Sledding, skiing, snowball fights, are just some of the fun activities that go on this time of year. One possible drawback to long hours outdoors is frostbite. Jackie Heinle, RN, a nursing specialist in the Burn Treatment Center at University of Iowa Hospitals and Clinics, has these comments:
Is frostbite a common problem during the winter months?
There are all kinds of fun reasons for us to be outside in the winter. But when we're outside our skin is really vulnerable to getting cold, and we have to be sensitive to that and be aware when our skin is starting to freeze; that we have to take precautions to prevent that and in the event that skin is frozen, that we have to deal with that.
What are the conditions under which frostbite is possible?
Frostbite occurs when the tissue freezes and that happens when you've exposed temperatures at the freezing point to the skin. And what we have to remember is that temperatures at 32 degrees Fahrenheit or zero degrees Centigrade are what put us at risk.
Then, when you add the wind chill, that also increases the chances of freezing. If you get wet while you're outside because it's starting to rain, or drizzle, or sleet, or you've been playing in the snow and your clothing gets wet, that cold temperature also increases the evaporative heat loss from your tissue causing quick freezing of that skin.
Who is most susceptible to frostbite?
The adult and the elderly really are susceptible at the same level as the young. If we think about this, the young have really small arms and legs (and fingers and toes and noses and ears) which makes them more likely to freeze; but when you get to the elderly, even though they have larger arms and big legs, they may have medical conditions, such as diabetes or heart disease, or even dementia or Alzheimer's that puts them at risk for that type of thing.
Other groups that are at risk are the homeless. We've got a homeless population around here and they're outside in the environment. We also have people who consume too much alcohol or other drugs that put them at risk for not recognizing that it's cold and they don't get out of the cold as much as they should. So there are several different people at risk for frostbite.
What are the warning signs of frostbite?
The thing we need to keep in mind is the areas may appear actually quite healthy at first. When frostbite occurs to the top of the skin, you experience some burning, numbness, tingling, itching, and cold sensation, and the regions actually appear white and frozen, but you can still move them around. But with deeper frostbite, what you're going to see is swelling - you're actually going to see some blisters form, and the tissue appears waxy, yellowish, and white, and your fingers and toes may not bend. Then as frostbite progresses it can actually become blackened and no longer be alive.
If I am outside with children, any signs I should be looking for to make sure they're not having this problem?
Ask them questions: Do your fingers feel cold? You can actually take them in periodically and take their gloves and shoes off, and feel, and look at those areas. And pay attention to their face, their nose, and ears. Of course we hope that noses and ears and figures and toes would be covered with warm clothing.
How can we prevent frostbite? And if I do start to feel that numbness or little bit of a pain in my hands or toes, what should be done to help treat the problem?
Dress for the weather. Think about how to I dress but not overdress. Some of the things you can do to not overdress are to dress in layers. Use mittens instead of gloves because with mittens your fingers are together so they're really warm. Wear two pairs of socks. The reason we suggest two pairs of socks is because the one sock will wick sweat away from the skin-because when you have moisture against your skin such as sweating, it can actually cause frostbite, too. The second sock is for additional heat - insulation. Use wool because it is a very warming, insulating type of material.
Be sure your head, face, and nose are covered at all times. If you're traveling in the winter, travel with a friend. Make sure that there's help available.
Avoid excessive alcohol consumption, avoid smoking. People who have diabetes or vessel disease are at risk.
If frost bite occurs, get into a warm environment to prevent further heat loss, call for assistance, remove any constrictive jewelry or clothes, and have drink some warm fluid, but not alcoholic or caffeinated fluids.
If blisters or any type of skin sloughing starts to occur, cover it with a dry bandage and seek medical attention.
Please don't ever rub snow on it. Put your hands and feets in warm water. Make sure that somebody else touches that warm water before you, because you may not be able to determine if it's too hot.
The most important thing is prevention. Be aware, be smart, be cold smart on those kinds of things. |
