First Aid Guide: Cold Emergencies

First Aid Guides and Checklists

Hypothermia


General Observable Phases of Hypothermia

  1. Shivering
  2. Apathy
  3. Loss of Consiousness
  4. Decreasing Pulse & Breathing Rate
  5. Death

Hypothermia Medical Stages (Three)

Medical Stage I
Body temperature drops by 1°C – 2°C below normal temperature C (1.8°-3.6°F, or between 96.8°F – 95°F). Mild to strong shivering occurs. Unable to perform complex tasks with the hands; the hands become numb. Blood vessels in the outer extremities contract, lessening heat loss to the outside air. Breathing becomes quick and shallow. Goose bumps form, raising body hair on end in an attempt to create an insulating layer of air around the body (a vestigial response, but useful in other species).

Medical Stage II
Body temperature drops by 2°C°- 4°C (3.6°F – 7.2°F, or between 95°F – 91.4°F). Shivering becomes more violent. Muscle miscoordination becomes apparent. Movements are slow and labored, accompanied by a stumbling pace and mild confusion, although the victim may appear alert. Surface blood vessels contract further as the body focuses its remaining resources on keeping the vital organs warm. Victim becomes pale. Lips, ears, fingers and toes may become blue.

Medical Stage III
Body temperature drops below approximately 32°C or 90°F (normal is 37°C or 98.6°F). Shivering usually stops below 32°C; difficulty speaking, sluggish thinking, and amnesia start to appear; inability to use hands and stumbling are also usually present. Cellular metabolic processes shut down. Below 86°F (30°C) the exposed skin becomes blue and puffy, muscle coordination very poor, walking nearly impossible, and the victim exhibits incoherent/irrational behavior including terminal burrowing behavior or even a stupor. Pulse and respiration rates decrease significantly but fast heart rates (ventricular tachycardia, atrial fibrillation) can occur. Major organs fail. Clinical death occurs. Because of decreased cellular activity in stage 3 hypothermia, the body will actually take longer to undergo brain death.

Call for immediate medical help as soon as the burn occurs and do not apply any type of butter or greasy substance to the burn. This can hamper cooling of the burn area and also do further damage. Consult medical personnel about whether or not to administer fluids to victim before arriving at a hospital.


Frostbite

Frostbite is an injury caused by freezing of the skin and underlying tissues. In the earliest stage of frostbite, known as frostnip, there is no permanent damage to skin. Symptoms include cold skin and a prickling feeling, followed by numbness and inflamed or discolored skin. It’s most common on your fingers, toes, nose and ears. Treatment for frostbite varies based on the stage.

You’re more likely to get frostbite in any situation that leads to prolonged cold exposure, especially during the winter, in windy weather conditions, at high altitudes, and no shelter from the cold weather. You can get frostbite even under cold-weather clothing.

Stages of Frostbite

Stage I – Frostnip
During frostnip or the first stage of frostbite, you may see affected skin is red to purple or lighter than natural skin tone. Skin may also feel cold, slightly painful and tingly. Frostnip is the warning stage when skin damage is just temporary. If you notice symptoms, get inside immediately and thaw the affected area of skin with room-temperature/luke-warm (never hot) water. Whether symptoms persist or new ones appear or not after treatment, seek medical attention to be sure there isn’t long-term damage from frostnip.

Stage II – Superficial (surface) Frostbite
This is the second stage of frostbite, and it requires medical treatment. The skin might feel warm, but the water in your skin is slowly freezing into ice crystals. The skin contains over 60% water. This can cause a “pins and needles” feeling. In addition, the skin may sting or swell up. After rewarming, there might have painful, spotty patches or purple or blue areas of skin like a bruise. The skin might start to peel and feel just like a sunburn. The body may also get fluid-filled blisters in the area after a day or so.

Severe (deep) Frostbite
In the third stage of frostbite, the lower layers of skin (subcutaneous tissue) freeze and total numbness sets in. It can be difficult to move the area that’s frostbitten or the victim may not be able to move it normally. Seek medical attention immediately if experiencing any of these symptoms. Large blisters will appear on the frostbitten skin a day or two after cold exposure. Frostbitten skin turns black because the skin cells die after freezing. The skin might form a hard, black covering (carapace) that falls off on its own. If it doesn’t, a healthcare provider will remove it surgically.