Preventing frostbite and hypothermia

Our region is no stranger to extremely cold temperatures. When temperatures dip below freezing, hypothermia and frostbite are a concern. It can happen when a person has prolonged exposure to extremely cold temperatures.

Dr. Megan Garcia, general surgeon and medical director at the Grossman Burn Center at Research Medical Center — a part of HCA Midwest Health — offers tips on how to stay out of the ER during freezing temperatures.

“When people usually think of burns, they think of heat-related burns, but frostbite is a cold-related thermal burn or skin injury when the temperatures drop,” Dr. Garcia says. “When your body starts to get cold, it pulls the blood from your skin and brings it inward to your important organs such as your heart, lungs and brain. So, when it’s pulled away from the skin, the blood vessels constrict and you will not get good blood flow and you begin to develop ice crystals in the tissue under underneath your skin. This is when you notice that your fingers or ears may be numb and you can’t feel anymore.”

Dr. Garcia says if you continue to stay out in freezing temperatures, you may not even realize that you are freezing at that time.

“This is when you will see the exposed area turn like a white, waxy color or even bright red,” she says. “You do not want to stay out much longer.”

What are the stages of frostbite?

• Frostnip: the first stage of frostbite that doesn’t cause permanent damage, causes the skin to look pale or red and sensations of cold, prickly, and numbness.
• Superficial frostbite: the second stage of frostbite where previously red skin becomes pale or turns white, and ice crystals form on the skin. The skin may feel warm despite these changes — a warning sign of skin damage.
• Severe or deep frostbite may affect all layers of the skin and the tissues that lie below the skin. Watch for numbness and loss of the sensation of cold and pain/discomfort in the affected area(s).

What is hypothermia?

Dr. Garcia says hypothermia is a potentially dangerous drop in body temperature, usually caused by prolonged exposure to cold temperatures.

She says symptoms include shivering, slow, shallow breathing, confusion and memory loss, drowsiness or exhaustion, slurred or mumbled speech, loss of coordination and slow, weak pulse.

Who is at risk?

In these low temperatures, it is important to stay vigilant. People who work outside during the winter, elderly who are prone to falling, pregnant women, smokers, those who are at risk for coronary heart disease and kids waiting for the bus stops are at risk for prolonged exposure.

“The cold air is hard on the lungs, which can result in pneumonia or other respiratory illness. People who have asthma or who smoke, are also at a higher risk.” Dr. Garcia says.

She also says that people with coronary heart disease often suffer chest pain or discomfort when they're in cold weather and some studies suggest that harsh winter weather may increase a person's risk of heart attack due to overexertion.

“It seems simple enough but shoveling snow could put you at a higher risk for a heart attack,” she says. “The combination of cold temperatures and physical labor means your heart has to work harder to keep up. And you’re going from sitting down or lying — to this very rapid and prolonged exercise that your body isn’t used to.”

How to prevent frostbite

Avoid frostbite by limiting exposure to cold, wet or windy weather. In freezing, windy weather, exposed skin can develop frostbite in minutes.

Wear layers of loose, warm clothing, windproof and waterproof outerwear, hand protection, and a hat that fully covers your ears.

Also, choose undergarments and socks that wick moisture away from the skin. Change out of wet clothing as soon as possible.

When to seek care

“Most people come into the ER with intense pain and it feels like the exposed area is burning,” Dr. Garcia says. “They may also have blisters on their skin.”

She recommends seeking medical attention for frostbite if you experience:

• Signs and symptoms of superficial or deep frostbite
• Increased pain, swelling, redness or discharge in the area that was frostbitten
• Fever
• New, unexplained symptoms

Get emergency medical help if you suspect hypothermia, a condition in which your body loses heat faster than it can be produced. Signs and symptoms of hypothermia include:

• Intense shivering
• Slurred speech
• Drowsiness and loss of coordination

When an unexpected, severe injury or illness occurs, you need high-quality care fast. Our 11 ERs provide 24/7 emergency care to patients of all ages with locations throughout Kansas City and its surrounding communities. Find an HCA Midwest Health emergency room near you.