Exposure to cold may cause decreased body temperature (hypothermia) and focal soft-tissue injury.
Tissue injury due to cold, without freezing, includes frostnip, immersion foot, and chilblains.
Tissue injury with freezing is frostbite.
Treatment is rewarming and selective, usually delayed, surgical debridement of injured tissues.
Susceptibility to cold injury is increased by exhaustion, undernutrition, dehydration, hypoxia, impaired cardiovascular function, and contact with moisture or metal.
(See also Raynaud syndrome.)
Prevention of Cold Injury
Prevention is crucial (1). Even when the weather does not seem to threaten cold injury, individuals should be prepared to protect themselves from cold, moisture, and wind. They should wear, or have available, several layers of warm clothing, preferably made of wool or polypropylene, to maintain insulation even when wet. A warm head covering is important. Gloves and socks should be kept as dry as possible. Insulated boots that do not impede circulation should be worn in very cold weather.
Consuming ample fluids (particularly warm fluids) and food helps sustain metabolic heat production. Alcohol should be avoided because it can increase heat loss through vasodilation of the skin, impair thermoregulatory responses, and impair behavioral responses to cold.
Paying attention to when body parts become cold or numb and immediately warming them may prevent cold injury.
Reference
1. Dow J, Giesbrecht GG, Danzl DF, et al. Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 Update. Wilderness Environ Med. 30(4S):S47-S69, 2019. doi: 10.1016/j.wem.2019.10.002
