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>> Christopher DeFlitch: So some of the things we see coming into the emergency department
from cold stretches include exposure. And exposure can range anything from just being
cold, chilled to the bone as they used to say, to something we would call medically
related coldness, or hypothermia. Hypothermia is one of those things that when patients
get exposed to cold temperatures for a long period of time, it goes through certain levels
of injury patterns to your extremities, usually your fingers and toes. And the first level
of hypothermia would include redness to your fingers or toes, very cold, painful, tingling,
numbness, things like that. It can progress pretty quickly to the second degree, which
would include blistering, and then the more severe episodes, which include tissue death.
What actually happens inside of there is that the water from inside your body freezes, and
it crystallizes and causes cell damage. Best thing you can do with that, or any other cold,
is to get out of the cold, not expose yourself. So there are things people can do to prevent
injury from cold temperatures, simple things like covering up, you know, [inaudible] hat
[inaudible] gloves. You'll see people run into this situation when they don't expect
to run into this situation. So they're driving in their car, and they run out of gas, or
they slide off the road and they can't get the car unstuck. And they didn't expect to
be exposed because they're inside of their car, but they're not prepared. So they don't
have hats, they don't have gloves, they don't have multiple layers of clothing, they don't
have good shoes to be able to walk in. And so being prepared is nine-tenths of the situation.
So if you have to go out, you want to keep yourself covered, covered in layers are best.
So if it happens to warm up, you can take some of those layers off, or if it cools down
you can layer yourself back up again. That's one of the best things you can do to protect.
If you happen to be in that situation, get yourself out of that situation is really the
best thing. I'm sure all the time we remember as kids running around outside and being cold,
and your nose is a little bit red, and your fingers felt a little bit cold. You know,
that's a touch of hypothermia. And so what do you do to treat that? You don't have to
go running to the doctor every time you have just a little bit of that, so we talk about
sort of first degree, it's a little bit red and it's a little bit sore, kind of tingly.
Get yourself out of that exposure, take off that wet clothing, that is the best thing
that you can do. Once you take off that wet clothing, dry yourself off, and get yourself
re-equilabrated to a normal temperature. So when you bring the kids in, bring them inside,
take their wet clothing off, and dry them off in the areas that are cold and, you know,
go ahead and expose them to the warm temperature. You don't want to too rapidly re-warming up
and don't get hot water or anything like that, because that would then cause injury from
the higher temperatures. You know, let the temperature come back up. If you have to run
a little cool water over the top of it to make them feel a little bit better, that's
okay too, but make sure you dry it and keep your hands nice and warm. Sit next to a fire,
or, you know, just warm yourself up in a blanket can go a long way. There's a couple of things
that people were -- had more severe hypothermia, whether it be second or third degree, you'll
notice some findings. The pain will be severe, something they really can't handle, and that's
kind of a sign that you may be having some tissue damage and probably worth getting checked
out. Clearly blistering on the skin, there's something there. If you have skin that's changing
colors and it's not changing back -- a little bit of redness is okay, dark color, black
color is not okay. We want to -- that would be a significant injury related to it. But
if you're having pretty severe pain up until that point, it's one thing that is relatively
unique to lower temperatures is the exposure to carbon monoxide. You'll see that in a couple
of different situations. People will be in their garage, and they'll turn on their car
because they want to warm it up, but there's no ventilation, and your car produces carbon
monoxide. It's an odorless gas, it's a tasteless gas, and it can very quickly overwhelm you.
You'll get dizzy, you might get lightheaded, you may get confused. And so very quickly
when you get dizzy, lightheaded, and confused, you may fall down, you may have situations
where they can't get yourself out of that carbon monoxide poisoning, and bad things
can happen from that. So not only the car, but also from heaters, and from fireplaces.