Holy Buckets it is cold! Staying safe when it is freezing outside 

West End Healthline

By Matthew Burgstahler, MD 

Being a transplant to Minnesota, I have heard the strangest sayings about the winter cold from locals such as, “could be worse,” or “at least it isn’t snowing” and “it wouldn’t be so bad if it wasn’t for the wind.” I have respect for those that brave the cold winter weather and continue to stay active. Physical activity helps just about every system in our body. While it may be old hat for a lot of you, for many of us Minnesota transplants it is important to learn about cold-related emergencies and how to prevent and treat them. 

“Extreme cold” in some areas of the country is right around freezing, which is often when Minnesotans think about putting away their shorts for a few months. However, when temperatures do drop significantly below normal and especially as wind speeds pick up, heat can rapidly leave your body. This extreme cold can lead to serious health problems and dangerous situations, especially for those most susceptible, such as those without shelter.

Frostbite is an injury caused by freezing and can permanently damage the body. If you notice white or grayish-yellow skin, firm or waxy skin or profound numbness do not wait− take action! Get inside. Do not walk on feet or toes that have signs of frostbite if possible. Do not rub frostbitten areas or massage. Put the areas in warm-to-the-touch water or use body heat (such as an armpit). Do not use a heating pad, heat lamp, the heat of a stove or fireplace or radiator as affected areas are often numb and can easily burn. Gradually warm the area and seek medical care if ongoing discoloration or concerns. 

Another common cold weather health emergency is hypothermia. Hypothermia is a significant and potentially dangerous drop in body temperature, usually 95°F (normal being 97-99°F). This low body temperature can occur from cold water immersion or staying out in cold environments for a prolonged time. Risk factors for hypothermia include: reduced ability to move around, low body weight and intoxication from alcohol and/or drugs. While hypothermia is most likely at very cold temperatures, it can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat or submersion in cold water. If untreated, hypothermia can be deadly. 

In order to be careful this winter season, please wear appropriate clothing including several layers of loose clothing. Your goal is to keep your body warm and dry. Layers provide better insulation. Consider wool, silk or polypropylene as an inner layer. Try wool, goose down or fleece as an insulation layer. As an outer layer, focus on water and wind resistance. Tight clothing is not helpful as it reduces blood circulation. Make sure to cover and protect your ears, face and hands and wear boots that are ideally waterproof and insulated. Including a thermometer and chemical hot packs in a first aid kit is also an excellent prevention idea. When getting hot with activity, put a stop to sweating by shedding layers as sweat causes your body to lose heat faster. 

Be aware of the following signs and symptoms of low body temperature while outside in the cold: shivering, confusion, feeling very tired, fumbling hands, a pale or swollen face, memory loss, slurred speech and drowsiness. Later signs include a slow heartbeat, slow, shallow breathing and going in and out of consciousness. In babies, look for bright red, cold skin and very low energy. If you notice these symptoms, in yourself, a loved one or a stranger, please seek help and work on ways to warm the person.  

• Get the person into a warm room or shelter.  
• Remove any wet clothing the person is wearing. 
• Warm the center of the person’s body. Chest, neck, head, and groin.  
• Warm drinks can help increase body temp, but do not give alcohol. Do not give beverages to an unconscious person.  
• Once warm, keep the person dry and wrap their body, including head and neck in a warm blanket.

Please continue to get outside and move your body, but prepare for the cold! Have a plan for what you will wear and how you can get help if you are concerned about frostbite or hypothermia. Check the weather, layer and stay dry when you are outside in the cold. Hope to see you out there!

Dr. Burgstahler is a family physician at Allina Health United Family Physicians at 233 Grand Ave, St. Paul, MN 55102, phone 651-241-52000.