COLD WEATHER INJURIES

The weather forecast warns of freezing temperatures for a couple of days as a blast of Arctic cold air embraces Texas today. Extreme cold is dangerous which isn’t rare in North Texas. Take extra caution if needed to be out and about in the cold.

It can be challenging to stay safe and healthy during this weather and emergency departments always get to see people suffering from cold weather injuries. Today, we will learn more about common cold weather injuries and ways to avoid them.

COMMON COLD-RELATED INJURIES

1. Icy Condition Injuries: Slips and Falls, Strains and Sprains, Back and Neck Injuries, Broken Bones, Concussions

Roads are expected to be slick and snow-covered where it has not been cleared. Most injuries result from slips and falls. It can happen while shoveling snow with related injuries and slipping or falling on ice.

When temperatures decrease, blood flow to the extremities and the elasticity of the muscles, tendons, and ligaments also decrease. This prevents our body movements from being as efficient as they usually are increasing the risk of muscle strain or joint sprain.

• How you walk on ice can decrease the risk of slipping. Take short slow steps with slightly bent knees and extend your arms to your sides. Putting your hands in your pockets will make it harder to keep balance. Use handrails whenever possible and be careful with every walkway even if you don’t clearly see ice.
• Park your car in a well-lit area and ensure footing is solid when you step out with 2 legs instead of the usual one leg to provide more support. It can also be helpful to carry salt or cat litter to sprinkle outside the door for grip.
• Choose your footwear wisely. Choose shoes that are comfortable and well-fitting. Go with a pair with good treads and some grip wherein shoes with rubber soles tend to have the best traction or consider adding cleats for the extra traction.
• If using a cane, adding a non-slip cane tip specific for snow and ice will help.
• Wear bright-colored clothing or a reflective material especially when walking in the dark. Dress for cold temperatures but be sure that your hat or scarf doesn’t get in the way of your vision.
• Proper form for shoveling snow is important. Push the snow away instead of lifting it onto the shovel. Protect your back with a slight bend in your knees as you shovel through. An additional tip is to warm up with stretching before you go shoveling.
• Always carry a phone with you to call for help in the event that you fall and can’t get yourself up.

2. Hypothermia

Hypothermia is a significant drop in body temperature below 95°F or 35°C as the body loses heat more than its heat production. It often occurs with extended exposure to cold, wet, and/or windy conditions with insufficient clothing and equipment, poor nutrition, and exposed/uncovered skin. This can occur quickly within a couple of hours or gradually over days and weeks.

The signs and symptoms may vary with each individual. It is typically classified as mild, moderate, or severe depending on the measured core temperature. Initially, you will feel cold and begin to shiver then you will not be able to perform motor function leading to loss of dexterity, impaired thinking, high pulse, and increased breathing. Shivering is one way for the body to maintain its temperature. If hypothermia progresses, the shivering mechanism may stop then confusion will start and fatally, the heart can stop working normally.

• If you need to be outside during extreme cold weather, put on plenty of layers of clothing and stay as dry as possible.
• Young children and the elderly are at more risk although hypothermia can affect anyone. Alcohol consumption also makes one susceptible to hypothermia.
• Any person suspected to have hypothermia should be brought to the nearest hospital for evaluation and treatment.

3. Frostnip and Frostbite

Frostnip is the mildest form of tissue freezing and is a precursor to developing frostbite. When only the superficial skin is frozen and the underlying tissues are not permanently damaged then it is frostnip.

On the other hand, frostbite is an injury to the body caused by the freezing of tissues. It causes loss of feeling and color in the affected areas. The first signs are numbness, clumsiness, and cold skin. The skin can become discolored or turn black. The most common areas are the nose, ears, cheeks, chin, fingers, or toes. Frostbite can permanently damage body tissues, and severe cases can lead to amputation.

• In extreme cold, the risk of frostbite increases in people with reduced blood circulation and those who are not dressed properly. Avoid prolonged exposure outdoors in frigid weather. If you must, wear gloves, warm socks, and hats to prevent frostbite.
• If you think, you or someone you know is suffering from frostbite, seek emergency care.

4. Chilblain

Chilblain is the body’s inflammatory response to extended exposure to cold, wet conditions. The most commonly affected areas are the hands and feet. It causes small red bumps on the skin, swelling, tenderness, or itching and pain. Swelling caused by excess fluid can also be present.

There is prolonged restriction of skin blood vessels, same with frostnip and frostbite, causing low oxygen levels in the tissue and blood vessel walls resulting in inflammation.

• Avoid extended exposure to cold and wet conditions. Always check for hypothermia for suspected chilblain cases. Remove wet clothing and gently wash and dry the affected area. Elevate and cover with loose, dry, and warm blanket or clothing. Also, avoid friction and pressure on the area.
• Go to the nearest hospital for evaluation and treatment.

5. Heater Burns and Carbon Monoxide Poisoning

Fire danger increases in cold weather. Firefighters observe an increase in fires associated with home heating safety.

Carbon monoxide is called the silent killer as it is an odorless, colorless gas found in exhaust fumes of carbon-containing fuels like gas, wood, coal, etc. Inhaling the fumes will cause a carbon monoxide buildup in the bloodstream decreasing the delivery of oxygen to the body. This will lead to brain and heart problems manifested in headache, nausea, dizziness, and tiredness. The risk for carbon monoxide poisoning increases in cold weather due to increased use of fume-producing products like fireplaces, furnaces, and kerosene heaters.

• Use space heaters with fall protection which will automatically turn the heater off if it tips over. Plug the cord directly into the wall instead of a surge protector. Keep the heater at least 3 feet away from anything inflammable including curtains, blankets, paper, wood, etc. Do not put it in concealed areas. Turn the heater off and unplug it when you leave the room. Do not leave the heater on or plugged if you will be sleeping.
• Ensure the chimney is clean before starting a fire. Put your trust in professional chimney cleaning services to inspect for wood-burning fireplaces and to handle any creosote buildup which is a wood-burning residue that is highly flammable and combustible. Ensure the flue is open to keep smoke from backing up into your home. When starting a wood fire, use wood and paper and avoid using gasoline or a charcoal starter indoors. Utilize a screen once the fire is going so embers don’t spark off fire in the room.
• If you find yourself needing to use a generator due to the weather conditions, it is recommended that the generator is clear of the house at least 6 feet away. It should be out in the open and not inside a garage or near the HVAC (heating, ventilation, and air conditioning) system where the heater could suck exhaust fumes back into the house.
• The use of ovens or stoves in heating a home is strongly prohibited. Any type of oven, may it be gas or electric, presents a fire hazard. Using charcoal grills also brings the same dangers. If a space heater is unavailable or the central heat is not working, use blankets to stay warm. Pile blankets or go to a family or your neighbor’s house.
• Do not warm up your car in the garage, as this can lead to a build-up of carbon monoxide. Install a carbon monoxide alarm or test your existing alarm for safety.
• If there is suspected carbon monoxide poisoning, get them outdoors and call 911. Fire departments are also equipped with carbon monoxide testing and can initiate medical care as needed.

Cold weather can be fun with snowball fights and cuddling up by the fire, but staying warm while staying safe should be our priority.

Author

Jenna Wishnew Dr. Jenna Wishnew is a board-certified general surgeon with over a decade of experience serving the North Dallas community. Known for her compassionate, patient-centered care, she specializes in wound care and hyperbaric oxygen therapy (HBOT), currently serving as Medical Director at the Wound Care and Hyperbaric Center at Methodist Richardson Medical Center. Dr. Wishnew is a recognized leader in her field, earning two international awards for excellence in wound care. She also has extensive experience managing gastroparesis and Enterra Gastric Stimulators.