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Frozen Z.  Photo by Dale Jancic.  

Mountaineers are more susceptible to frostbite/hypothermia above 8,000 feet due to lower temps, higher winds, and lack of oxygen. More....

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PREVENTING AND SURVIVING HYPOTHERMIA AND FROSTBITE
- by E. A. Zimmerman
 

Two words: BE PREPARED.  The Boy Scout and Girl Guides motto says it all.  Most people who are injured or die from the cold did not follow this simple advice.  Robert Baden-Powell, a military man who founded the Boy Scout movement, explained that being prepared means thinking ahead about any accident or situation that might occur.  It also means always being in a state of readiness, both mentally and physically, so you know the right thing to do at the right moment.  

Here are the top 3 tips for preventing cold-related injuries.

#1.  I always wondered why outdoorsmen watch The Weather Channel for hours on end.  But being prepared includes checking (and re-checking) the short and long term weather forecast and wind chill factor.  Unfortunately mountain weather is very unpredictable.  Avoid travelling alone during extreme weather.

#2.  Dress appropriately.  Layering loosely with wool or polypropylene is best.  Wet down is useless.  Cotton will not wick the wet away.  Headgear like a balaclava (which is not the same as baklava) will prevent heat loss from your head; human hair is not an adequate insulator.  A knit facemask is especially important when temperatures dip below 0 degrees F.  Mittens are better than gloves.  Make sure boots are not too tight (which interferes with circulation.)  Stuff an extra set of clothes and socks, and wind and waterproof outerwear in a waterproof bag that you keep with you. 

#3.  Even if it’s supposed to be just a day trip, bring along a survival kit that includes extra food (candy bars, raisins, nuts) and water to stay hydrated.  Skip the Yukon Jack, even though the label says it is “a taste born of hoary nights, when lonely men struggled to keep their fires lit and cabins warm.”  Alcoholic beverages impair judgment and the ability to feel cold.  Even though you may feel warmer, alcohol decreases circulation and reduces shivering, which actually increases body heat loss.  Eating unmelted snow lowers body temperature.  The caffeine in coffee increases susceptibility to cold.  Don’t smoke either, as it lowers circulation.  A means of starting a fire; a compass, GPS or maps; a fully charged cellphone; a flashlight or headlamp with extra batteries; and a pocket heater/foot warmer can be lifesavers.  In extreme cold, don’t touch metal objects, as skin can freeze almost instantaneously upon contact.

Here are the top 3 treatment tips to remember.  Note that some commonly accepted approaches do more harm than good, and can even prove deadly.

#1. This is kind of obvious:  go to a warm, dry place if possible.  If you’re stuck outdoors, build a shelter and huddle together with companions. 

#2.  Change a hypothermia or frostbite victim into dry clothes, and put them in a sleeping bag or wrap them in blankets. Keep them horizontal.  Avoid excess jostling, especially for elderly hypothermia victims, as it can cause a heart attack.  If a nearly unconscious person is immersed in a warm bath or exposed to a large fire, they could actually go into shock and die!  Offer warm beverages to the conscious. Even if you think they are dead, administer CPR while getting them to a hospital.  There are cases where people who appeared to lack a pulse were resuscitated – you can’t tell for sure until the body is warmed up.  On Everest, Dr. Beck Weathers was left for dead, yet walked into camp the next day, although his arm, fingers on one hand and nose did have to be amputated.)

#3.  For frostbite, where there is no chance of refreezing (which can cause more extensive tissue death) gently remove gloves, rings and any restrictive clothing.  Blowing on frostbitten parts doesn’t help.  Warm the affected part in a crotch or armpit (this is not the time to be shy) for 20-30 minutes until skin softens and warmth returns.  It will hurt like heck as it thaws – 400 mg of ibuprofen will help – avoid aspirin.)  If medical help is more than 2 hours away, put the frostbitten part in warm (NOT HOT) water – about 104 degrees (which will be comfortable to the touch on unaffected parts of the body.)  Gently dry and apply a dressing of dry, sterile gauze bandages, using cotton balls or spacers in between toes and fingers so they don’t rub together, which could cause more tissue damage.  Do NOT apply direct heat from a heating pad, stove, fireplace or radiator as numbed parts could be easily burned.  Do NOT disturb or debride blisters unless you’re a doctor, as it can increase the risk of infection. And finally, do get medical attention as soon as possible.  Antibiotics may be needed for frostbite.    

 
 
Originally published in the Villager newspapers on December 12, 2008
 
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