UMEM Educational Pearls

Title: Cold Exposure and Associated Conditions

Keywords: hypothermia, cold, environmental (PubMed Search)

Posted: 8/9/2014 by Jon Mark Hirshon, MD, MPH, PhD (Updated: 4/19/2024)
Click here to contact Jon Mark Hirshon, MD, MPH, PhD

General Information:

Hypothermia is when the body’s core temperature is less than 35º C. Often thought as a winter disease, it can occur in nearly any climate or weather condition. However, a number of cold related conditions can occur without a drop in core body temperature.

Specific Cold Related Conditions:

Frostnip
- Condition: Ice crystal deposited in the dermis
- Exposure: Freezing, damp exposure over hours to days
- Treatment: Warm water (37º-41ºC) immersion with movement of affected area for 15-30 minutes

Frostbite
- Condition: Frozen skin surface with damage to dermis and deeper structures
- Exposure: Freezing, damp exposure over hours to days
- Treatment: Warm water (37º-41ºC) immersion with movement of affected area for 15-30 minutes

Trench foot
- Condition: Tissue necrosis without freezing
- Exposure: Cold water exposure for hours to days
- Treatment: Warm water (37º-41ºC) immersion with movement of affected area for 15-30 minutes

Chillblains
- Condition: Epidermis repeatedly partially frozen and thawed
- Exposure: Chronic cold, dry wind exposure over weeks
- Treatment: Calcium-channel blockers can provide pain relief and decrease necrosis

Bottom line:

Remember that cold related injuries can occur without core hypothermia. Don’t forget the tetanus and antibiotics, as indicated.

References

Pathophysiology, management and complications of hypothermia. Lantry J, Dezman Z, Hirshon JM. Br J Hosp Med (Lond). 2012 Jan; 73(1):31-7.