Deep Freeze

Let’s go over some basic precautions and things to look out for when out and about in cold temps. We prepare for the shootouts and trauma but in many cases, the environment is our biggest enemy and its one fight that's pretty easy to win with some good, solid planning and keeping a level head.

The first thing is remaining dry. Cold and dry, while not the best, isn’t such a bad deal. Cold and wet sucks and it's pretty dangerous. DRESS APPROPRIATELY--Layer up in wicking clothing that breathes and doesn't trap moisture. Cotton kills! It traps moisture, things like Patagonia's Capilene doesn't. It’s one thing to be cold and dry but entirely another to be cold and wet. That will kill you. Good boots and socks are also essential. Get a pair of gaiters as well to keep your pants from getting wet. Bring extra clothing and socks in your ruck. Another good preventative measure is properly hydrating. The average person can lose around 1.5 L of water every day in 'insensible loss' (passive) just through respiration. Cold weather tends to make us want to drink less also, plus it inhibits ADH (anti-diuretic hormone), the hormone responsible for 'water-handling' so we tend to urinate more. Combine the insensible loss, decreased intake of fluids by mouth and increased urination and you're heading down a hard road in a hurry. So, in the words of a very wise fellow medic brother from TX, “DRINK WATER!” Remember, from our “Shock” article, cold weather also inhibits clotting, so if you're dehydrated already, you're fluid reserves are low and if you get wounded, you're going to be deep in the hurt locker. Keep your Direct Action Response Kit (D.A.R.K.) close at hand to control any hemorrhage which may occur.
Alright, so what are the cold injuries and how do I recognize them? Well, we'll start with 'frostnip'. Frostnip is basically a minor, localized cold injury to areas of the body with decreased circulation (ie. ears, nose, fingers, toes). The area can a have a reddened or even a pale appearance and will be painful (pins and needles feeling). Think of how bad it hurts when someone thumps your cold ear!
How do you take care of it? First, get out of the cold and start rewarming the affected area. It'll usually recover pretty quickly provided exposure isn't repeated multiple times. If that happens, you can find yourself with a case of mild frostbite which can progress to severe frostbite.
How can you recognize frostbite? Frostbite is literally frozen tissue and can be similar to a burn in that it can be superficial in which the skin will blister up and slough off and repair itself after a few weeks or deep in which case the tissue is dead, can necrose (rot) and cause serious infections, loss of digits/limbs and death.
How can it be treated? GET OUT OF THE COLD! Do not attempt to rewarm the affected area until you are in a treatment facility and wrap it in loose gauze, much like you would a burn. Don't allow the injured areas to rub against one another as this will damage the tissue further.
One last type of cold injury to be on the lookout for and is easily preventable, is hypothermia. Hypothermia can set in rather quickly and you need to know the symptoms and what to do in case you see it. Mild hypothermia is characterized by a body temp of 93-95 F and the victim will have uncontrollable shivering (this is the body's attempt at rewarming). Get them out of the cold, into dry clothing and give them warm liquids by mouth--nothing with alcohol as it can actually make the hypothermia worse. The next couple of stages gradually have the person acting lethargic and drunk to actually feeling hot and taking off the clothing to lying down to rest. Their temps at these stages run from 85-92 F. Their skin will be pale or they may have blue-tinged lips or nail beds and be cold to touch. All of these symptoms show that the body has lost the ability to rewarm itself and you must act quickly. Again, get them out of the cold and rewarm them rapidly. Watch their level of consciousness and protect their airway. But warming them back up is imperative. Even if it means getting them out of their clothes and into a sleeping bag and crawling in with them, it's their life at stake. There are several pieces of great kit out there like the Blizzard Blanket that are great at keeping folks warm while being lightweight. Another alternative is to make a 'tee pee' out of a mylar blanket, wrap it around yourself and the victim and put a candle on the ground between you and you've made yourselves 'baked potatoes' and you will warm up quicker than you think and also help dry out wet clothing. We happen to have mylar blankets in all of our Gen 3 D.A.R.K.’s as well. Also, if the situation allows, build as large a fire as is safe and utilize i's heat to rewarm, dry out and make some warm liquids to warm your core.
Be prepared, dress right, hydrate, stay dry and get out of the cold.

-Pocket Doc