:
- Stay well hydrated before, during, and after strenuous activity
- Practice good nutrition
- Dress in layers
- The first layer, closest to the skin, should be a moisture wicking fabric
- The middle layer, a warm layer, should preferably be made of fleece or wool
- The outermost layer should be a wind/rain resistant layer
- Protect your extremities with gloves and hats
- Wear appropriate socks and shoes
- If you will be outside for extended periods of time, or if there is a chance your clothing will become sweaty or wet, you should have a change of clothes and shoes
- Take multiple rest breaks during strenuous activity, indoors if possible
- Use external heaters
- Get enough sleep
- Regularly exercise
- Limit excessive caffeine, drug, and alcohol intake in colder weather
- Look out for your fellow Tactical Athletes
Cold injuries can lead to serious medical conditions. If not properly identified and treated,
serious organ damage can occur, which may be fatal. Cold injuries can be avoided if the proper
steps are taken. As Tactical Athletes,
you need to be aware of your surroundings and limit your risk factors. All Tactical Athletes’ work as part of a
team, it is important to look out for each other.
By: J. Scott, DPT, ATC, TSAC-F
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