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If you or someone you care about must venture outdoors during extreme cold this winter, dress in layers. Cover exposed skin to reduce your risk of frostbite or hypothermia. Try to seek shelter from the wind as much as possible while outside. Once inside again, change into dry clothing immediately if you are wet. Understand and watch for signs of frostbite and hypothermia.

Watch for Frostbite

Frostbite can happen in minutes, especially on the extremities such as fingers, toes, nose and ears but can affect any area of exposed skin. If you suspect frostbite, immediately move inside to a heated location and begin warming the affected areas using warm water or body heat. Do not use hot water or radiant heat such as a fireplace since affected areas can be easily burned. Seek medical attention for severe frostbite.

Frostbite happens when the body's survival mechanisms kick in during extremely cold weather. To protect the vital inner organs, the body cuts circulation to the extremities: feet, hands, nose, etc., which eventually can freeze. To avoid frostbite, stay inside during severe cold, especially when the windchill is -50°F or below. If you must go out, try to cover every part of your body: ears, nose, toes and fingers, etc. Mittens are better than gloves. Keep your skin dry. Stay out of the wind when possible. Drink plenty of fluids since hydration increases the blood's volume, which helps prevent frostbite. Avoid caffeine, alcohol and cigarettes. Caffeine constricts blood vessels, preventing the warming of your extremities. Alcohol reduces shivering, which is the body's way of helping to keep you warm. Cigarettes shut off the blood flow to your hands. Below are indicators of frostbite:

• First degree: Ice crystals are forming on your skin.
• Second degree: Skin begins to feel warm even though it is not yet defrosted.
• Third degree: Skin turns red, pale or white.
• Fourth degree: Pain lasts for more than a few hours and skin color may begin turning dark blue or black. See a doctor immediately if these symptoms arise. Gangrene is a real threat.

Frostbite First Aid

Get indoors as quickly as possible. Until you can get indoors:

• Do not rub or massage cold body parts.
• Put your hands in your armpits.
• Hold onto another person or animal.
• Drink warm liquids.
• Put on extra layers of clothes, blankets, etc.
• Remove rings, watches and anything other tight jewelry or similar items.

Once indoors:

• Do not walk on a frostbitten foot. You could cause more damage.
• Get in a warm (NOT hot) bath and wrap your face and ears in a moist, warm (NOT hot) towel.
• Do not get near a hot stove or heater or use a heating pad, hot water bottle, or a hair dryer. You may burn yourself before feeling returns.
• Frostbitten skin will become red and swollen and feel like it is on fire. You may develop blisters. Do not break the blisters. It could cause scarring and infection.
• If your skin turns blue or gray, is very swollen, blistered or feels hard and numb even under the surface, go to a hospital as soon as possible.

Beware of Hypothermia

When your body temperature sinks below 96°F, you have hypothermia, a serious health hazard that occurs when body temperature is lowered too much. Get medical attention immediately. Move the victim inside to a heated location and begin warming the center of the body first. If the person is unconscious, administer CPR.

Hypothermia can occur in temperatures as warm as 60°F, particularly in water or if you are outside for a long time and not dressed for the weather. Of the approximately 1,300 people the CDCP lists as being killed by hypothermia each year, most are older adults, according to the National Institute of Aging, but some are children and young adults. Everyone needs to be careful. Some medicines, problems with circulation and certain illnesses may reduce your body's ability to resist hypothermia. As you age, your body becomes less efficient at letting you know when you are too cold. In addition, older people tend not to shiver effectively, one of the ways the body warms itself up. Remember these tips to help prevent hypothermia:

• Dress in layers.
• Wrap up well when going outside in the cold.
• Avoid breezes and drafts indoors.
• Eat nutritious food and wear warm clothes to ward off winter chill.
• Wear a warm hat in the winter.
• Eat hot foods and drink warm drinks several times during the day.
• If you live alone, ask a family member or neighbor to check on you daily or have a camera installed that a family member can view on their computer.
• Ask your doctor if any medicine you are taking increases your risk of hypothermia. Drugs that may cause a problem include barbiturates, benzodiazepines, chlorpromazine, reserpine and tricyclic antidepressants.

If your temperature is 96°F or less, you feel cold and sluggish, or are having trouble thinking clearly, see your doctor immediately or go to the nearest emergency room. It is better to be overly cautious than to die of a disorder that does not have to be deadly.

If you are trying to help someone who may have hypothermia, first call an ambulance. Then lie close to the person and cover both of you with thick blankets. The hotter you get, the more warmth you can give the other person. Do not rub the person or handle him or her roughly.

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