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Treating for Cold Exposure and Frostbite
The following material may assist you in treating a victim for
exposure to the cold and also how to deal with frostbite. This
information is derived from "Advanced First Aid & Emergency Care,"
2nd edition, by the American Red Cross. To obtain a copy of this
book and to take instruction in first aid, please contact the local
office of the American Red Cross. They are listed in the white
pages of your telephone book.
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The extent of injury caused by exposure to abnormally low
temperature generally depends on such factors as wind velocity,
type and duration of exposure, temperature and humidity.
Freezing is accelerated by wind, humidity or a combination of
the two. Injury caused by cold, dry air will be less than that
caused by cold, moist air or exposure to cold air while wearing wet
clothing. Fatigue, smoking, drinking of alcoholic beverages,
emotional stress and the presence of wounds or fractures intensity
the harmful effects of cold.
SIGNS AND SYMPTOMS
The general manifestations of prolonged exposure to extreme
cold include shivering, numbness, low body temperature, drowsiness
and marked muscular weakness. As time passes there is mental
confusion and impairment of judgment. The victim staggers, his
eyesight fails, he falls and he may become unconscious. Shock is
evident and the victim's heart may develop fibrillation. Death, if
it occurs, is usually due to heart failure.
Frostbite results when crystals form, either superficially or
deeply in the fluids and the underlying soft tissues of the skin.
The effects are more severe if the injured area is thawed and then
refrozen. Frostbite is the most common injury caused by exposure to
the cold elements. Usually, the frozen area is small. the nose,
cheeks, ears, fingers and toes are the most commonly affected.
Just before frostbite occurs, the affected skin may be slight-
ly flushed. The skin changes to white or grayish yellow as the
frostbite develops. Pain is sometimes felt early but subsides
later. Often there is NO pain; the part being frostbitten simply
feels intensely cold and numb. The victim commonly is not aware of
frostbite until someone tells him or until he observes his pale,
glossy skin. The extent of local injury cannot be determined
accurately on initial examination, even after rewarming. The extent
of tissue damage usually corresponds to that in burns. In superfi-
cial frostbite, there will be an area that looks white or grayish
and the surface skin will feel hard but the underlying tissue will
be soft. With deeper involvement, large blisters appear on the
surface, as well as in underlying tissue, and the affected area is
hard, cold and insensitive. Destruction of the entire thickness of
the skin will necessitate skin grafting and will constitute a
medical emergency, because gangrene may result from loss of blood
supply to the injured part.
FIRST AID
The objectives of first aid are to protect the frozen area
from further injury, to warm the affected part rapidly and to
maintain respiration. Formerly, it was recommended that victims of
frostbite be treated by slow warming -- rubbing with snow and
gradually increasing the temperature. But recent studies have shown
conclusively that much better results are obtained if the affect
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