How to prevent frostbite?

21 January 2019

Who says winter, says cold!

The winter season brings a lot of benefits such as outdoor activities, snow, the festive atmosphere of the holiday season, but also a few problems such as cold, ice, slippery roads, etc. It is important to protect your body by covering yourself from head to toe with good winter clothes, because unfortunately, prolonged exposure to cold with inadequate protection can cause frostbite.

What is frostbite?

It is an injury to the skin due to freezing, caused by cold weather, especially during the presence of moisture and gusts. The most sensitive parts of the body are the cheeks, the nose, the ears, the chin, the fingers and the toes.

What are the symptoms to watch for?

There are 2 types of frostbite:

Superficial frostbite:

• The skin turns red and then white with sometimes a grayish look

• A tingling, numbness, pain or burning sensation

• Some small superficial blisters

• Difficulty moving the affected area

Deep frostbite:

• Insensitivity to the affected area

• The skin becomes cold, white, shiny

• Presence of large blisters

What are the possible complications following frostbite?

➢ Greater sensitivity to cold

➢ Risk of developing frostbite again

➢ Long-term numbness in the affected area

➢ Infection

➢Tetanus

➢ Gangrene potentially leading to amputation

➢ Possible hypothermia

Who is at risk?

Some people are more at risk of experiencing the harms of the cold, such as:

o Children of all ages

o The elderly

o People with reduced mobility

o People with loss of autonomy

o Smokers

o People with problems related to drug and alcohol use

o Homeless people

o People working outside for long hours

o Women

o People suffering from certain chronic diseases, such as:

• heart or respiratory failure

• asthma

• diabetes

• malnutrition

• certain neurological disorders

• people suffering from Raynaud’s phenomenon or acrocyanosis

How to take care of frostbite?

Usually, frostbite is benign but in any case, do not hesitate to contact a health care professional for any questions.

Here is what you should do if you have frostbite:

• Quickly take refuge in a warm place

• Avoid re-exposing cold-weathered skin for several hours

• Slowly warm up the affected area (eg. hands) by placing them under the armpits, between the thighs or simply by blowing on them

• Gently remove the clothes covering the frostbite

• Place the affected area in warm water (hot water exponentially increases the burning sensation)

• Move the affected joints to activate the blood circulation except in case of frostbite in the feet, the person must avoid moving

• Take pain relief medications such as acetaminophen or ibuprofen if needed, please check with your pharmacist at all times if this type of treatment is right for you

• Cover the blisters with a dry dressing and consult a healthcare professional to assess the severity of the condition

• Drink plenty of fluids, especially water in order to hydrate

• Avoid smoking or drinking alcohol, which can lower your body temperature

You should avoid doing this at all times:

–  Rubing and massaging the affected area

–  Applying creams or ointments or other products to the damaged skin

–  Covering the affected area with snow, cold or hot water

–  Use a heating object or a heat source

How to prevent frostbite?

• Check the outside temperature and the wind factor before planning an outdoor activity

• Dress warmly and cover any exposed part of the body with a tuque, mittens, scarf and warm boots

• Bring snacks and, hot and sugary drinks

• Take refuge inside occasionally if possible

• Wear multiple layers of clothing that are both, waterproof and windproof

• Do not smoke or drink alcohol

• Always be on the move to activate blood circulation and keep warm without causing body exhaustion

• Have an emergency kit with a blanket, spare clothing, etc.

• Watch for signs of frostbite

Enjoy the joys of winter, but do not forget to cover yourself!

  • Rehydration and nutrition

It is very important for a traveler to include oral rehydrating solution (either in the form of powder sachets, effervescent tablets or a ready to use solution) in their travel kit. On the diet side, it is recommended to continue your usual diet however, it is suggested to avoid fatty foods that slow down gastric emptying and foods rich in sugars, because they can exacerbate the episodes of diarrhea. Beverages such as caffeine, tea and alcohol are also to be avoided because they have a diuretic effect and can cause dehydration.

  • Antiperistaltic drugs

There are two antiperistal agents on the market: loperamide, an over-the-counter drug, and diphenoxylate hydrochloride, available with a prescription. These medications are suggested in cases of mild diarrhea only. These drugs should be avoided in severe cases (more than 6 liquid stools per 24 hours or blood or fever or mucus), because they can delay healing and even cause a toxic megacolon. They can be used for up to 48 hours and the main side effect of these medications is constipation. It is best not to use these drugs in children under 12 years of age without the recommendation of a doctor.

  • Antibiotics

Self-treat antibiotics use while traveling reduces the duration of symptoms and improves the quality of stay. The main antibiotics prescribed are ciprofloxacin, levofloxacin, azithromycin and cefixime. An antibiotic treatment can be started if the diarrhea is moderate (more than 3 liquid stools in 24 hours), persist for more than 48 hours and if there is an impairment of the general state. The antibiotic can usually be stopped when the symptoms are over.

If the diarrhea is severe (more than 6 liquid stools in 24 hours with fever or blood or mucus), it is recommended to continue the treatment until the end. However, if you do not see any improvement after 36 hours, it is important to consult a doctor.

It is important to plan your vacation to take full advantage of it because, as the old saying goes, “Prevention is better than cure”

REFERENCES

1.   “Travel Health Intervention Guide 2015”, National Institute of Public Health of Quebec, Quebec Advisory Committee on Travelers’ Health. Online at https://www.inspq.qc.ca/sante-voyage/guide/risques/diarrhee-des-voyageurs

2.   “Statement on the Diarrhea of the Traveler”. Advisory Committee on Tropical Medicine and Travel Medicine (CATMAT). Available online at https://www.canada.ca/en/public-health/services/reports-publications/release-transmissible-cities-canada-rmtc/numer-mensual/2015-41/rmtc-volume-41-11 -5-November-2015-disease-origin-food / rmtc-volume-41-11-5-November-2015-disease-origin-food-2.html

3.   CONNOR, BA. “Traveler’s diarrhea. The Yellow Book Centers for Disease Control and Prevention. Online at https://wwwnc.cdc.gov/travel/yellowbook/2018/the-pre-travel-consultation/travelers-diarrhea

4.   “Diarrhea of the traveler”. Health Canada. Online at https://travel.gc.ca/travel/health-safety/maladies/diarrhee

5.   Act 41 Algorithm developed by the Quebec Association of Banners and Drug Stores. Online (private site)

6.   “Oral rehydration solutions”. Health Canada. Online at https://travel.gc.ca/travel/health-safety/drinking

7.   Charbonneau, Kim. “Diarrhea of the traveler”, [In pdf] Quebec Pharmacy. February-March 2014, pp.29-36.

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