Frostbite
We’ve had a good hard freeze this year and our first significant snowfall. Most of our children will want to take advantage of our snow before it melts with some good outdoor play which is not only fun but the exercise will do us all some good. Let’s dust off the sleds, put on the mittens, and get out there! While we are thinking about some snow fun though, let’s talk about how to keep our kids safe from the dangers of the cold, specifically, Frostbite.
Frostbite takes place when the skin and outer tissues become frozen. The body works very hard to keep itself warm. When exposed to cold temperatures, our bodies will shunt our warm blood away from cold extremities like fingers and toes where it would cool off too quickly. Instead it keeps the warm blood deep in our body core where it maintains our temperature. However, this shunting of warm blood makes our extremities more vulnerable to cold. This is why frostbite tends to occur on the fingers, toes, ears, and nose, which may become pale, gray and blistered. At the same time, the younger child may complain that his skin burns or has become numb. When initial Frostbite occurs, stinging or aching of the skin can progress to cold areas of numbness, hard skin, or white and shinny areas of skin. As the area is re-warmed, it can become itchy, red, painful, blotchy, or swollen. In its worst case, Frostbite can progress to death of the skin and underlying tissue with formation of infections including Gangrene.
How to Prevent Frostbite:
Foremost is to dress for the weather. Children should have their extremities well covered and dry, to include mittens for fingers, hats that cover little ears, and a facemask to cover cheeks and nose. Almost as important as covering those extremities is to keep the “core” warm. Dress in layers with jackets and vests that are wind proof. Remember, if we keep the shoulders, chest and bellies warm, the body will not shunt that warm blood away from little toes and fingers keeping them nice and warm. Besides dressing for the cold, periodic checks are a must. On very cold or windy winter days, we should bring our younger children in every 15-20 minutes to check for cold injury. As they get to early school age, we can spread the checks to every 30 minutes, and for older kids, a check at least every hour is warranted. Remember, our kids may be having so much fun that a numb toe or ear may not be enough to make them want to leave their friends and come inside.
When Frostbite occurs:
Bring the child indoors, where you should place the frostbitten parts of his body in warm (not hot) water; warm washcloths may be applied to frostbitten nose, ears and lips. Do not rub the frozen areas, although a cold extremity could be held against a warm hand, arm or belly from Mom or Dad. After a few minutes, dry and cover him with clothing or blankets. Give him something warm to drink. If the numbness continues even after warming is complete, call your doctor.
Tips:
- Dress the trunk in layers. Keep the “core” warm!
- Mittens, water and windproof, work better than gloves.
- Boots, waterproof and sealed at the top as best you can to keep out snow.
- Hats and facemask to protect cheeks, noses, lips and ears.
- Periodic parent checks indoors. Every 15-20min for preschool. 30 min for young school age, and at least every hour for older children.
Watch for me, I’ve been know to pull out “Ole Red” , the best sled ever, and make an appearance at some of the local hills. Be safe this winter and of course have fun!
M. Scott Applegate, M.D., F.A.A.P.
Complete Children’s Health
