People with Disabilities and Freezing Temperatures

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When I woke up this morning it was two degree below zero in Pueblo, Colorado where I am visiting some people who are important in my life. My little hearing assistant dog, Frijole, popped out of the front door with me and then promptly headed back to the front door. As I was out front of the house, parents of children who attend the school across the street who were not aware of the two-hour delay drove up to the front of the school to encounter a staff member who reminded them of the fact.

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When the temperatures drop down to such a degree, the schools in Pueblo become concerned for all of the students, as well as their family members. With no real understanding of just how many students and family members experience forms of disabilities, it was gratifying to find the schools taking this step. It must be exceptionally hard on people who have forms of disabilities to also endure sub-zero temperatures.

Imagine, if you will, that you are a person who uses a wheelchair, walker, or other type of adaptive equipment and might take additional time to get out of your home, into a means of transportation, and then into a school or place of employment. During a time of year when the temperatures are below zero, this can be a true hardship. It isn't that there is a lot of snow on the ground here in Pueblo today, it is simply the reality of the cold and the potential for things such as frostnip or frostbite.

When exposed to cold temperatures, your body begins to lose heat faster than it can be produced. It is very important to remember to take caution during extremely cold temperatures and severe winter weather to prevent injuries and illness, such as hypothermia and frostbite. Hypothermia occurs most commonly at very cold environmental temperatures, but can occur even at cool temperatures (above 40 degree F) if a person becomes chilled from rain, sweat, or submersion in cold water.

Defining Frostnip, Hypothermia, and Frostbite

Frostnip

The reversible freezing of superficial skin layers that is usually marked by numbness and whiteness of the skin.

Hypothermia

A condition in which body core temperature drops below the required temperature for normal metabolism and body functions defined as 35.0 degree C (95.0 degree F). Body temperature is usually maintained near a constant level of 36.5 to 37.5 degree C (98 to 100 degree F). Hypothermia can quickly become life threatening and should be treated as a medical emergency. Hypothermia is the opposite of hyperthermia which is present in heat exhaustion and heat stroke.

Frostbite

Much more serious and may occur when skin is exposed to a temperature lower than 14 degree F (-10 degree C). Skin first becomes very cold and red, then numb, hard, pale and swollen when underlying tissues are affected. Frostbite requires immediate medical attention because of possible extensive injury, which can be complicated by infection and nerve damage.

Dealing with Frostnip

'Frostnip,' is a milder form of frostbite and commonly affects areas of a person's body that are exposed to the cold such as a person's nose, ears, cheeks, toes, and fingers. The result of frostnip is redness, numbness, or tingling. Frostnip is something that can be treated at home and improves through re-warming. The following are steps you can take to deal with frostnip:

• Bring the person indoors immediately
• Remove any wet clothing; it draws heat away from the person's body
• Call a doctor if the person's sensation does not return, or if they have signs of frostbite or hypothermia
• Do not use stoves, heating pads, radiators, or fireplaces to re-warm a person with frostnip because the affected areas of skin may be numb and burn easily.
• Immerse chilled parts of the person's body in warm, not hot, water for twenty to thirty minutes until their sensation returns. Do not allow a child to control the water temperature while re-warming them. Numb hands will not feel the temperature of the water and they might be severely burned by water that is too hot. Body heat may also be used to re-warm a person.

Cold, Frostbite, and People with Disabilities

'Frostbite,' means quite literally, 'frozen body tissue,' most often a person's skin, although it may also involve deeper tissues. Frostbite must be dealt with very carefully in order to prevent permanent damage to tissues. There are varying degrees of frostbite that are based upon the depth of the injury to a person's tissues, ranging from a superficial area of the skin all the way to muscle and bone injury in more severe instances. Frostbite is something that requires prompt medical attention from a health care provider.

Children are at an increased risk for frostbite, more so than adults, not only because children lost heat from their skin more quickly but also because they might be reluctant to wear appropriate clothing or leave winter fun to inside and warm back up. Areas of the body that are most prone to frostbite include a person's ears, face, feet, and hands. Frostbite may also be associated with hypothermia - a serious medical condition requiring emergency medical assistance.

Dealing with Frostbite

Frostbite is characterized by skin that is white and waxy and feels hard and numb. Frostbite is something that requires prompt emergency medical attention. The condition may be associated with hypothermia - also a serious medical emergency. The following are steps you should take in relation to frostbite:

• Get the person into dry clothing and a warm environment
• Call a doctor immediately, or take the person to a hospital emergency room
• If the person's feet are affected, carry them if possible - do not allow a child to walk on feet that are frostbitten

If you are unable to get to a hospital promptly, or you have to wait for an ambulance, give the person a warm drink and start first aid treatment to include:

• Do not rub skin that is frostbitten, or rub snow on it
• Immerse frozen areas of the person's body in warm water, approximately 100 degrees.
• Do not use direct heat such as a heating pad or a fire - the person's skin might be numb and may burn easily.
• If you do not have warm water, wrap the person gently in warm blankets, or use body heat on the areas of the person's body that are affected.
• Re-warming is accompanied by a burning sensation. The person's skin might blister and swell, and might turn blue, red, or purple. When a person's skin is pink and is no longer numb, the area is thawed.
• Do not thaw areas of a person's skin that are frostbitten if they are at risk of re-freezing before you are able to get to a health care provider because skin that is thawed and then re-frozen may cause severe tissue damage.
• Apply a sterile dressing to the area while ensuring that the dressing is not too tight, placing it between toes and fingers if they are affected. Try not to disturb any blisters and keep the person's wound clean in order to prevent infection.
• Wrap areas that have been re-warmed to prevent re-freezing and have the person keep thawed areas as still as they can. If you have first aid training, splinting the areas that have been affected can help to reduce the risk of injuring the area further.

Preventing Frostbite

You can take some different steps to help prevent frostbite during cold weather. One of the things you can do is remain updated on weather forecasts in your area. If it is very cold, even a brief exposure to the cold may cause frostbite. You can also:

• Make sure children come indoors at regular intervals
• Watch out for frostnip, the early warning sign of frostbite
• Change children out of clothing or shoes that are wet as soon as possible
• Take a CPR and first aid class to learn what to do in emergency situations
• If you are planning to travel to a remote area, make sure you have appropriate supplies in the event of an emergency and inform family members and friends of your travel plans.
• Dress children in layered and warm clothing such as gloves, hats, thick socks, scarves, and well-insulated boots to cover parts of their body that are most prone to frostbite. Inner layers of clothing that absorb moisture, as well as outer layers that are waterproof and windproof, help to prevent frostbite.

Resources That Provide Relevant Information

• Chilblains: Causes, Symptoms and Prevention
• Extreme Cold Weather: Staying Safe
• Hypothermia: Symptoms, Prevention, Treatment

Author Credentials:

Thomas C. Weiss is a researcher and editor for Disabled World. Thomas attended college and university courses earning a Masters, Bachelors and two Associate degrees, as well as pursing Disability Studies. As a Nursing Assistant Thomas has assisted people from a variety of racial, religious, gender, class, and age groups by providing care for people with all forms of disabilities from Multiple Sclerosis to Parkinson's; para and quadriplegia to Spina Bifida.

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