To Your Health: Winter is passing but frostbite is still dangerous

The New England marine environment can be unforgiving, and even more so in the cold winter months.  As with most outdoor activities, preventing an injury is always better than treating an incident after it has occurred.  
Cold-related injuries can range across a wide spectrum, from the reversible to the life-threatening. All of us have probably forgotten our gloves at some point and experienced cold hands (frostnip) and were glad to return to a warm environment. However, if left unchecked more serious cold-related injuries such as frostbite can occur. Frostbite is a serious condition; it results from ice crystals forming inside our tissues and may lead to the loss of toes and fingers.  
Signs and symptoms of frostbite are numbness, tingling, or an itching sensation can occur in fingers or toes.
Frostnip can start this way too but the fingers and toes remain pliable. If frostnip goes into frostbite, the fingers and toes may become stiff and unusable.  
The skin can turn white and may be swollen. Sometimes blisters can form as well. Be cautious of hypothermia which may be occurring at the same time.
Shivering is an early sign of hypothermia, which is a drop in the body’s internal temperature to below normal.
Certain medical conditions put some individuals at more risk than others for developing frostbite:  
Diabetes can affect how one responds to the cold. A diabetic may not notice just how cold his or her feet or hands are until it’s too late.
Peripheral vascular disease, usually caused by long-term smoking, can also make one more likely to suffer cold-related injuries.  
Raynaud’s disease: If your hands seem to respond unusually quickly to even a small amount of coldness, you may want to see your health care provider. Typically, just placing hands in a cold stream of water may cause those with Raynaud’s to have their fingers turn “red, white, and blue.” Raynaud’s can sometimes be associated with other medical conditions.    
Both smoking tobacco and drinking alcohol can predispose one to cold-related injuries.       
Hands and feet are most susceptible to cold-related injuries as they are the farthest away from the core of the body. But don’t forget about the nose and earlobes as well. Here are several tips to protect hands and feet:
Wearing several layers of protection is recommended rather than wearing just one thick layer.  
Don’t make a layer too constricting. If a layer is too tight, circulation of blood can be cut off and the insulating layer will not trap heat properly.   
Wool, wool blends, and polypropylene are recommended instead of cotton. Feet and hands should be protected by at least two layers. For the feet, the first layer should be polypropylene and the outer layer should be wool. Hands should have an additional water-proof or wind- proof layer. The goal is to trap heat within an insulating layer but also allow sweat to permeate out. A layer that is saturated with sweat or water will lose much of its insulating properties and will transfer heat away from the hands or feet.
If you are working hard and sweating, make sure that you change these base layers as frequently as possible to remove the damp layer.  
Stay hydrated! Sometimes, especially in the cold, we forget to keep up with drinking water.
Make sure to use a hand moisturizer throughout the day or at the end of the day to keep hands in good shape and avoid cracking and dryness.
“Keep warm, keep moving, and keep dry” is a good motto to remember.
If you think you may have frostbite, here is a list of what to do:
Seek medical attention. Frostbite can be very serious and should be attended to by a medical professional.
Remove any wet clothing and replace with dry clothing. Cover yourself with blankets if possible to raise your core temperature. Get out of the wind if possible.
Leave any blisters alone.  
Elevate the feet or hands to minimize swelling.
What not to do:
Do not grab cold metal with bare hands; this can cause immediate frostbite.
Do not rub injured feet or hands because this can cause further injury.
Do not smoke. Smoking will further decrease blood flow to an injured hand or foot.
If there is a chance that re-freezing will occur, do not try to warm an injured body part. Seek medical attention first. 

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