How to prevent,
recognize and treat

Hypothermia
Frostbite
Trench foot
And other cold-related illnesses

HYPOTHERMIA

Warning Signs:

For anyone exposed to very cold temperatures for even a short time, and especially very young children, premature or small infants, or elderly people who keep the heat at home below 65EF, look for:

	violent shivering. At the earliest stage of hypothermia, this is the most noticeable symptom. As body temperature continues to drop, symptoms will change. These are:
	shivering decreases and stops.
	speech is distorted or slurred.
	behavior is confused or irrational.
	drowsiness or numbness occurs.
	pulse weakens and there is shortness of breath.
	unconsciousness.

What to do:

SEEK MEDICAL ATTENTION IMMEDIATELY. Hypothermia can be fatal if not treated.
While waiting for assistance, you can:

	prevent further heat loss by moving the person from the cold area.
	remove wet or damp clothing and replace it with dry clothing.
	slowly give the person warm liquids if (s)he is conscious.

Caution: do not warm the person further. If the arms and legs are warmed before the chest and abdomen, the person could go into shock.

FROSTBITE

Frostbite is three conditions that increase in severity: early frostbite, or frostnip; superficial frostbite; or deep frostbite, or freezing. Frostbite usually affects the nose, ears, upper cheeks, hands and feet.

Warning signs:

Anyone exposed to cold, including workers who handle liquids such as gasoline or alcohol, should look for:

	skin and muscle under the skin feels soft to the touch.
	skin reddens, then becomes white.
	the area feels numb.

If frostnip is not treated, it may develop into:

FROSTBITE

	skin feels hard to the touch but the muscles below it still feel soft.
	the affected area of skin feels as if it's burning, but then it becomes numb.
	the area is red on a light-skinned person or light colored or white in a dark-skinned person.

If frostbite is untreated, it can develop into:

FREEZING

	both the skin and the muscle below it feel frozen and hard to the touch.
	the affected skin turns a grayish-blue.

In very severe cases, gangrene can develop.

What to do:

	DO NOT RUB THE AFFECTED AREA. This can cause severe damage to the skin and muscle.
	gently warm the affected area by putting it against a warm part of the body (such as the armpit), or by blowing warm air on it.

If the affected area still does not feel warm to the person, do the following:

	remove the person from the cold
	gently warm the affected area by putting it in warm water (100EF to 105EF). This will feel comfortably warm to an unaffected person. Make sure that the part of the body with frostbite doesn't touch the container. The person may have some pain as the area warms up. This usually means the treatment is working.
	contact your health care provider to find out if additional treatment is needed.

Anyone (but usually a child) who touches a very cold surface with the lips, tongue or hands can become stuck to the surface and develop one of the frostbite conditions. If this happens, DO NOT use force to separate the person from the surface. Instead, pour warm (NOT hot) water or apply a warm, damp cloth to the surface until the body part comes away freely.

IMMERSION or TRENCH FOOT

Warning signs:

If clothing becomes wet in cold weather, or if a part of the body is covered with water or wet mud that is just above freezing for a long period of time, look for:

	the affected area becomes swollen and pale.
	the affected muscles feel weak.
	the area feels numb and cold to the touch
	the person may become extra sensitive to cold.

What to do:

	remove all wet clothing
	gently rewarm the area as described for frostbite
	wrap with a sterile bandage
	slightly raise the affected area
	seek medical care - this condition can last if untreated.

CHILBLAINS

Lesions on the skin, usually the face, ears, hands and feet.

Warning signs:

If you have had extended exposure to temperatures below 60EF, look for: red, swollen areas that feel hot, tender and itchy chilblains usually occur 12 to 24 hours after exposure.

What to do:

	Protect the area by removing the person from the cold
	seek medical care. Chilblains can last for months.

Too much cold can be hazardous to your health. Cold temperatures can cause several conditions, including the sometimes fatal hypothermia, three kinds of frostbite, and common chilblains. To prevent your risk of getting any of these conditions, the New Jersey Department of Health and Senior Services recommends:

	keep temperatures in your house no lower than 68EF
	keep warm clothing (such as hats, gloves, socks and boots) at work and in your car. Keep blankets and easy to store high calorie food (such as nuts and candy) in your car, also.
	Wear clothes in layers, which will keep you warmer than a single layer of thick clothing.
	Replace wet clothing with dry as soon as possible in cold weather.
	Be extra careful in cold weather if you: have any circulatory problems are on medication such as chlorpromazine are elderly have young children, or participate in outdoor activities.
	Avoid using alcohol and tobacco (both increase your chances of getting a cold-related condition).
	If you routinely look in on an elderly or disabled person, make sure you check on them at least twice a day during cold spells.

IN CASE OF HEALTH EMERGENCIES, CALL YOUR PHYSICIAN OR VISIT YOUR LOCAL HOSPITAL EMERGENCY ROOM.

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