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Cold Respect
(Frostbite & Hypothermia)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed in the March 3-4, 2007 issue. Reprinted on page 11 in the January 26-27, 2008 issue, page 15 in the December 13-14, 2008 issue, and page 10 in the November 7-8, 2009 issue of The Mississauga News under the feature: Health, Wellness & Beauty, Medicine Matters
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

When winter starts with a bang, I often wonder how it is that we tend to let our guard down about the true perils of cold and snow. The airwaves are full of news of fanfare and excitement with approaching snowstorms. It seems that the cell phone age has made us complacent to hazards. Gone are the days when it was essential to memorize and rehearse your driven route because making a call on the road was just not an option. At one time, the family Chevy carried essentials for winter survival buried deep in the crevices of the large trunk: chains, shovel, blanket, light, salt, flares, gloves, tool kit and assorted other things. Many people now seem to feel that the cell phone is able to replace all that. I often wonder why the 400 series highways pose such severe hazards for anyone finding themselves on the shoulder in a disabled vehicle. It seems that your mind uses different cues when driving on multi-lane highways as opposed to urban streets. Without stop-lights or signs, you become part of a wave of movement and your mind uses cues to help keep you in a lane of cars. For example, your mind knows that you are driving in the right lane, because in addition to road markings, there is a flow of cars on your left flank, a vehicle in front of you which appears to be standing still if moving at the same speed and then an empty space or median is on your right. These cues can remain unaltered for long periods of time. The sudden intrusion of an unexpected stimulus such as a stalled car can result in a confused response especially if you are fatigued. Remaining in a disabled vehicle on a multi-lane highway in adverse weather is an extremely high-risk behavior. If you drive the 400 series highways and develop car trouble, act quickly. Using emergency flashers along with highway safety flares is prudent. Carry cold weather gear in the car, and be prepared to move well away from your vehicle if you experience trouble. Never sit in a stalled car on a highway. These situations define Coroner's Nightmares.

Frostbite and hypothermia are serious health problems that are associated with cold weather. Frostbite is the term applied when tissue begins to freeze. The skin begins to turn white or grayish and feels firm, hard or even waxy. It is a painless process beginning with numbness. This is why it is usually someone else that spots it on you. The treatment is to immediately warm up the area. Rubbing frostbite with snow is an old myth that should be avoided. Human cells tend to burst when completely frozen. Severe frostbite can produce enough damage to an area that it is unable to recover. The damaged dead tissue becomes infected and turns black. Often, amputation is the only option.

Hypothermia is a much more severe scenario. As the body loses heat to the surrounding environment, it burns stored energy to replenish it. If the pace cannot be maintained, then the core temperature starts to fall to dangerous levels. Initially, you have no idea that this is happening. Your brain is most affected and has trouble functioning. To an outside observer, you appear confused and disoriented. Hypothermia can strike under mild conditions such as being drenched by rain. Older persons, those with low body masses and those who are fighting chronic diseases are more affected. An interesting feature of hypothermia is that it slows down metabolism, and so people who are found unconscious and seem cold should be vigorously resuscitated. They stand a chance of making a recovery if appropriately and quickly assessed, warmed and treated. Learn to respect extreme weather, especially while driving. The most frequent comment that I hear from cold weather victims is how quickly things go from good to catastrophic. A little preparation can go a long way.

Related resources:

Frostbite and Hypothermia Symptoms and Stages from eMedicine Health.

Frostbite and Hypothermia from American Red Cross.

Minnesota Winter Hazard Awareness Week. Facts. Safe behavior. "A cell phone is a valuable tool for drivers who witness, or are involved in, emergency situations."

Winter Driving Emergency Kit. Video from Transport Canada, 1:36 min.

Driving Safety Tips: Driving in Snow and Ice. Winterize Your Car.

Winter Storms and Extreme Cold from FEMA.

Physical Hazards → Cold Stress from Safety Library.

Hypothermia from Wikipedia, the free encyclopedia.

Hypothermia FactSheet from Texas Department of Insurance, Division of Workers' Compensation.

How to Treat Hypothermia from About.com.

Frostbite from Wikipedia, the free encyclopedia.

How to Treat Frostbite from wikiHow.

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