Warning signs and misconceptions about frostbite and hypothermia in extreme cold

Frostbite without gloves
Frostbite without gloves
Published: Dec. 23, 2022 at 1:55 PM CST
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GREEN BAY, Wis. (WBAY) - If you must spend any time outside this weekend, doctors want to remind people about the early warning signs of frostbite and hypothermia.

“With the risk of frostbite, it’s those things that are small and kind of hanging off of you, so things like ears, nose, chin, fingers and toes,” said Dr. Jeff Pothof, Chief Quality Officer and Emergency Medicine Physician at UW-Health.

Dr. Pothof said the first sign of frostbite is known as frostnip, a tingly and somewhat numb sensation.

“Typically, with frostbite, we go from being tingly to nearly completely numb and then we start to lose color in those extremities or those areas that are getting too cold, they get very pale,” said Dr. Pothof. “That’s a warning sign that you’re starting to get a little bit of crystal formation in your tissues. the moisture in your tissue is starting to turn to ice and that’s how we get harm from frostbite. It’s really ice crystals, which are sharp, that kind of mash against our tissues.”

Dr. Pothof said severe cases of frostbite can show up in the form of blood blisters.

“Seeing blisters is a sign of cold-related illness. It’s a bad sign and at that point you’re going to have to seek medical attention to get that addressed,” said Dr. Pothof. “That means that you are damaging your tissues and we can see damage from just your soft tissue all the way to damage at the bones, which would often lead to amputations and things like that.”

If you think you are experiencing frostbite, do not run your hands or extremities under hot or scalding water because you could end up burning yourself. Dr. Pothof said some people don’t realize your nerves are not sending pain signals. He also said if you think you can ‘walk it off’ to warm up your toes and increase blood flow, he said it isn’t the best option.

“What they don’t realize is those ice crystals that are in their feet are then kind of being mashed into their tissues that makes that injury worse. Likewise, folks will rub their hands together really quickly and that friction will increase the heat and think it helps with the frostbite. It actually doesn’t. What it actually does is jam those ice crystals more into the tissue to create a bigger tissue injury,” said Dr. Pothof.

Dr. Pothof said the right way to warm up after frostbite is by using lukewarm water, heated blankets or other insulating layers that can trap body heat. He said if you do that for about 30-45 minutes, but the numbing continues and the color doesn’t come back, then it’s time to seek medical care.

When it comes to hypothermia, where the cold simply shuts down the body, early warning signs include unusual behavior or an altered mental status.

“Sometimes they’ll make strange decisions. I think we’ve all heard of people with hypothermia who like took off all their clothes and then kept going. Those are some of the early stages,” said Dr. Pothof.

Dr. Pothof said other warning signs include the shift from extreme shivering to none and the diminishing of body functions, such as memory loss, slurred speech and drowsiness.

If someone is experiencing hypothermia, get them into a warm room, remove any wet clothing and try to warm the center of the person’s body with an electric blanket or dry layers.