Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Frostbite
is an injury resulting from freezing of the
tissues in the body. The hands and feet are most commonly affected by frostbite,
but the nose,
cheeks, shins, ears, and even the corneas of the eyes may be affected by
frostbite.
Frostbite typically occurs in soldiers or others who work outdoors, or in
outdoor winter sports enthusiasts. People who become stranded outdoors can also
become victims of frostbite. Nicotine and other
drugs that reduce blood circulation to the extremities (called vasoconstrictive drugs) can increase a
person's chances of developing frostbite. There is no official reporting system
for frostbite cases in the U.S., but it is known to affect predominantly
residents of the northern states, including Alaska. Research has shown that
African American men and women are slightly more prone to develop frostbite than
Caucasians. Other people who may be more predisposed to frostbite are those of
Arabic descent and those who reside in warm climates. Men develop frostbite more
often than women, but this may reflect a greater participation in sports and
outdoor activities.
The areas of the body affected by frostbite feel cold
and firm. Burning, tingling, stinging, or numbing sensations may be present...
Cold weather-related injuries occur with and without freezing of body
tissues.
Cold weather-related injuries include chilblains, trench foot, frostnip, and
frostbite.
Signs and symptoms may include tingling, numbness, and changes in the color
and texture of the skin.
Treatment generally includes moving out of the cold environment, removing
wet clothing, and re-warming the affected area.
Frostbite is a serious cold weather-related injury that requires immediate
medical attention and rapid re-warming. Do not thaw the affected area if there
is the risk of refreezing.
Certain individuals, such as the elderly, children, alcoholics, and the
homeless, are at increased risk of developing cold weather-related injuries.
Prevention of cold weather-related injuries is best accomplished through
proper planning and preparation for cold weather.
Introduction to frostbite and cold
weather-related injuries
Winter cold and snow provide a number of opportunities to get outside and participate in activities such as skiing, sledding, and snowmobiling. However, without proper protection, cold weather-related injuries can occur even when temperatures are above freezing (32 F, 0 C). This is especially true if there are high winds or if clothing is wet. In general, however, it is both the temperature and the duration of exposure that play a role in determining the extent and severity of cold weather-related injuries. This information describes the different types of cold weather-related injuries, as well as what to do to prevent and treat them prior to reaching a health care
practitioner.
What type of injuries can be caused by cold
weather?
Cold weather-related injuries can be divided into two general categories. There are those injuries that occur without the freezing of body tissue, such as chilblains, trench foot, and frostnip, and those injuries that occur with the freezing of body tissue, such as frostbite. Hypothermia is a medical condition characterized by a core body temperature that is abnormally low.
Cold weather-related injuries
without tissue freezing
Chilblains
Chilblains (also known as pernio) are a common type of cold weather-related injury that can develop in predisposed individuals after exposure to nonfreezing temperatures and humid conditions. Chilblains typically develop because of an abnormal vascular response several hours after the area exposed to cold is re-warmed. Chilblains are itchy, painful, reddish, or purplish areas of swelling that usually affect the fingers, toes, nose, or ears. In some individuals, blisters or small open sores may also form, increasing the risk for developing an infection. Chilblains usually last for several days, and the affected area usually heals after several weeks. Though the affected area may remain sensitive to the cold in the future, there is usually no permanent damage. It is not uncommon for chilblains to recur in susceptible individuals.
Hypothyroidism is any state in which thyroid hormone production is below normal. Normally, the
rate of thyroid hormone production is controlled by the brain at the pituitary.
Hypothyroidism is a very common condition and the symptoms of hypothyroidism are
often subtle.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Hyperthyroidism is an excess of thyroid hormone resulting from an overactive thyroid gland. Symptoms can include increased heart rate, weight
loss, depression, and cognitive slowing. Treatment is by medication, the use of
radioactive iodine, thyroid surgery, or reducing the dose of thyroid hormone.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Raynaud's phenomenon is characterized by a pale-blue-red sequence of color changes of the digits, most commonly after exposure to cold. Occurring as a result of spasm of blood vessels, the cause is unknown. Symptoms of Raynaud's phenomenon depend on the severity, frequency, and duration of the blood vessel spasm. Treatments include protection of the digits, medications, and avoiding emotional stresses, smoking, cold temperature, and tools that vibrate the hands.
A bruise, or contusion, is caused when blood vessels are damaged or broken as the result of a blow to the skin. The raised area of a bump or bruise results from blood leaking from these injured blood vessels into the tissues as well as from the body's response to the injury. Treatments include applying an ice pack and pressure to the area by hand.
Gangrene may result when blood flow to a tissue is lost or not adequate to keep the tissue alive. There are two types of gangrene: wet and dry. All cases of wet gangrene are infected by bacteria. Most cases of dry gangrene are not infected. If wet gangrene goes untreated, the patient may die of sepsis and die within hours or days. Dry gangrene usually doesn't cause the patient to die. Symptoms of dry gangrene include numbness, discoloration, and mummification of the affected tissue. Wet gangrene symptoms include swelling, pain, pus, bad smell, and black appearance of the affected tissue. Treatment depends upon the type of gangrene and how much tissue is compromised by the gangrene.
Hypothermia is having a body core temperature of less than 35 C or 95 F. Most causes of hypothermia are preventable. Risk factors for hypothermia include age, mental status, medical conditions, and medications. Symptoms of hypothermia generally depend upon the severity of the condition. Treatment depends upon the severity of hypothermia. If not treated early, hypothermia can lead to cardiac arrest, coma, or death.
Growth plate fractures and injuries occur in the area growing tissue near the end of the long bones of children and teens. Both boys and girls are susceptible to growth plate fracture and injury. Common causes include: a fall while playing sports or playing on furniture or playground equipment, overuse injury from sports, injuries from competitive sports, child abuse, frostbite, and juvenile arthritis. Growth plate fracture and injury are classified into five categories according to the Salter-Harris Classification.
First aid is a complicated subject and it is situation-specific. First aid is the help and medical assistance that someone gives, not only to an injured person, but to a person who is sick. Preparedness is a key element of first aid, like having basic medical emergency kits in your home, car, boat, or RV. Cuts, puncture wounds, sprains, strains, nosebleeds are one type of injury that may require first aid; heart attacks, strokes, seizures, and heat stroke are examples of more critical first aid emergencies.
Hypothyroidism
is a condition characterized by abnormally low thyroid
hormone production. There are many disorders that result in
hypothyroidism. These disorders may directly or indirectly involve the thyroid
gland. Because thyroid hormone affects growth, development, and many cellular processes, inadequate thyroid hormone has widespread consequences for the body.
This article will focus specifically on hypothyroidism in adults.
What are thyroid hormones?
Thyroid hormones are produced by the thyroid gland. This gland is located in the lower
part of the neck, below the Adam's apple. The gland wraps around the windpipe
(trachea) and has a shape that is similar to a butterfly - formed by two wings (lobes) and
attached by a middle part (isthmus).
The thyroid gland uses iodine (mostly available from the
diet in foods such as seafood, bread, and salt) to produce thyroid hormones....
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