Cold Temperature Exposure
Cold Temperature ExposureSkip to the navigationTopic Overview It's easy to get cold quickly if you are
outside in
wet, windy, or cold weather. Cold temperature exposure can also happen if you
spend time in a dwelling or other building that is not well heated during cold
weather. Injuries from cold exposure- "Frostnip" usually affects skin on the face,
ears, or fingertips. Frostnip may cause numbness or blue-white skin color for a
short time, but normal feeling and color return quickly when you get warm. No
permanent tissue damage occurs.
- Frostbite is
freezing of the skin and the tissues under the skin because of temperatures
below freezing.
Frostbitten skin looks pale or blue and feels cold,
numb, and stiff or rubbery to the touch.
- Cold injuries, such as
trench foot or
chilblains, may cause pale and blistered skin like
frostbite after the skin has warmed. These injuries occur from spending too
much time in cold, but not freezing, temperatures. The skin does not actually
freeze.
- Eye pain or vision changes caused by cold exposure most often occur in
individuals who try to force their eyes open in high winds, cold weather, or
during activities such as snowmobiling or cross-country skiing. Snow blindness
is not directly caused by cold temperatures but does occur in snow conditions.
Sunlight reflecting off the snow can cause a corneal injury or
burn. Eyelids may become red and swollen. Eyes may feel dry and as
though they have sand in them.
- An abnormally low body temperature (hypothermia) occurs
when the
body loses heat faster than it can make heat. (There may be other reasons a person has a low body temperature. For more information, see the topic Body Temperature.) Early symptoms of hypothermia
include shivering in adults and older children; clumsy movements; apathy (lack
of concern); poor judgment; and cold, pale, or blue-gray skin. Hypothermia is
an emergency condition-it can quickly lead to unconsciousness and death if the
heat loss is not stopped.
Risk factors for cold exposure injuryThere are many
factors that increase your risk of injury from exposure to cold
temperatures. Many people get cold hands or feet, which often are
bothersome but not a serious health problem. You are more likely to feel cold
easily if you: - Do not have much body fat. Fat under the skin
helps keep you warm. People who have low body fat may be more likely to get
hypothermia. Babies, older or ill adults, or malnourished people have low body
fat.
- Smoke cigarettes or drink caffeine. Nicotine (from tobacco)
and caffeine cause narrowing of the blood vessels in the hands and feet. When
blood vessels are narrowed, less blood flows to these areas, causing the hands
and feet to feel cold.
- Are under a lot of stress or feel tired.
Chronic stress or anxiety can cause your nervous system to release adrenaline,
which acts to narrow the blood vessels that supply blood to the hands and
feet.
- Have a medical condition, such as
hypothyroidism or
Raynaud's phenomenon, that makes you feel or react
more strongly to cold temperatures.
If you have already been exposed to the cold,
first aid measures can warm you up and may even save your life. Check your symptoms to decide if and when you should see
a doctor. Check Your SymptomsDo you have a problem from being exposed to cold temperatures? This could include problems like frostbite or hypothermia. How old are you? Less than 12 years Less than 12 years 12 years or older 12 years or older Did you pass out completely (lose consciousness)? If you are answering for someone else: Is the person unconscious now? (If you are answering this question for yourself, say no.) Are you back to your normal level of alertness? After passing out, it's normal to feel a little confused, weak, or lightheaded when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do. Yes Has returned to normal after loss of consciousness No Has returned to normal after loss of consciousness Did the loss of consciousness occur during the past 24 hours? Yes Loss of consciousness in past 24 hours No Loss of consciousness in past 24 hours Hypothermia is an abnormally low body temperature. It occurs when the body gets cold and starts losing heat faster than it can make heat. Yes Symptoms of severe hypothermia No Symptoms of severe hypothermia Yes Symptoms of cold-injured skin No Symptoms of cold-injured skin Does the skin feel hard and stiff like a block of wood? Yes Skin feels hard and stiff No Skin feels hard and stiff Have you tried rewarming the skin for more than 1 hour? You can warm small areas by blowing warm air on them, tucking them inside clothing, or putting them in warm water. Yes Rewarming for more than 1 hour No Rewarming for more than 1 hour Do you still have symptoms even though you have tried to rewarm the area? Yes Symptoms have persisted despite rewarming No Symptoms have improved with rewarming Have you had any new vision changes or problems with your eyes? These could be caused by sunlight reflected off the snow. It may be 6 to 8 hours after exposure before you notice any problems. Yes Changes to eyes or vision No Changes to eyes or vision Do you have any eye pain? How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain 5 to 7: Moderate pain Moderate pain 1 to 4: Mild pain Mild pain Have you had any new vision changes? These could include vision loss, double vision, or new trouble seeing clearly. Does light make your eyes hurt? Does the light hurt so much that you have trouble opening your eyes? Yes Hard to open eyes because of discomfort with light No Hard to open eyes because of discomfort with light Yes Repeated episodes of cold temperature sensitivity No Repeated episodes of cold temperature sensitivity Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
Pain in adults and older children - Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.
- Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
Pain in children under 3 years It can be hard to tell how much pain a baby or toddler is in. - Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
grimace.
- Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.
Early symptoms of hypothermia may
include: - Shivering.
- Cold, pale, or blue-gray
skin.
- Clumsy movements.
- Poor judgment and a lack of
interest in or concern about what's going on.
- Not speaking
clearly.
Cold injury to the skin may
cause: - Severe pain.
- Numbness, tingling, or a
prickly feeling.
- Hard, stiff, shiny, or rubbery skin.
- Cold, pale, white, pink-purple, or blue-gray skin.
- Blisters or sores.
Low body temperature means: - In an adult or older child,
95°F (35°C) or
lower.
- In a baby,
97°F (36.1°C) or lower. Rectal temperatures are the most accurate.
Some people's skin is very sensitive to cold temperatures and reacts abnormally. For example: - The fingers, toes, nose, or ears may turn pale or
white. Later they may turn blue.
- These areas may feel numb and
tingly and feel very cold to the touch.
- As the areas warm, they may
turn red and start to throb.
Symptoms of severe hypothermia may
include: - Stumbling and having trouble
walking.
- Weakness, confusion, or extreme
sleepiness.
- Slow, shallow breathing.
- Slow or uneven
pulse.
- Passing out.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Home TreatmentMost minor cold injuries will heal
on their own, and home treatment is usually all that is needed to relieve your
symptoms and promote healing. But if you think you may have a more severe
cold injury, use first aid measures while you arrange for an evaluation by your
doctor. These first aid measures can also be used for children. Be sure to warm
the child's whole body with blankets as well as the cold injured parts. - If you have
hypothermia, try
immediate first aid measures. Stay calm, find shelter,
change to dry clothes, keep moving, and drink warm fluids to prevent further
heat loss and slowly rewarm yourself.
- If small areas of your body
(ears, face, nose, fingers, toes) are really cold or frozen, try
home treatment first aid to warm these areas and prevent further injury to
skin. Warm small areas by blowing warm air on them, tucking them inside your
clothing, or putting them in warm water.
Frostbitten skin may be more sensitive after the cold injury.
The injured skin area should be protected with sunscreen and protective
clothing to prevent further skin damage. The color of the injured skin may also
change over time. Apply aloe vera or another moisturizer, such as
Lubriderm or Keri lotion, to windburned skin. Reapply often. There is little
you can do to stop skin from peeling after a windburn-it is part of the healing
process-but home treatment may make your skin feel better. Use
nonprescription artificial tears warmed to body temperature to moisturize and
soothe eyes that are cold, sore, or dry from exposure to cold or wind. Medicine you can buy without a prescription Try a nonprescription
medicine to help treat your fever or pain: |
---|
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine. | Safety tips Be sure to follow these
safety tips when you use a nonprescription medicine: |
---|
- Carefully read and follow all directions
on the medicine bottle and box.
- Do not take more than the
recommended dose.
- Do not take a medicine if you have had an
allergic reaction to it in the past.
- If
you have been told to avoid a medicine, call your doctor before you take
it.
- If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
- Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.
| Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home
treatment: - Symptoms of a
skin infection develop, such as redness, swelling, or
pus.
- Blisters develop after you begin home
treatment.
- Symptoms have not gotten better or have gotten worse
after 1 hour of rewarming treatment.
- Symptoms become more severe or
frequent.
PreventionMany cold injuries can be prevented by
protecting yourself when you are outdoors in cold weather. General tips- Bring an
emergency kit if you are going into the backcountry so
you are prepared for cold, wet, or windy weather conditions that might
arise.
- Head for shelter that will protect you from wind and rain if
you get wet or cold.
- Avoid doing too much activity and sweating.
Sweating increases heat loss through evaporation, so you will feel
cold.
- Avoid touching metal, especially with wet hands, because it
will make you feel colder and may cause frostbite.
Nutrition tips- Eat plenty of food to help maintain your body
heat. Carry high-calorie foods, such as candy bars and trail mix, when going
out in cold weather.
- Drink plenty of water. Carry extra water with
you and drink it hourly. Your urine should be clear, not yellow or orange. If
you are not urinating every 2 to 3 hours, you probably are not drinking enough
fluids.
- Do not drink alcoholic beverages. Alcohol:
- Interferes with your body's ability to
regulate body temperature.
- Affects judgment. For example, a person
may not put on more clothing when it is needed if his or her judgment is
changed by alcohol.
- Can cause blood vessels in your skin to dilate.
This increases heat loss.
- Reduces your ability to sense cold
because it depresses the nervous system.
- Do not use caffeine and do not smoke while in the
cold. Nicotine (from tobacco) and caffeine cause narrowing of the blood vessels
in the hands and feet. When blood vessels are narrowed, less blood flows to
these areas, causing the hands and feet to feel cold.
Clothing tips- Wear
proper clothing and shoes. Keep extra protective
clothing and blankets in your car in case of a breakdown in an isolated area.
Know the different
ways in which the body loses heat so you can protect yourself from cold
exposure.
- Keep your hands and feet dry. Wear mittens instead of
gloves. Wear socks that retain warmth and keep moisture away from your
skin.
- Protect your eyes from cold and wind by wearing glasses or
goggles if you are planning outdoor activities.
Prevention measures for childrenChildren may not be
aware of cold temperatures. Parents need to understand the
ways in which the body loses heat and: - Limit the amount of time a child is out in
cold, wet, or windy weather.
- Dress children appropriately for the
weather conditions. Remember C-O-L-D:
- Cover your child's
head, neck, and face as much as possible since a lot of heat loss can occur in
these areas. These areas are also at risk for frostnip or
frostbite. Apply lip protection.
- Overexertion (being too active) can cause your child to sweat
and chill more quickly. Sweating causes clothing to become damp and increases
heat loss.
- Layers of clothing will keep your
child warm and protect your child best against wind and cold
conditions.
- Dry is key in preventing cold
injury. Keeping your child dry with waterproof clothing reduces heat
loss.
- Keep close watch on your children's body heat
even in the summer when they are swimming in a lake or pool for a long
time.
- Teach children to avoid touching cold metal with bare hands
or licking extremely cold metal objects. Cold is transmitted more easily
through metal and increases the risk of a cold injury, such as frostbite. Also,
your child's tongue might stick to the cold metal and be difficult to
remove.
Older or less active people can prevent indoor
hypothermia by
dressing warmly while indoors and keeping room
temperatures above 65°F (18°C).
Be aware that some states fund programs to help low-income
families add insulation or "weatherize" their homes to keep the family warm. Also, some low-income families may qualify for help in paying their heating
bills. Contact your state or local energy agency or the local power or gas
company for more information. Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions: - What are your main symptoms?
- How long
have you had your symptoms?
- What was the weather when you were
outdoors and your symptoms began?
- How long were you exposed to cold
temperatures?
- Have you had cold injuries before? Do you have any
continuing problems because of them?
- What first aid home treatment
measures have you tried? Did they help?
- If your skin was frozen,
how long was it frozen? Did it rewarm? Did it get frozen
again?
- Were you using any illegal drugs, alcohol, or tobacco at the
time of your cold exposure?
- Are you currently taking any medicine?
If so, are you following the prescribed dosage and schedule? Has there been any
recent change in your dosage or schedule?
- Do you have any
health risks?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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