How to protect oneself from frostbite and hypothermia in extreme weather?

I.Pavlovsky, Vitebsk

During recent winters in Belarus the weather has been noticeably unstable. Frost follows thaws, frequently accompanied by bitter wind and snowstorms. Weather such as this causes a sharp increase in cases of hypothermia and frostbite of various parts of the body. Annually with the approach of frost, from 1,500 to 3,500 people are admitted to the emergency departments of hospitals with frostbite of varying degrees. 

Frostbite is damage of tissues of an organism, caused by low temperatures. In most cases it arises during the coldest part of winter when temperatures are between -10°С and -20°С. However, during long periods outdoors, especially with high humidity and strong winds, frostbite can even happen in the autumn and spring when temperatures are above zero. The condition is not helped by tight and damp clothes and footwear, physical fatigue, hunger, long periods of staying still, the weakening of the organism as a result of diseases, hyperhidrosis of the feet, chronic diseases of the blood vessels of the lower extremities and the cardiovascular system, and also heavy mechanical injuries with loss of blood, smoking, etc.

Research shows us that almost all severe frostbites which led to amputations of the hands and feet, occurred when the sufferer was heavily intoxicated.

Fingers and toes, noses, ear cavities and faces with no protective fatty layer are commonly subject to the injury. Vascular changes in the smallest blood vessels are increased at low temperatures. As a result, the blood flow slows down and the activity of tissue enzymes stops.

Minor frostbite usually appears as a result of a short exposure to the cold. The affected site of the skin is pale, after warming it becomes red, in certain cases has a purple-red shade; oedema develops. After approximately seven days it is possible to observe peeling of the skin. Full recovery is usually seen by the 5-7th day after frostbite sets in.

More serious frostbite known as 2nd degree, occurs when there is longer exposure to low temperatures. Initially, there is blanching of the skin, coldness and loss of sensitivity, as with other degrees of frostbite. These symptoms would be followed by the formation of blisters. Complete recovery of the skin occurs after 1-2 weeks, without lasting scars. With second degree frostbite, the pains are stronger and longer when the skin is warmed, itching and burning are observed.

With 3rd degree frostbite there would have been an even longer period of extreme cold and drop in tissue temperature. Blisters form but these are blood filled. All parts of the skin die and scars will result. Any nails that fall off will not grow again or will grow back deformed. The rejection of dead tissue comes to an end in the 2nd to 3rd week, after that there is scarring for up to 1 month. The intensity and duration of painful symptoms is greater.

Frostbite of the 4th degree arises with a long exposure to extreme cold, and the temperature decrease in the tissues is the greatest. It is quite often combined with frostbite of the 3rd and even 2nd degrees. All layers of soft tissues die, while bones and joints are often affected. The damaged area of the extremity is a blue colour, sometimes with a marbled appearance. Swelling and fluid retention develops right after warming and quickly increases. The temperature of the skin is much lower than on tissues surrounding the affected site. The absence of blisters at the main site and a loss of sensitivity are evidence of fourth degree frostbite.