Local Doctor Gives Insight

LOCAL DOCTOR GIVES INSIGHT ON FROSTBITE AND HYPOTHERMIA

By Marie Tolonen

NORTHERN ADVENTURES RECENTLY REACHED OUT TO DR. PETE OLSEN, M.D., VICE PRESIDENT OF MEDICAL AFFAIRS AND EMERGENCY DEPARTMENT PHYSICIAN AT FAIRVIEW RANGE, FOR INFORMATION ON THE DANGERS OF FROSTBITE AND HYPOTHERMIA. BELOW ARE HIS REPLIES.

Q. What are signs that you might be experiencing frostbite or hypothermia?

A. Hypothermia occurs when a person’s body becomes so cold from exposure that it can’t warm up on its own. Q. How common is frostbite and/or hypothermia in our area?

A. Hypothermia is common in the Midwest due to the prolonged cold temperatures throughout the fall and winter.

Q. How dangerous is frostbite?

How dangerous is hypothermia?

A. If not treated early, both frostbite and hypothermia may quickly worsen.

A normal body temperature is 98.6° Fahrenheit (37° Celsius). Shivering, bluish skin and difficulty talking are signs of mild hypothermia (defined as a body temperature of 90 – 95 degrees Fahrenheit). Shivering stops below 90 degrees, the cut-off for moderate hypothermia, and the point where medical attention is necessary for continued assessment and reversal of hypothermia. Severe hypothermia is defined as a body temperature less than 82 degrees, which is accompanied by loss of consciousness, respiratory arrest and cardiac arrest. Often, people forget that the temperatures above refer to core body temperature, so a rectal temperature is preferred since a peripheral thermometer (forehead, ear, under the tongue) may misrepresent the actual temperature in hypothermia. Additionally, most peripheral thermometers don’t read low enough to accurately assess hypothermia. Medical thermometers continuously monitor the extremes of temperature accurately. Frostbite occurs when circulation to an extremity decreases due to cold temperatures. This is associated with numbness and a waxy appearance to the skin, as well as difficulty moving the affected extremity. Skin from prolonged exposure to cold temperatures begins to die, turning black in color days later.

Every year, multiple people lose fingers and/or toes from frostbite when their circulation is literally frozen and no longer provides oxygen to tissues. The tissues themselves freeze and die. Hypothermia requires intervention since a person’s body is not able to heat itself on its own. As body temperature drops, hypothermia progresses to organ failure including cardiac arrest.

Q. What should a person do if they suspect they or someone they are with has frostbite or hypothermia?

A. Removing the person from the cold environment and getting them to a

warm location is most important. Next, removing any wet clothing is critical to prevent ongoing heat loss. Covering with warm blankets and providing warm beverages may be helpful.

However, ongoing or moderate/severe symptoms may require calling Emergency Medical Services (EMS) for immediate assistance. Frostbite, as well as moderate and severe hypothermia, are best assessed and treated in your local emergency department because there are varying interventions required based on the degree of hypothermia. Once frostbite has been treated, it is important not to re-expose the affected extremity to cold temperatures.

Q. Is there a timeline in which someone should seek medical attention if they have either of these conditions?

A. If a person demonstrates signs of moderate or severe hypothermia such as lack of shivering, confusion, inability to walk/ navigate normally, difficulty breathing or loss of consciousness, it is important to immediately seek medical attention, likely contacting EMS for safe transfer.

Q. What is the typical treatment for frostbite? How about hypothermia?

A. Medical treatment of frostbite includes gradual, active rewarming of affected areas with warm fluids as well as medications to restore blood flow.

Medical treatment of moderate or severe hypothermia can require specialized active warming techniques including heated intravenous fluids or even invasive methods of rewarming the chest abdominal regions through continuous heated water irrigation.

Q. What can you do to prevent frostbite and/or hypothermia?

A. Minnesotans are often well-versed in

wearing multiple layers. It is especially helpful to wear a thin layer of polypropylene or similar material close to the skin to wick away moisture (preventing heat loss through conduction) as well as bulky over-layers that trap warm air (preventing heat loss through convection). A hat prevents a tremendous amount of heat loss (some estimates suggest that up to 10 – 15% of a person’s body heat can be lost this way). The best way to prevent hypothermia, however, is to carefully limit exposure during particularly cold weather spells with prolonged subzero temperatures.

Q. Are there certain segments of the population that are more prone to frostbite and/or hypothermia?

Who are they?

A. Because young children have a large surface area relative to their body size and because the elderly have less efficient mechanisms to heat themselves, these populations are more prone to frostbite and hypothermia.

Q. Any other advice for people wanting to enjoy the outdoors?

A. There is no greater feeling of freedom than that which accompanies being outdoors and experiencing all of

Minnesota’s beautiful seasons. As you explore, be sure to be prepared for each season’s weather, bringing multiple layers of clothing, water and an emergency signal device to safely enjoy the outdoors.

Marie Tolonen is a staff writer for the Chisholm Tribune Press and also covers Chisholm for the Mesabi Tribune.