How To Handle Winter Weather Emergencies

Great activities so long as you can return home, take a hot shower, grab a wool blanket and enjoy a cozy fireplace.

But what happens when these comforts are unavailable, unobtainable or non-existent. The cold brings more than Old Man Winter and Jack Frost who is eager to nip at your nose. As cold weather creeps in, two unseen silent assassins eagerly wait to claim their next victims. 

In this ProSurvivalStrategies.com article, you will learn:

• Who are the two unseen cold weather silent assassins?
• What is hypothermia?
• And much more!

The wind has turned cold and the weather forecast is possible snow. Two reapers patiently wait for their opportunity to strike.

Who Are The Two Cold Weather Silent Assassins?

These two unseen silent assassins have names, hypothermia and frostbite. Both are classified as cold-related environmental emergencies. They can be a serious threat to life and limb, and even more under disastrous conditions when our environmental comfort zone is compromised. Simply keeping yourself alive becomes extremely difficult. 

Hypothermia and frostbite are not exclusively reserved for mountaineers climbing Mount Everest or those living off the grid in Alaska. This is far from the truth.

In 2021, Texas was devastated by a winter storm. Snow, ice and subfreezing temperatures crippled the state’s electrical infrastructure resulting in massive power outages. Citizens froze to death as they struggled to stay warm after electricity was cut to millions of homes. Heat was nonexistent as temperatures plunged into the single digits. It was estimated that 111 people lost their lives (mostly to hypothermia), including an 11-year old boy who died in his bed. 

Hypothermia is also a real threat in Florida, because its citizens never suspect it can happen. Data from the National Weather Service indicates that “The winters of 1983-84, 1984-85 and 1989-90 accounted for 65 of the 124 cold deaths”. Major freezes occurred during each of these winters. Even the sunshine state is not immune from Old Man Winter’s silent assassin.

Hypothermia and frostbite are not strictly reserved to rural outdoor activities. Metropolitan grid failures, blizzards, broken down vehicles and immersion into a body of water are all common occurrences that can quickly lead to frostbite and hypothermia.

Between 2003 and 2013, more than 13,400 people have died from hypothermia in the United States according to the Centers for Disease Control and Prevention (CDC). Cold weather exposure claims the lives of 1,330 people annually in the United States.

Hypothermia and frostbite are killers of the unprepared. 

What is Hypothermia?

It is well-established that normal body temperature is 98.6℉ (37℃). The Mayo Clinic interprets hypothermia “as a medical emergency condition that occurs when your body loses heat faster than it can produce heat causing a dangerously low body temperature”.

Think of your body as an engine. With all the activities you are engaged in, it can put off some serious heat. What happens with hypothermia, is that your body is exposed to such extreme cold for such a long period of time, it can no longer produce heat faster than it loses. If your core body temperature drops below 95℉, (35℃) you become hypothermic.

This is particularly dangerous because your brain, heart, nervous system and other organs are compromised. As hypothermia sets in, it becomes more challenging to think, move and take preventative measures to keep yourself warm and safe. If not treated, it can lead to death. 

DID YOU KNOW?

While hypothermia is most likely to occur at very cold temperatures, it can also occur even at cool temperatures (above 40℉). If a person becomes chilled from rain, sweat, or submersion in cold water, hypothermia begins to affect core body temperature. Remember, a person doesn’t have to be in sub-zero temperatures to risk hypothermia - it only requires the environment temperature to be less than the body temperature and a person will ‘donate' heat to the atmosphere.

What Are The 5 Stages Of Hypothermia?

Hypothermia generally progresses in 5 stages. It is extremely important to assess the situation and the hypothermic individual to determine how severe the condition may be. The Swiss Hypothermia Staging System can be used to determine which stage of the condition the person is in, then act accordingly. This system is favored over the traditional staging (mild, moderate, severe and profound) whenever the person's core temperature cannot be found. 

The Five Stages of Hypothermia (according to the Swiss Hypothermia Staging System) are as follows:

Stage I Hypothermia occurs when a person’s core temperature is between 95.0 - 89.6℉ (35 - 32℃). 

Symptoms:

• Person is conscious and alert.
• Shivering (your body’s automatic defense against cold temperature - an attempt to warm itself).
• Vitals are present. 

Treatment:

• At this stage focus should be on warming the core of the body first.
• If the person is wet, remove their clothing and get them dry first. Give them warm clothing. 
• Move the person to a dry place (bring them indoors, close to fire or a vehicle with a working heater).
• Apply warm packs or hand warmers to their armpit, groin and neck.
• Place the person under covers and lie next to them to transfer your own body heat, if possible, have someone else lie next to them.
• If the above-mentioned options are unavailable, an emergency blanket will have to do.
• Give the person warm liquids to drink (avoid caffeine or alcohol). A sugary drink is also helpful because the body uses up glucose to stay warm.
• Give the person warm, not hot broth or soup.
• Active movement if possible. 

Stage II Hypothermia occurs when a person’s core temperature drops between 89.6 to 82.4℉ (32-28℃). 

Symptoms:

• May or may not be shivering.
• Vitals are present.
• Impaired level of consciousness - meaning that the person may be confused and speaking nonsensically.
• Disoriented. 

DID YOU KNOW?

Hypothermia causes the muscles necessary for vasoconstriction to become exhausted and fail, causing warm blood to rush from the core to the extremities. This results in a kind of “hot flash” that makes victims of severe hypothermia - who are already disoriented and confused - feel as though they are burning up, so they remove their clothes in the absence of shivering. This is known as paradoxical undressing. 

Treatment:

• Same rewarming protocol used for first stage hypothermia. 
• Minimal and cautious movements to avoid arrhythmias. 
• Advanced medical care must be rendered such as additional internal rewarming techniques - specifically warmed IV fluids and cardiac monitoring. 

Stage III Hypothermia occurs when a person’s core temperature drops below 82.4℉ (28-24℃). 

Symptoms:

• Person is unconscious.
• Not shivering.
• Risk of cardiac instability increased.
• Vitals are present. 

Treatment:

• Management for Stage II Hypothermia as indicated.
• You need to provide the hypothermic victim rescue breathing.
• The victim must be evacuated for infinitive care in a hospital setting. 

Stage IV Hypothermia occurs when a person’s core body temperature drops less than 72.5℉ and less than 24℃. This involves the total loss of vital signs. 

Symptoms:

• Unconscious.
• No shivering.
• No vital signs. 

Treatment:

• It isn’t a death sentence. CPR is required immediately. “You are not dead until you are warm and dead." This phrase was created after many victims survived prolonged hypothermic events and received CPR in the field or a medical facility. 

Stage V Hypothermia occurs when a person’s core body temperature is less than 50℉ (less than 10℃). 

At this time the person is deceased. 

SURVIVAL TIP:

When you are in the field and not in a medical facility determining what stage of hypothermia a person is in is often based on indirect observation of their behavior, sensation and external signs. Keep a very close eye on indicators such as:

• The sensation of cold.
• The onset and progression of a shivering response - one of the ways a body rewarms itself.
• The loss of ability to perform normal activities such as zipping up zippers, carrying equipment, tying boots, walking without stumbling, etc.
• Impairment of mental ability as the brain cools such as slurred speech, disorientation, sleepiness, etc. 
• Degree of consciousness.
• The decrease or absence of signs of life like breathing or heartbeat.

Remember: Cold, Shiver, Bumble, Stumble, Sleep, Die.

How To Prevent Hypothermia?

Remember death from the cold can happen even if the body isn’t literally frozen. Now that you understand what hypothermia is, it is critical to know how to avoid this silent assassin. 

• Education - Education of the general public is the number one preventive measure to prevent hypothermia. 
• Limit your time outdoors in cold, wet or windy weather - Pay attention to weather forecasts and wind chill readings. In very cold weather, hypothermia can develop and subtly begin affecting your well-being. 
• Plan to protect yourself - When traveling in cold weather, carry emergency supplies and warm clothing in the event you become stranded. If you are in a remote territory, always inform others of your route and expected return date. 
• Activity Levels - should be maintained at a steady, constant rate. Avoid quick bursts of activity. Be mindful when exercising outdoors in cold temperatures because sweat can cool you down making you more susceptible to hypothermia. 
• Out in the field - travel in pairs and conduct welfare checks. 
• Take breaks in warm dry shelters - This allows your body to warm up. 
• Keep your clothing clean, free of oil and dirt - Oily and dirty clothing quickly loses its insulating effectiveness. 
• Avoid overheating - there are more heat exhaustion cases in cold weather environments because of overdressing for the type of work performed. Overdressing and over-exertion cause an increase of body heat production and decrease in heat dissipation. As body temperature increases, there is a directly corresponding increase in perspiration, which causes your clothing to be saturated with sweat. Wet clothing leads to hypothermia. 
• Dress in multiple layers - even if you don’t think it's cold outside. Wear at least three layers - a formidable base layer that absorbs moisture from your skin, an insulating layer and a protective outer layer against the wind, cold, rain and other elements. A quick way to remember the layering system is the acronym W.I.P. (W - Wicking Layer; I - Insulating Layer; P - Protective Layer). This gives you added flexibility to add or remove layers, depending on the weather and activity. Remember, it’s easier to remove clothing than battle hypothermia. 
• Layer your clothing correctly - clothes should be loose to trap air between the layers, which produces an insulating effect necessary for survival in the cold. Tight and constricting clothing can restrict the body’s blood flow circulation and can affect your body’s ability to keep itself warm. 
• Wear warm headgear - more body heat is lost from the top of your head than anywhere else. Wool is the best fabric to use, but remember anything is better than nothing. 
• Wear warm gloves or mittens - when possible you should use mittens before gloves. Mittens are warmer because they trap the heat of your entire hand and not just fingers like gloves. If gloves are your option, try a pair of glove liners made of a wicking material (such as polypropylene under a pair of heavier gloves). 
• Wear a scarf - don’t leave your neck exposed to the cold. 
• Keep your feet covered - avoid cotton socks. Cotton is a killer because it soaks up sweat and moisture causing your feet to become chilled more rapidly. Opt for wool, polypropylene or polyester socks. Also wear a quality pair of waterproof insulated boots. Remember to avoid overly constricting socks and boots. Socks and boots should be a little loose to trap the air which produces an insulating effect necessary for survival in the cold. Tight and restrictive socks and boots affect the body’s blood flow circulation and its ability to stay warm. 
• Remove wet clothing - if your clothing becomes wet so will your skin, which promotes hypothermia and frostbite - which will be discussed below. If possible, change into dry clothing at the first opportunity. 
• Find appropriate shelter - in any survival situation you must get out of the elements. A cave, an abandoned car, log cabin, a warehouse, a tunnel, or an improvised safety blanket can be used to make a tent. You have to think outside the box and adapt to your surroundings. 
• Eat enough - keep your calorie intake high. Winter activities require a lot of energy to perform, as well as to stay warm. Eat foods that are higher in fat content and calories. Warm foods and hot drinks will really warm your soul on a cold day. Your body will produce heat by burning the fuel you fed it. 
• Drink liquids -when it’s cold outside the air will suck the moisture out of you. If you are dehydrated, it’s harder for your body to stay warm. Drink water on a regular basis, and whenever you have a chance a hot drink such as herbal tea or hot chocolate. Hot drinks will keep your core body temperature up. 
• Don’t drink alcohol if you plan to be outdoors in cold weather - Alcoholic beverages cause your body to lose heat faster. 
• Watch for signs of hypothermia and seek medical attention - keeping your body at normal temperature is critical in preventing hypothermia. If your temperature begins to fall, seek medical attention even if you feel no symptoms of hypothermia. 

Always protect yourself from hypothermia because it is more serious and widespread in your body than frostbite which affects specific parts of your exposed skin. However, you can get both hypothermia and frostbite at once.

Now it’s time to meet the second unseen silent winter assassin - frostbite. Not pretty by any means but devastating to exposed skin by all means. 

What Is Frostbite?

Frostbite is the actual freezing of tissue fluids in the skin and subcutaneous tissues of the body due to freezing. Ice crystals form between and inside the cells causing them to rupture and die resulting in tissue destruction. Remember, the longer your tissue remains frozen, the greater the damage.

Normally our core temperature is a cozy 98.6℉ (36℃). This temperature is crucial for maintaining the critical body functions that keep us alive. But, strong winds and frigid temperatures can make staying warm a constant challenge. Which is why, if our core body temperature starts to dip, the hypothalamus (the thermoregulatory center of our brain) springs into survival mode in order to protect our vital organs and maintain that core temperature.

Dr. Harvey Willacy states, “Our blood carries oxygen molecules for energy but also distributes warmth to every part of our body. If your core temperature is compromised, your blood vessels will constrict and divert that warmth away from the extremities and toward the vital organs. Basically you can live without fingers or an arm but not without your vital organs and your body knows it. Once the hypothalamus diverts the warmth to protect your inner organs, your extremities are vulnerable to frostbite".

Frostbite typically occurs in the most susceptible bodily areas farthest from the core such as cheeks, ears, hands, fingers, feet, toes, lips, nose and male genitalia. 

It is caused by brief and prolonged exposure to cold temperatures, especially if they are accompanied by a low wind-chill factor.

Depending upon wind velocity and air temperature, the exposure time necessary to produce frostbite varies from a few minutes to several hours. For example , a temperature of 0℉ and a wind speed of 15 mph will produce a wind chill temperature of -19℉. Under these conditions, exposed skin can freeze in 30 minutes according to the National Weather Service.

SURVIVAL TIP:

To prevent frostbite and hypothermia, use a shell layer to keep moisture - rain, wind and snow off your clothing and yourself. In the wilderness, carry methods of making a fire, and consider an emergency bivy if conditions get too harsh. Most importantly, conduct routine evaluations of your party and seek shelter at the first signs of inclement weather, frostbite or hypothermia. 

What Are The 4 Stages Of Frostbite?

Frostbite progresses in 4 stages (i.e. First Degree also known as Frostnip, Second Degree, Third Degree and Fourth Degree). They are classified by depth of injury and clinical presentation. It is extremely important to recognize its stage to determine how severe the condition is and how to render the appropriate treatment.

First Degree Frostbite - This is commonly referred to as “Frostnip”. The Mayo Clinic states, “this is a mild form of frostbite. Continued exposure leads to numbness in the affected area. As your skin warms, you may feel pain and tingling”. You may not realize you have frostbite until someone points it out. If this process is prevented at this point it will not typically lead to permanent damage.

Symptoms:

• Just affects the epidermis of the skin.
• Cold skin.
• Skin appears red.
• Itching.
• Pins and needles sensation (paresthesia) - disappears during the rewarming process.
• Numbness.
• Pain in the affected area.
• No blistering or tissue loss. 

Treatment: 

• Soak the affected skin in warm, not hot water for 10-15 minutes. 
• Place affected such as fingers and hands area against a warm body surface into armpits or groin region.
• Rewarm at room temperature or against a buddy’s skin.
• Gently move the affected area as it rewarms. 
• Cover the affected area with gloves, a hat, earmuffs or headband. 

Second Degree Frostbite - If the freezing process continues, the area will go numb and your skin will become hard, waxy and pale in appearance. At this stage, frostbite freezes all the layers of your skin. This is a sign that damage to skin tissue is beginning to occur. 

Symptoms:

• Initially appears similar to First Degree Frostbite.
• Involves all the epidermis and superficial dermis of the skin.
• Skin may become hard, waxy and pale in appearance.
• Tissue surrounding the area is red and edematous - (swelling or puffiness of the tissue underneath your skin).
• Numbness is associated with an aching and throbbing pain.
• May experience burning.
• Thawing is rapid which results in superficial skin blisters that have clear or milky fluids after several hours.
• Blisters - no major damage is involved.
• Tissues underneath the skin will remain soft and normal at this stage.
• Healing occurs 3-4 weeks. 

Treatment:

• Rewarming the tissue as indicated for First Degree Frostbite should begin as soon as possible.
• Pain medication for the pain.
• If blisters appear to be infected a course of antibiotics will be prescribed to treat the infection.
• People can fully recover from Second Degree Frostbite (new skin forms under the blisters, however others may have permanent problems that can include pain and numbness in the frostbitten areas. 

Third Degree Frostbite - is a deep partial thickness injury, and a more severe stage because it affects both your skin and the tissues that lie directly below. Muscle tissue close to the affected area may or may not work properly. After your skin thaws, blood filled blisters appear. There is vascular trauma to deep tissue. In 1-3 weeks a blackened area will form. Deep tissue loss and loss of digits will occur. Third degree frostbite causes permanent tissue damage, and debridement of damaged tissue or amputation may be required to prevent severe infection. 

Symptoms: 

• White, pink-purple or blue-grey discoloration of the skin.
• Hard and frozen skin that “feels like a block of wood”.
• After tissue thaws - skin swells leaving blood-filled blisters, indicating vascular and trauma to deep tissue.
• Numbness followed by burning, throbbing or shooting pain.
• Skin is stiff with restricted movement.
• Skin loss occurs leading to mummification and sloughing of tissue.
• Healing is slow. 

Treatment: 

• Move to a warm shelter and provide supportive care.
• Rapid immersion of the affected area into warm water.
• Cover the affected area with loose, dry sterile dressing that is non-compressive and non-adherent.
• Do not allow the victim to walk on affected feet.
• Fingers and toes should be separated and protected with sterile cotton gauze.
• Do not drain blisters in the field - it can lead to infection.
• Provide pain medication as needed.
• Start IV of warm saline to treat dehydration and reduce blood viscosity.
• Do not give the victim alcohol or cigarettes.
• Do not allow the thawed area to refreeze (when the injured area freezes, thaws and then refreezes, the second freezing causes severe thrombosis, vascular damage and tissue loss).
• Requires immediate medical attention to prevent further damage.
• Amputation may be required to prevent infection. 

Fourth Degree Frostbite - This is the final stage where frostbite has infiltrated past your skin and underlying tissues. It’s the point of no return because it affects muscles, tendons and bone. This is a full-thickness injury which later becomes dry, black and mummified. It results in significant tissue loss and amputation is anticipated. 

Symptoms:

• Upon rewarming - you do not feel pain, numbness or cold.
• Limited mobility in nearby muscles and joints.
• Though skin is usually pale white or blue with severe frostbite, it will turn black upon warming if the outer skin tissue is dead. This condition is permanent and requires immediate medical attention. 

Treatment:

• Isolate the frozen part of your body to prevent further injury. For example, if it’s your foot, don't walk on it.
• It is significantly dangerous to thaw severe frostbite if there’s a significant chance it will refreeze before you get to safety.
• Surgery such as amputation is warranted to prevent the progression of necrosis which is caused by the lack of blood and oxygen to tissue. 

How To Prevent Frostbite.

Remember, frostbite can slowly creep in without you even knowing what hit you. Now that you are aware of what frostbite is, it is extremely important to know how to avoid this deadly cold weather predator. 

• Education - Education of the general public is the number one preventive measure to prevent frostbite. Recognize the symptoms.
• Limit your time outdoors in cold, wet or windy weather - Pay attention to weather forecasts and wind chill readings. In very cold weather frostbite can develop and subtly begin affecting your well-being.
• Plan to protect yourself - When traveling in cold weather carry emergency supplies and warm clothing in the event you become stranded. If you are in a remote territory, always inform others of your route and expected return date. 
• Activity Levels - should be maintained at a steady, constant rate. Avoid quick bursts of activity. Be mindful when exercising outdoors in cold temperatures because sweat can cool you down making you more susceptible to hypothermia.
• Out in the field - travel in pairs and conduct welfare checks.
• Take breaks in warm dry shelters - This allows your body to warm up. 
• Keep your clothing clean free of oil and dirt - Oily and dirty clothing quickly loses its insulating effectiveness. 
• Avoid overheating - there are more heat exhaustion cases in cold weather environments because of overdressing for the type of work performed. Overdressing and over-exertion cause an increase of body heat production and decrease in heat dissipation. As body temperature increases, there is a directly corresponding increase in perspiration, which causes your clothing to be saturated with sweat. Wet clothing leads to frostbite. 
• Dress in multiple layers - even if you don’t think it's cold outside. Wear at least three layers - a formidable base layer that absorbs moisture from your skin, an insulating layer and a protective outer layer against the wind, cold, rain and other elements. A quick way to remember the layering system is the acronym W.I.P. (W - Wicking Layer; I - Insulating Layer; P - Protective Layer). This gives you added flexibility to add or remove layers, depending on the weather and activity. 
• Layer your clothing correctly - clothes should be loose to trap air between the layers, which produces an insulating effect necessary for survival in the cold. Tight and constricting clothing can restrict the body’s blood flow circulation and can affect your body’s ability to keep itself warm. 
• Wear a face mask - it will protect your nose, cheeks, lips and ears from cold temperatures especially if the winds are howling. 
• Wear warm headgear - more body heat is lost from the top of your head than anywhere else. Wool is the best fabric to use, but remember anything is better than nothing. 
• Wear warm gloves or mittens - when possible you should use mittens before gloves. Mittens are warmer because they trap the heat of your entire hand and not just fingers like gloves. If gloves are your option, try a pair of glove liners made of a wicking material (such as polypropylene under a pair of heavier gloves). 
• Wear a scarf - don’t leave your neck exposed to the cold. 
• Keep your feet covered - avoid cotton socks. Cotton is a killer because it soaks up sweat and moisture causing your feet to become chilled more rapidly. Opt for wool, polypropylene or polyester socks. Also wear a quality pair of waterproof insulated boots. Remember to avoid overly constricting socks and boots. Socks and boots should be a little loose to trap the air which produces an insulating effect necessary for survival in the cold. Tight and restrictive socks and boots affect the body’s blood flow circulation and its ability to stay warm. 
• Remove wet clothing - if your clothing becomes wet so will your skin, which promotes hypothermia and frostbite. If possible, change into dry clothing at the first opportunity. 
• Find appropriate shelter - in any survival situation you must get out of the elements. A cave, an abandoned car, log cabin, a warehouse, a tunnel, or an improvised safety blanket can be used to make a tent. You have to think outside the box and adapt to your surroundings. 
• Eat enough - keep your calorie intake high. Winter activities require a lot of energy to perform, as well as to stay warm. Eat foods that are higher in fat content and calories. Warm foods and hot drinks will really warm your soul on a cold day. Your body will produce heat by burning the fuel you fed it. 
• Drink liquids - when it’s cold outside the air will suck the moisture out of you. If you are dehydrated, it’s harder for your body to stay warm. Drink water on a regular basis, and whenever you have a chance a hot drink such as herbal tea or hot chocolate. Hot drinks will keep your core body temperature up. 
• Don’t drink alcohol if you plan to be outdoors in cold weather - Alcoholic beverages cause your body to lose heat faster. 
• Watch for signs of frostbite and seek medical attention - keeping your body at normal temperature is critical in preventing frostbite. If you begin to experience First Degree Frostbite take appropriate measures immediately. Find shelter and warm up. Don’t let it progress because as you are well aware, it can cause life-altering injuries. 

Final Note.

Knowing how to handle winter weather emergencies is no laughing matter. The cold brings more than Old Man Winter and Jack Frost who is eager to nip at your nose. As cold weather creeps in, two unseen silent assassins eagerly wait to claim their next victims.

Hypothermia and frostbite are a serious unrelenting threat to life and limb, especially if our comfort zone is compromised. Don’t ever think it can’t happen to you. Grid failures, natural disasters, broken down vehicles or a fall from a canoe can quickly lead to hypothermia and frostbite. Simply keeping yourself alive becomes a serious battle. Remember both silent assassins can strike you at once.

Both hypothermia and frostbite are serious environmental emergencies. By understanding what they are, their symptoms and life-altering consequences, you will be better prepared to handle winter weather emergencies.

No matter where you are in the world, always stay safe, be vigilant and best wishes to you and your families.

All comments are welcomed. 

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