Cold Weather Operations—How to Prevent Frostbite
By MS. KATHY ALWARD, STAFF WRITER
We can all agree that the weather is sometimes unpredictable. According to the Armed Forces Health Surveillance Center, as cold weather is approaching, it is crucial to be prepared for and recognize the dangers of cold weather operations in the U.S. Military. One of the most common and severe cold-weather injuries to prevent is frostbite.
The Armed Forces Health Surveillance Center stated, “Frostbite is the freezing of skin tissue that can extend through all layers of the skin and freeze muscle and bone. Frozen skin may turn red and then gray-blue with blisters. In the worst cases, the skin dies and turns blue-black, often requiring amputation. Deep frozen skin feels ‘wooden’ to the touch, with zero mobility of the affected body part. Instantaneous frostbite can occur when [the] skin comes into contact with super-cooled liquids, including petroleum, oils and lubricants, antifreeze, and alcohol, all of which remain liquid at temperatures as low as minus 40 degrees Fahrenheit.”
The Armed Health Surveillance Center previously stated, “Frostnip is the freezing of the top layers of the skin and is considered the first degree of frostbite. Frostnip usually results from short-duration exposure to cold air or contact with a cold object, such as metal. Exposed skin such as the cheeks, ears, fingers, and wrists are more likely to develop frostnip.”
According to the Air Force Policy Directive (AFPD) 48-1, “Aerospace Medicine Enterprise emphasizes the need to ‘optimiz[e] the safety and health of AF personnel in the performance of their duties in any circumstance or location.’ Moreover, it directs the Air Force Medical Service to identify and reduce the risk of injury and illness through appropriate surveillance, prevention, and control programs. This Air Force Instruction supports AFPD 48-1 by providing commanders, supervisors, individuals, and medical personnel with guidance on collectively implementing an effective Thermal Injury Prevention Program to prevent and manage heat and cold injuries and illnesses among Air Force personnel. Failure to prevent and manage heat and cold injuries and illnesses can have a disastrous impact on mission capability through degraded human performance and potentially result in the prolonged or permanent incapacitation or death of Airmen and civilian workers.”
According to Health.mil, the official website of the Military Health System, from July 2018 through June 2019, there were a total of 513 active (446) and reserve (67) service members who had at least one medical encounter with “cold injury” as the primary diagnosis. The background of these findings mentions that the ears, nose, cheeks, chin, fingers, and toes are most frequently affected by frostbite. Factors that increase the risk of cold-weather injuries include “outdoor exposure, inadequate and/or wet clothing, cold water submersion, older age, exhaustion, dehydration, inadequate caloric intake, alcohol use, smoking (frostbite), previous cold injury (frostbite or immersion foot), chronic disease (e.g., peripheral vascular disease, diabetes), and medications that impair compensatory responses (e.g., oral antihyperglycemics, beta-blockers, general anesthetic agents). Situational factors that increase [the frostbite] risk of immersion foot include immobility, wet socks, and constricting boots.”
Health.mil fndings also stated that frostbite was the most common cold-weather injury among active component service members in 2018–2019.
According to Health.mil methods, it was noted that “the U.S. Armed Forces require expeditious reporting of these reportable medical events (RMEs) via one of the service-specific electronic reporting systems; these reports are routinely incorporated into the Defense Medical Surveillance System (DMSS). For this analysis, the DMSS and the Theater Medical Data Store (which maintains electronic records of medical encounters of deployed service members) were searched for records of RMEs and inpatient and outpatient care for the diagnoses of interest (frostbite, immersion injury, and hypothermia).”
The five signs of frostbite are1—
- Loss of feeling and color in the extremities;
- Redness and pain of the skin;
- White or greyish-yellow skin areas;
- Skin begins to feel firm or waxy; and
- Numbness.
According to this same article, the Centers for Disease Control and Prevention suggests that you seek emergency medical attention immediately if you experience any signs of frostbite. If medical care is not available, other suggestions include getting into a warm room, removing any wet clothing, and either warm the affected area using body heat or immersing it in warm (not hot) water. To prevent burning the affected area, it is best to avoid heating pads, stoves, fireplaces, heat lamps, and radiators. It also is recommended to wear warm clothes, multi-layered clothing, a hat or hood, and gloves to help stay dry so that frostbite can be prevented.
The Military News noted that most cold-weather injuries occur when it is cold and wet, but the temperature is only one factor.2 Another factor includes exposure time.
A 5-year study found that young soldiers had a far higher rate of cold injuries than older troops.
This research revealed that soldiers under the age of 25 were diagnosed with frostbite at a rate of “76 per 100,000 ‘per-years’”, a term the military uses to include population while [also] factoring in [the] time at risk. By comparison, the rate for soldiers in their early 30s was 38 per 100,000.” This same study found that frostbite remains the most common cold-weather injury. Frostbite is graded the same as burns in severity and can affect the nerves. It is imperative to prevent nerve damage because a nerve injury may not be reversible.
One thing is for sure; you should always be mindful of cold-weather injuries and the prevention and treatment of such injuries, including frostbite. Frostbite is a common cold-weather injury, so it is essential to take precautions to protect yourself and educate others as well.