Washington Ambulance Association Newsletter
Post Office Box 294, Washington Depot, CT  06794
In This Issue

Additional Resources


The Mayo Clinic on Frostbite 


Understanding Frostbite: Diagnosis and Treatment 


Frostbite Pictures 


The Mayo Clinic on Hypothermia 


Outdoor Action Guide to Hypothermia and Cold Weather Injuries 

Previous Newsletters



Top Ten Tips for Safe Winter Driving 


Don't Fall Victim to Carbon Monoxide Poisoning 


Preventing Falls 


The Life You Save May Be Your Own 


Learn to Recognize These Three Stroke Symptoms 


Join Our List

Join Our Mailing List
Issue # 8January 31, 2015


As we send this email to you, it's a beautifully bright and sunny day . . . . and bone-chillingly cold. 

One of our EMTs got stuck in the snow this morning, and had to spend an unexpected amount of time outside of her car. Our EMT said "I knew it was dangerously cold today, and I thought I was well prepared for the weather. I was, except for my cheeks. I had a scarf, but the wind kept tugging at it, and it was hard to protect my face. Can you add a bit to the newsletter about the extra danger posed by wind, and the value of a balaclava face mask on a day like this? And also, how important it is to have a way of calling for help if you get into trouble outside?" 

We lead with that story because it's a great example of the kind of thing that could happen to anyone. It makes sense to be prepared for cold weather, and it makes sense to be extra prepared for extra cold weather. 

The National Weather Service local forecast for this afternoon (Saturday, January 31) says: "Sunny, with a high near 17. Wind chill values as low as -7. Blustery, with a northwest wind 15 to 20 mph, with gusts as high as 34 mph." The week ahead is expected to continue cold, with daytime highs in the teens. 


With that forecast in mind, we are writing with some tips on preventing, recognizing and treating frostbite and hypothermia. 



What is Frostbite?


It's a condition that occurs when skin is exposed to temperatures cold enough that ice crystals begin to form in the tissues. In plain English, it's when your skin starts to freeze. 



Dress for cold weather, wearing clothes that will keep you both warm and dry. Use layers to keep your core warm.

Certain areas of the body are especially vulnerable to frostbite. Fingers and toes are vulnerable because they are extremities, far from the warmth of the body's core. The nose, ears and cheeks are vulnerable because they are more likely to be exposed to cold air. Protect your feet by wearing dry socks and appropriate footgear. Go through your collection of hats, scarves and gloves (and balaclavas!), and choose the best ones. 

In really cold weather, it does not take long to get frostbite. Recently, we did a first aid workshop for some Boy Scouts who were heading out to go ice fishing. We told them, your fingers can get very cold very quickly when you take your gloves off to bait your hook. We also told them that wind pulls heat from the body, and icy water is even worse at draining water and energy.    

In this weather and in this part of the world, it's important to be prepared to be outside. If your car breaks down or you are in an accident and find yourself outside for an unexpectedly long time, do you have enough winter clothing with you to be safe?

Finally, it's enormously helpful to have a way to call for help. Our EMT this morning had a cell phone with a working connection, as well as a radio. We advocate taking measures that will work for you. On a day like today, it would not be unreasonable to tell your family, "I'm going out to get the mail. Please notice if I'm not back in a few minutes." If you live alone, consider a medical alarm or other arrangements to protect yourself from the risk of falling and not being found for some time.       

A frostbite victim will usually (but not always) complain that the ears, nose, fingers, or feet feel painful and then numb. Grayish-white patches on the skin - indicating that ice crystals have begun to form in the top layers of the skin - are signals of the first stage of frostbite. If you are interested, here is a link to frostbite pictures.

Depending on the severity of frostbite, treatment ranges from first aid to hospitalization. First aid always includes getting into a warm place (a building or car) and then gently re-warming the frozen area. If an ear or cheek has "frostnip" (the very earliest stages of frostbite), you can warm it with the palm of your hand. If a hand has frostnip, slip it under your clothing and tuck it beneath an armpit. 

In more serious cases, you will want to call your doctor or 911. If Washington Ambulance is dispatched, we will have cranked up the heat in the back of the ambulance while en route to the patient. Our care during transport will include gently removing wet clothing (we will probably cut it off, as that is both fastest and most gentle) and wrapping our patient in layers of dry blankets. We will NOT massage the frozen area, since that can cause tissue damage.

What is Hypothermia?

In the words of the Mayo Clinic, hypothermia is "a medical emergency that occurs when your body loses heat faster than it can produce heat, causing a dangerously low body temperature." It's when you're very, very, dangerously cold. Specifically, below 95 degrees. 


General Prevention Measures. First, dress appropriately for the weather. Second, stay hydrated (drink enough fluids). Third, know that getting tired increases your risk of getting hypothermia. If you're hiking or skiing and start getting tired, it's time to warm up.


Special Risk Factors. Some groups of people are especially vulnerable to hypothermia: old people (as we age, our ability to regulate body temperature decreases), children (who may choose to stay outside if they're having fun, even when they're very cold), people who are under the influence, and people with particular conditions or medications. It's very possible for an older person to be chronically hypothermic inside their own home. If you fall into one of these risk categories, or care for someone with these risk factors, it makes sense to be especially attuned to the risk of hypothermia.


Fall Prevention is Hypothermia Prevention.  Some of the worst cases of hypothermia that we have seen involved people who went outside on what was intended to be a short errand, fell, could not get up, and had no way to call for help. In weather as cold as it is expected to be over the next week, it makes sense to take some extra precautions against that risk (we do!). For instance, put on outdoor clothes even to put out the garbage or get the mail. Tell a family member when you're going outside and how long you plan to be. 




Watch for the "umbles." In early hypothermia, we start to fumble and tumble and stumble. With no treatment, our blood vessels begin to contract and there is less blood flow to the brain. We get confused. We mumble and we grumble.


A person with mild hypothermia is still alert and making sense, but will have cold hands and feet and may be shivering. They will likely have some numbness in their limbs, with resultant clumsiness.


Moderate hypothermia looks and feels like mild hypothermia, with one addition: the person starts to get confused.


A person with severe hypothermia may appear drunk - that's to say, very clumsy, with slurred speech, and denying any problem. Shivering decreases or stops. Muscles become rigid.


Finally, a person with critical hypothermia will be unconscious and may appear to be dead. Their skin will be cold and may look bluish-gray; their body will be stiff, and their pulse will be slow, weak, and difficult to find. 



You can treat mild hypothermia in yourself or someone else with first aid treatments. Move to a warm, dry location. Snuggle up with blankets. A warm drink will help, but the drink should be non caffeinated and non alcoholic (think soup).


When Washington Ambulance is dispatched for a person with hypothermia, it's usually not the patient's only problem. They're hypothermic because they fell and could not get up . . . so it's a traumatic injury compounded by hypothermia, and we have to treat both, calling on additional resources as necessary. A fall through the ice and into Lake Waramaug will result in the dispatch of Washington Fire and Washington Ambulance, along with the Regional Dive Team and Lifestar. It's a web of resources that can be activated as needed.   

Last but not Least

How can we be prepared for the wide range of emergencies that come our way?  Because of you. You are an integral part of our web of resources.   We thank each and every one of you for your support.  

Speaking of support . . . We want to extend an enormous thank you to everyone who contributed to our annual fund drive. This year, we were fortunate to have many first-time givers, and many faithful donors who increased their support. We are truly grateful, and are working hard to complete our thank you notes. 
The Volunteers of Washington Ambulance Association
Susie Wallace-Wyant, Chief