Cold Injuries - Causes, Symptoms and Treatment

Cold injuries occur when the body is unable to protect itself from the environment. Cold injuries are usually due to prolonged exposure to cold temperatures, although they can occur with brief exposure to extremely cold conditions. They occur because our body's ability to generate heat and to limit heat loss is quite limited. Cold injuries include hypothermia, frostnip, chilblains, immersion foot, and frostbite. Cold injury to our body's core is called hypothermia, and cold injury to our body's shell is called frostbite. Hypothermia and frostbite commonly occur together, but they can occur separately. Frostbite may be superficial or deep. Superficial frostbite affects skin and subcutaneous tissue, especially of the face, ears, extremities, and other exposed body areas. Deep frostbite extends beyond the subcutaneous tissue and usually affects the hands and feet. The cold causes ice crystals to form within and around tissue cells. This in turn causes cell membranes to rupture, interrupting enzymatic and metabolic activities. Untreated or improperly treated frostbite can lead to gangrene, requiring amputation.

Cold injuries usually do not occur, even in extremely cold weather, if the skin, fingers, toes, ears, and nose are well protected or are exposed only briefly. Individuals who drink alcohol, as well as those who suffer from fatigue, spinal cord injuries, or poor nutrition, are at greater risk for hypothermia. To help someone with hypothermia, contact the emergency medical system immediately. Remove all cold, wet clothing and replace it with warm, dry clothing to prevent further heat loss. Avoid rapid rewarming with hot water or massaging cold extremities. If done improperly, it could lead to serious tissue damage. In addition, do not give alcohol or nicotine products to someone suffering from hypothermia. To prevent hypothermia and frostbite in cold conditions, wear layered clothing to create insulation. This should include mittens or gloves, a cap or hood, thermal underwear, and multiple layers of socks.

Causes of Cold Injuries

The common causes of Cold Injuries:

• Prolonged exposure to freezing temperatures or to cold, wet environments.

Symptoms of Cold Injuries

Some sign and symptoms related to Cold Injuries are as follows:

• Difficulty breathing.
• Loss of normal bowel and bladder control.
• Numbness and weakness.
• Severe pain.
• Inability to move or to feel sensations (e.g., cold, heat, touch).

Treatment of Cold Injuries

• Active external rewarming with heating blankets, warm water immersion, heated objects such as water bottles, and radiant heat.
• Assive rewarming (the patient rewarms on his own).
• Active core rewarming with heated I.V. fluids; genitourinary tract irrigation; extracorporeal rewarming; hemodialysis; and peritoneal, gastric, and mediastinal lavage.
• Surgery usually isn't required, but amputation may be necessary if gangrene develops.