California has been hit hard with cold and wet weather(for CA standards). If you were on a job site, would you recognize the signs of a cold weather injury? Would you know what to do in the event that one of your coworkers or family members suffered from a cold weather injury? In this article, I will answer these questions and tackle the basics of cold weather injuries. The three most common and severe cold weather injuries are hypothermia, frostbite, and trench foot. We will look at warning signs as well as some some do's and don'ts of treating these injuries. 

Hypothermia

Warning Signs 

First signs of hypothermia generally include fatigue or feeling tired, shivering, trouble speaking, increased breath rate, unable to problem solve or slight confusion, nausea, lack of coordination, dizziness, and an increased heart rate. If you spot any of these signs, offer proper treatment promptly, and get them to a medical professional.

Progressed or severe signs include uncontrollable severe shivering, or if shivering stops, loss of coordination, loss of speech, confusion, if they stop caring about having hypothermia, taking off their clothes because they feel hot, weak pulse, slow shallow breathing, or if they are slowly losing consciousness. Any of these signs are extremely severe and will require medical attention immediately.

What To Do

Call 911 Immediately. While you are talking to the operator, bring the person into a warm, dry environment (e.g. a vehicle: if you are in a vehicle slowly heat up the vehicle with indirect heat). Carefully and slowly remove any wet clothing, wrap them in anything dry and warm focusing on the head and chest. If they can swallow give them something warm to drink and something high in energy to eat like a chocolate bar. Stay with them until help arrives, monitor their temperature and breathing. If they are coherent, start up a conversation. If breathing stops, perform CPR.

What Not to Do

Don't rub or massage the skin, don't use any jerky movements, and avoid any excess movement. Don't apply direct heat such as a truck heater (keep it slow and indirect). Heat pads or a heating lamp are also bad. Don't give the person any alcohol. Any one of these things can cause cardiac arrest. 

Frostbite

Warning Signs 

The first stage of frostbite is called frost-nip. Your skin pales or turns red and feels cold which then leads to prickling and numbness. The second stage is superficial frostbite, in which the skin appears reddened or turns white or pale. During this stage the skin may remain soft, but some ice crystals might form in the tissue. The skin will then begin to feel warm which means that you are incurring serious skin damage known as frostbite. Frostbite affects all layers of the skin including the tissue that's below the surface. It will feel numb, and you will lose all sensation of cold, pain or discomfort. Joints or muscles may no longer work. 

What To Do

Apply indirect heat and place a warm washcloth on the affected area or submerge the affected area in warm(not hot) water. See a doctor if you experience anything beyond frost-nip.

What Not to Do

Don't rub or apply direct heat to the affected area as this can cause serious permanent damage to the tissue. If you are alone, don't pour yourself a tub of hot water, because without having feeling you can easily burn yourself causing more damage.

TRENCH FOOT

Warning Signs

Trench foot is caused by having your feet in damp, cold, unsanitary conditions for a prolonged period of time. If you've been in these conditions, that should be your first indicator. First signs that you have it include: tingling, itching, pain, swelling, foot odor, cold feet, red blotches on the skin, numbness. If you experience bleeding under the skin, you definitely have it. 

What To Do

Remove anything wet. Clean and dry the feet thoroughly, then put them in an elevated position while warming them with hot pads or any heat source that won't burn you.

What Not to Do

No rubbing, and don't put the socks or shoes back on. Just let those dogs breath.

General rules

When you know you are going out in cold weather, know your body's limit. Each person can handle different temperatures to varying degrees(all pun intended). Second, stay hydrated, as your body needs lots of water to generate heat. Keep the calories higher than normal, and know that things such as smoking, coffee, and alcohol increase your risk of a cold weather injury generally because they mess with your blood vessels and mostly because they dehydrate you. Lastly and most importantly, stay DRY. Bring extra socks, extra gloves, etc. Anything that holds water may need to be swapped out periodically during your day in the cold.

I hope this article was a help. If I got anything wrong, do us all a favor and leave a comment. Please remember that this is an article based off of my own previous experience and in no way replaces cold weather safety training that should be taking place within your company.

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Picture: Christian Ochoa of CalTrans removes debris to allow water to flow into the Truckee River. (Credit: Gary Coronado / Los Angeles Times)

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