Exposure to cold and health: How do I prevent hypothermia or frostbite and how do I provide first aid in an emergency?

Hypothermia - Hypothermia

Definition

Hypothermia is when the body's core temperature falls below 35°C and the body loses more heat than it can produce over a longer period of time. This can happen when we are outside for a long time in winter. A cold home, rain or perspiration can also be the cause of hypothermia. Children, due to their larger ratio of body surface area to body mass, older people and exhausted people are particularly affected. However, impaired people (alcohol, drugs, etc.) also have a higher risk of suffering hypothermia.

Classification of hypothermia

Hypothermia can be divided into three different classes:

Depending on the degree and severity of hypothermia, various symptoms may occur, such as shivering, shivering or an increase in blood pressure. In moderate to severe hypothermia, symptoms can range from a slowed heartbeat and reduced breathing to respiratory failure and thus respiratory-circulatory arrest.

Rescue teams at the scene usually classify their patients according to the Swiss classification system, which is divided into the following five stages:

Heat regulation of the body and symptoms of hypothermia

The body controls heat processes via temperature sensors. These sensors measure the actual value, which is then compared with a target value. If the actual value is lower than the target value, the body tries to increase the actual value through activity, e.g. shivering. If the actual value is higher than the target value, the body tries to cool itself down, e.g. by sweating. Heat is transported through the blood to all areas of the body. If our body can no longer compensate for the deviations from the setpoint, either hypothermia or fever occurs.

In the case of hypothermia, our body tries to protect the most important organs for as long as possible. This increases blood flow in the trunk of the body and reduces blood flow to the extremities. This phenomenon is also known as circulatory centralization and explains why we usually get cold in our fingers and toes first.

Depending on the stage, there are other symptoms that indicate hypothermia:

From a core body temperature of <24°C, respiratory-circulatory arrest occurs. People with hypothermia are usually unaware of their situation, as their consciousness is altered due to impaired brain function. Confusion, tiredness, drowsiness and unconsciousness occur.

General first aid measures

If there are signs of hypothermia, you should proceed as follows:

Further first aid measures depend on the stage of hypothermia.

In stage I (see above for symptoms), the following first aid measures should be taken:

• Affected person should be taken to a warm place and warmed up SLOWLY
• Remove cold and/or wet clothing and wrap the affected person in dry (rescue) blankets
• Avoid further exposure to cold
• Do NOT actively warm the affected person (with hot water bottles, cherry stone cushions, rubbing, etc.)
• if the person is conscious: give warm, sweetened drinks (e.g. teas)
• Do not give alcoholic drinks
• Calm the affected person and wait until the emergency services arrive
• NEVER leave the affected person alone

In stage II or higher (see above for symptoms), the following first aid measures should also be taken:

• DO NOT attempt to warm up
• DO NOT ACTIVELY warm the affected person (hot water bottles, cherry stone cushions, etc.)
• If unconscious, place the victim in a stable lateral position and cover them up

If the victim is lying on the cold floor, it is advisable to place a blanket underneath.

Frostbite

Definition of frostbite

Frostbite is skin and tissue damage caused by cold temperatures or touching cold objects. Parts of the body that protrude are more frequently affected than others. These include fingers, ears, nose, cheeks or toes. Children are also more at risk of frostbite than other people. The cold leads to circulatory problems in the affected areas of the body, resulting in a lack of oxygen and, in the worst case, cell death (necrosis).

Classification

Frostbite is roughly divided into superficial and deep frostbite. Superficial frostbite affects the uppermost layers of the skin and is not normally an emergency. The symptoms usually subside a few minutes after the affected area has been protected and warmed up again. However, medical help should be sought in the event of prolonged numbness.

In the case of deep frostbite, all layers of skin up to and including the muscle can be affected. In very severe cases, bone damage may even occur and the affected body part may have to be amputated. Deep frostbite is a medical emergency and therefore requires immediate medical treatment.

Symptoms

Those affected have numbness or numbness in the affected areas. The areas of the body may turn bluish-red, white-yellow or white-grey. People with frostbite also often report the feeling that their shoes are too small. The affected areas are cold, soft and painful at first and then hard and numb. There may also be bruising and blistering.

The problem with frostbite is that it is hardly noticed at first, but only when it warms up again, when severe pain occurs. At this point, the damage is usually already very severe. The onset of numbness in cold weather should therefore always be taken very seriously.

What can I do to avoid hypothermia/frostbite?

To avoid hypothermia or frostbite, you should avoid extreme cold as a first measure. It makes sense to find out about the weather before you leave your home. In very extreme weather conditions, it makes sense to stock up on heating material and food so that you can wait out the weather at home. If this is not possible, you should make sure you choose the right clothing. It should be breathable and windproof at the same time. Spare clothing and provisions can be a lifesaver for longer stays outdoors. It is important to eat and drink enough, not only in the heat but also in the cold. However, alcoholic drinks are contraindicated because alcohol dilates the blood vessels and the body loses heat even faster. The saying "alcohol warms you up" is a myth. It only changes the sensation of warmth, which gives you a warming feeling. Alcohol therefore not only ensures that the body cools down more quickly, but also gives you a warming feeling. This combination makes alcohol very dangerous in extremely cold weather. You should also carry a cell phone with you on longer car journeys or snow hikes so that you can call for help quickly.

Caritas cold telephone

A special project to combat cold deaths, which is run by Caritas, is the cold telephone. You can call it if you discover homeless people sleeping rough during the winter months. The cold phone is manned around the clock from November to the end of April. Click here for the telephone numbers.

So if you discover a sleeping place of a homeless person, you can call them and should provide the following information:

• Date
• time
• exact location
• Description of the person(s)

Due to the large number of reports received, it is not always possible to guarantee immediate intervention. In acutely life-threatening situations, call the emergency number: in Austria and Switzerland 144 or in Germany and throughout Europe 112.