First Aid - Cold Injury, Frost Bite

COLD INJURY:
When working in cold, note that you MUST drink also just as normal even though you may not feel the need, dehydration occurs just as much in the cold as in the hot place.
Cold can cause chilblain up to complete body freezing. Chilblain is a light frost byte, on small surface.

SYMPTOMS:
Pain or pricking followed by insensibility. The skin gets whiter with a waxy appearance.
1) Outside: Warm up the frozen part with your body heat.
2) For the ears, nose, cheeks: Use your hand in or out of glove.
3) Warm up the fingers by placing them in pocket or under armpit.
4) With frozen toes or heel: Put yourself in a shelter, take off your shoes & sock & warm them up with your body heat. Once they are unfrozen, put on dry socks then back in your shoes.
5) When the thawing starts, you feel a burning sensation, the skin becomes red, painful & sensitive. Blister can appear, but don't break them.

NOTE ABOUT COLD PREVENTION:
Eskimos & science has taught us that we loose 35 % of the heat by the head uncovered, so cover up & you'll feel a lot warmer quicker.

FROST BITE: (SEVERE)
SYMPTOMS:
Skin gets waxy white, flesh hardens don't ply to touch. Articulations are all tense & tighten up.

FIRST-AID:
1) Bring the victim to nearest shelter.
2) Warm his limbs with your hands or warm blankets.
3) Give him hot drinks to warm him.
4) Don't place hot sources near his body, having loss his sensitivity he may get burn.
5) Don't bend or stretch frozen limbs till they are unfrozen.
6) As soon as unfrozen, encourage the victim to move his toes & fingers to activate circulation & warmth.
7) To protect blisters cover them lightly with dry Dressing

GENERALIZED FROSTBITE:
The whole body exposed a long time to deep cold can bring death, if not treated quickly.

SYMPTOMS:
1) Vision becomes blurry & mirages appear.
2) Victim feel frozen & exhausted.
3) Can fall for his desire to sleep, then fall into coma, then death will follow.

FIRST-AID:
1) Make the victim walk, keep him awake until you have reach a shelter.
2) If you can make him drink hot drinks.
3) In the shelter roll him up in hot blankets or keep him in a hot room.
4) Frozen limbs MUST be treated as above.
5) If respiration ceases give A/R
6) URGENT to get medical aid

WARNINGS:
1) Don't rub frozen parts because rubbing can wound the skin &
frozen tissue.
2) Don't apply snow, for snow is colder then the frozen tissue.
3) Don't apply any form of direct heat. Except body heat.
4) Don't bend nor stretch frozen limbs, because frozen tissue will easily tear when frozen.
5) Because of danger for infection, don't break blisters.

PREVENTION:
Factors predisposing to frostbite are: old frostbite, illness, hunger, old age, thirst, exhaustion, bad state of health. Avoid to wear gloves, socks, boots too tight.
Remove all gloves or socks that are damp or wet. Maintain good circulation by moving your hands and toes, stamping your feet, lifting & lowering your arms while slapping your body.

NOTE:
Avoid cold feet by using sole newspaper, or hay. It absorbs humidity, thus keeps feet warmmm!

FROSTBITE ADDED NOTES:*
Throughout the convalescence, wherever it takes places, give the patient the best available food, maximum comfort & total rest.
Healing may be somewhat accelerated by a high protein diet supplemented by multi-vitamin capsules.*
As treatment progress be sure to warn well in advance about the dramatic appearance that his injured part is soon to have.
Even a well balanced and experienced northerner can loose his moral fast unless he is prepared to accept philosophically the blisters, discolouration and grisly necrosis of his fingers or toes.
Furthermore, many an inexperienced doctor has been argued into needless & tragic amputation of basically sound tissue as a result of the hysterical pleadings of an unreasonable frostbite patient.
Surgery is now considered as a last resort to be used only if uncontrollable infection is present & then to be done only in a hospital. Even minor surgery is to be avoided both on the field &
in hospital.
Most tissue which you feel should be removed will probably remove itself much more effectively.
Then even the best surgeon can do it & with a saving of more tissue, that may seem at all possible at the time when surgery appeared to be necessary & unavoidable.
The worst looking hands or feet, if treated properly & patiently will shed their shrivelled black shells painlessly like a glove suddenly & unexpectedly, revealing a healthy, pink skin underneath. Patience pays.

GANGRENE FOLK REMEDY:
As for gangrene, backwoods medicine Eskimos had this trick; they would cover the wound with earth & clay mixed with a lot of worms who would suck the "pus" off leaving a clean pink flesh wound. You may have to resort to this method.
I don't know how or if it works, or how they had worms in winter, but what have you got to loose to try if in desperate situation.
Blood suckers may do the trick as well, I am telling you this as food for thought. There is also a folk medicine that gave results, this is a long process however.
The person has to put raw graded potatoes all around the gangrene part, then wrap it with a clean bandage, this is done many times a day & for weeks until the wound is healed. You need a lot of potatoes but the result is what counts.
Grated raw potato over the gangrene part repeated over and over every hour for many weeks, will get rid of it and you will not have to cut off toes or foot or hands.
Put this grated raw potato all around the limb and wrap the whole thing with clean cloth or clean paper towel type.

FIRST-AID TREATMENT FOR FROZEN BODY SPECIAL NOTE:
It has been known for a long time that when Eskimos find one person suffering from deep freezing they would get him naked under furs or blankets & between 2 of their wives also naked.
A sort of human sandwich if you want, Their heat body would be best to thaw quickly & safely the victim. No dirty mind story rather true story of many polar explorers. (Not pole-her story!) PREVENTION OF FROSTBITE ADD ON:
Overall physical well-being, good clothing&intelligent operations in the field are by far the best insurance against frostbite.
When you are exhausted, hungry, sick, injured or hypoxic your chances of frostbite are increased.

SOME COLD TIPS: PSYCHOLOGY FILE:
An unhealthy proportion of accidents occurs because deep down underneath, someone wants them to happen. A mishap may be a face-saving excuses for some failure.
Very often it is deliberately willed because the individual believes he should be punished.
Now & then an accident offers the simplest excuse to escape responsibility. Some use a misadventure as the easiest way to attract attention.
But once someone definitely realizes that he cannot afford an accident, the percentage line up heavily against the probability of one overtaking him.
If you want to survive you most likely will. If not; then you wont!
This is why it has been seen that people will deliberately destroy good equipment whereas other will improvise to survive and help others.

SPECIAL FILE IN FIRST AID FOR COLD PROBLEMS:
At -10F. & lower, I have seen a friend with a bathing suit rolling & laughing in the snow quite comfortably, but if the temperature rises to -5F or 0F. he was freezing.
The reason he said was that at -10F the humidity is nil and that the snow feels like hot sand in mid-june.
You may have to try it, should you fall into a river or lake due to a hot spot, to roll yourself in the snow to dry up.

COLD PROBLEMS & REMEDIES:

FROSTBITE & HEAT UNITS PAD:
If you have those heating pads, hand-warmer type but only a few, you can place them in the following order; the pit of the stomach, the small of the back, the wrist & between thighs and ankles.
While the units are being warmed or not available, strip the patient of clothing & place 2 naked persons on each side of the patient keeping them well covered by blankets.
Massaging the patient will help raise his temperature. If the shelter is lower than 70F, this should be done through the sleeping bag, by reaching the hand down in the s/bag. If the person is conscious, stimulation can be helped by hot drinks. In treatment of hypothermia, avoid the use of alcohol as the surface blood vessels open up allowing warmth to escape, even though the patient may feel warmer

HYPOTHERMIA & FROSTBITE:
Hypothermia may be avoided by conserving body heat & energy. (Ex: keep head covered).

MAKE CERTAIN that starting a journey, all ESSENTIALS are included, that a proper meal has been eaten & clothing has not been permitted to become damp from perspiration or that clothing was damp at the start of the journey.

HYPOTHERMIA IS THE PRELUDE TO FROSTBITE, which is the actual freezing of the living tissue. Usually experienced by feeling of numbness of the part affected.
The skin turns yellowish-white or blue in appearance & finally the area becomes inactive.

3 DEGREES OF FROSTBITE:

FIRST: It is distinguish by the yellowish-white colour the fact that the area remains elastic.

SECOND & THIRD DEGREE:
Frostbite can only be determined as the thawing takes place.
During the thawing process blisters will appear on the second degree.

IN THE THIRD DEGREE:
Ice will appear on the surface and the area will swell proportionately as the thawing continues.
The swelling will discolour as the tissue has been destroyed. In some cases the outer skin will come off & an odour will be noticed. This is an indication of gangrene presence.
In treating frostbite of any degree, the first step is to seek shelter. First degree may be thawed by placing the warm bare hand over the affected area.

AVOID RUBBING to prevent the breaking of the skin. 2nd and 3rd degree frostbite to treat as hypothermia.
The heating units should be placed on the unfrozen area. Hot drinks should be given &a mild form of heat applied to the frozen area.
This may be done by immersing the frozen portion in warm but not hot water, or the use of wet compress. Theses should be changed frequently as they may freeze to the skin when first applied.
If a compress freezes to the skin, DON'T pull it off, but gently thaw out by using the hand or other compress.
Care MUST be taken with blisters rising from 2nd degree frostbite.

DON'T BREAK THEM as they is a danger of infection causing a delay in healing. These blisters MUST be given adequate protection if going out in the cold.
In attempting to thaw a third degree frostbite, ice appears on the surface of the frozen portion.

AVOID BREAKING IT OFF as it usually results in breaking the surface skin. The pain usually becomes severe as sensitivity is restored to the frozen area.
The patient may have to be restrained but the area MUST be thawed. After the area has thawed completely, the area should be covered with sterile bandages.
These should be applied in good quantity & rather firmly. They will be required to absorb considerable matter and may require loosening if swelling occurs.
If an arm or a leg are the frozen members, circulation may be helped by elevating that member to 20 degrees.
Examine the area the following the thawing and if infection is starting, antibiotics should be given if available to keep the infection from spreading.
Frostbite should be prevented rather than be cured. For ex; A location where wind velocity of 30 mph at temperature of 30F. can freeze the human flesh in 1/2 minute, & it's no place for ignorance, carelessness or bragging.
Fingers, feet, ears, nose and cheeks are most susceptible to frostbite.
So if 2 or more people are together, they MUST frequently check one another for signs of yellowish-white colour or numbness in these areas. If alone be doubly suspicious.
Frostbite can be prevented by being prepared for sudden change of wind, velocity or temperature. Dressing for emergency rather then just counting on the car or plane heat.
Clothing should be vented to avoid perspiration. AVOID also touching metal with bare skin, keep out of head-winds.
The most effective FIRST AID measure where possible is: to thaw a frozen foot or hand slowly in a warm bath.***

SNOW BLINDNESS:
It's a temporary form of blindness caused by a concentration of direct or reflected sun's rays, from fresh snow or ice.
It occurs most frequently during the spring or early summer when the sun is high in the sky. The eyes become very sensitive to the glare & start squinting & watering. The vision starts to a pink to a red and the eyes appear to have sand & ground glass in them.
If nothing is done to correct the situation, vision will be blanked out completely & the person will be in excruciating pain for 3 to 4 days.
Fast immediate relief before too late, to apply dark cloth or dark colour grease or soot just below the eye. The patient should be place in a dark room or have his eyes covered with a blindfold.
Cool compress may be applied followed by Skyrotien being placed on the inside of the eyelid.
Again prevention is better then cure. Wear sunglasses or goggles made of cloth, wood, paper but not from metal. The same precaution is to be taken even when the sun is overcast.

SHOCK IN COLD CLIMATE:
Shock is apt to occur after an accident & may appear in 2 forms.
The one involves panic, hysteria, mental anxiety & confusion. The other is the result of body injury, wounds etc.
It is recognize by a quickening of the respiration, a pallor of the skin, cold perspiration, confused mental processes, a fast weak pulse or muscle tensions.
Shock is not peculiar to Arctic, yet cold temperatures make it more difficult to treat. When burns & frostbite occur the plasma oozes from the wounds & if internal injury occurs there is a decrease in the amount of blood in the system.
This deprives the heart of its normal supply of blood & thus the extremities are more susceptible to cooling down & freezing.
The cooling of the extreme regions of the body has a tendency for the blood to return to the vital organs thus aggravating the situation.

TREATMENT:
For such condition is similar to that of hypothermia, to restore the body to its normal temperature by protection from the cold, applying external heat & massaging.
Shock in the more or less dazed form should be treated with sympathy, humane and understanding rather then harsh full and critical.