Cold-Related Emergencies

Cold-Related Emergencies

Serious health conditions can result from prolonged exposure to cold weather. The most common cold-related emergencies are hypothermia and frostbite.12 Signs and symptoms for cold-related emergencies, especially hypothermia, can be subtle, and an accurate diagnosis often is difficult because they can occur even when temperatures outside are not considered very low. Cold-related emergencies occur when the body is unable to protect itself from the outdoor environment. Inadequately clothed athletes are at risk for accidental cold injuries caused by prolonged exposure to low air temperature, humidity, and wind. Clothing made wet as a result of perspiration from activity or from wet weather conditions may also contribute to an athlete’s risk. Exposed body parts not protected by clothing are particularly susceptible to freezing in frigid temperatures. Athletic trainers, emergency medical services personnel, physicians, officials, and coaches should be aware of the many signs and symptoms associated with the various classifications of cold-related emergencies such as hypothermia and frostbite. Immediate care must be instituted to protect the exposed athlete from potential serious injury and possible death.


Hypothermia is a condition in which the body’s temperature becomes dangerously low.Many of the body’s organs can be damaged by hypothermia. Normal body temperature ranges between 97.2°F and 99.5°F. If the body temperature is just a few degrees lower than this, bodily functions tend to slow down and become less efficient. If the body temperature drops too low and stays low for more than a couple of hours, the body’s organs can begin to shut down, and death will ultimately result. Body temperature can drop gradually as the body is continually exposed to cold temperatures. This could happen when an athlete is outside in the cold weather without proper protection against the cold, wind, rain, or snow. Hypothermia can also occur when an athlete is out in the cold wearing wet clothing for an extended period. The signs and symptoms of hypothermia usually appear gradually. They progress from relatively mild conditions to extreme catastrophic events that could result in death if not treated promptly. An athlete with hypothermia needs immediate attention.  Take the athlete to an emergency care facility as

soon as possible for continued or advanced care if necessary. The extent of care will depend on how low the body temperature has dropped. Health-care providers may use warm oxygen, warm intravenous fluids, and warming blankets. Specific treatments for affected organs may also be given in the emergency care facility.

Rewarming the athlete must be done slowly to prevent a rush of blood to the surface of the body away from the vital Signs and Symptoms of Hypothermia


■ Individual feels cold and begins to shiver.

■ Individual has difficulty thinking and becomes mentally confused.

■ Individual loses the ability to shiver.

■ Individual’s heart starts beating irregularly.

■ Individual falls into a coma and death may occur.

Treatment of Hypothermia

1. Monitor/maintain airway, breathing, and circulation.

2. Move the athlete out of the cold.

3. Take off cold and wet clothing.

4. Wrap the athlete in warm blankets and cover the head.

5. Do not try to warm cold skin by rubbing or massage.

6. Do not allow the athlete to walk.

7. Do not give anything by mouth if the athlete is not alert.

8. Transport to an emergency care facility as soon as possible


Frostbite is a medical condition in which the nerves, blood vessels, and other cells of the body are temporarily frozen by exposure to cold temperature. In frostbite, intracellular water actually freezes and blood supply to the affected areas is compromised or even stopped altogether, resulting in a skin injury. Frostbite commonly occurs at the extremities: toes, fingers, tip of the nose, earlobes, and cheeks. In most circumstances, the wind chill factor determines how quickly frostbite occurs.18 Frostbite can also be much worse if the skin or clothing is wet at the time of the cold exposure. Frostbite comes in three different levels of severity :

1. Frostnip: skin appears white and waxy. There is possible numbness or pain in affected areas. No skin

blistering occurs.

2. Superficial frostbite: skin appears white, blue, or gray. Superficial skin feels hard but deeper tissue is

soft and insensitive to touch. This is a serious medical condition; permanent damage is imminent. Skin

blistering to affected areas is possible.

3. Deep frostbite: skin is white or blue and has a hard, wooden feel. The tissue underneath is hard and cold

to touch. The entire area is numb. Skin blistering occurs to affected areas. It is a life-threatening emergency

because of probable hypothermia and later risk of infection to affected body parts.

Treatment for Frostbite

■ Do not rub area.

■ Remove all wet clothing.

■ Cover area with dry bandage and/or clothing.

■ Gently rewarm the area by blowing warm air on area.

■ Place the area against a warm body part.

■ Place the area into warm (98°F –102°F) water for several minutes.

■ If not certain that the area will stay warm after rewarming, do not rewarm it.

Refreezing thawed frostbitten tissue can cause more extensive tissue damage.

■ If an athlete is also suffering from hypothermia, the first concern is core rewarming.

Transport athlete to an emergency care facility as soon as possible.

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