As winter weather approaches, take time to brush up on how to deal with hypothermia and frostbite. Wilderness Medicine magazine offers prevention strategies to those who must brave the cold.

Hypothermia, the result of the inability to overcome heat loss by the generation and conservation of body heat, can be acute or chronic. Acute signifies a sudden drop of core body temperature and chronic hypothermia is when there is a gradual drop in core temperature. Chronic hypothermia is more common, often occurring in ambient temperatures between 30 and 50 degrees.

More important than the classification is the recognition of the signs and symptoms. An easy way to remember this is by remembering the “umbles”—mumbling, grumbling, fumbling and stumbling—that represent the intellectual and physical impairments often observed. Hypothermia can be further divided into mild, moderate or severe hypothermia. Patients with mild hypothermia will be able to rewarm themselves as long as the symptoms are recognized and treated appropriately. Patients with moderate and severe hypothermia will not be able to rewarm themselves and the application of any external sources of heat, including body-to-body rewarming, will likely be inadequate. They should be taken to a medical facility immediately.

Hypothermia can be difficult to manage, but is much easier to prevent. The following prevention strategies are recommended: Stay well hydrated. Maintain a good energy level. Dress appropriately. Plan ahead. Recognize the signs and symptoms

Whereas hypothermia involves a reduction of the core temperature, frostbite is the result of actual freezing of the cells and soft tissues. Risk factors for frostbite include freezing temperatures, high wind and altitude, tobacco and drug use, contact with heat-conducting materials such as metal, and a previous history of frostbite.

Like hypothermia, frostbite can occur in varying degrees. The degree of severity—superficial, partial-thickness, or full-thickness frostbite (the most severe)—determines the course of action that needs to be taken. Treatment for superficial and partial-thickness frostbite may begin outdoors. However, refreezing after the area has been thawed has been shown to cause much more extensive damage. Especially with partial- and full-thickness frostbite, care is needed in a medical facility.

Frostbite is often seen in high-risk types of activities such as high-altitude mountaineering but can also occur in unplanned situations closer to home. It is important to recognize the loss of sensation or an inability to move the affected area and seek immediate ways to reverse the situation. To read the entire article, visit: www.allenpress.com/pdf/wimm-25-01-16-17.pdf

Wilderness Medicine is a quarterly medical magazine published by the Wilderness Medical Society. For more information, visit www.wms.org