Cold Temperature Exposure

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Topic Overview

It's easy to get cold quickly if you are outside in wet, windy, or cold weather. Cold temperature exposure can also happen if you spend time in a dwelling or other building that is not well-heated during cold weather.

Injuries from cold exposure

• "Frostnip" usually affects skin on the face, ears, or fingertips. Frostnip may cause numbness or blue-white skin color for a short time, but normal feeling and color return quickly when you get warm. No permanent tissue damage occurs.
• Frostbite is freezing of the skin and the tissues under the skin because of temperatures below freezing. Frostbitten skin looks pale or blue and feels cold, numb, and stiff or rubbery to the touch.
• Cold injuries, such as trench foot or chilblains, may cause pale and blistered skin like frostbite after the skin has warmed. These injuries occur from spending too much time in cold, but not freezing, temperatures. The skin does not actually freeze.
• An abnormally low body temperature (hypothermia) occurs when the body loses heat faster than it can make heat. Early symptoms of hypothermia include shivering in adults and older children, clumsy movements, apathy (lack of concern), poor judgment, and cold, pale, or blue-gray skin. Hypothermia is an emergency condition—it can quickly lead to unconsciousness and death if the heat loss is not stopped.

Risk factors for cold exposure injury

There are many factors that increase your risk of injury from exposure to cold temperatures.

• Being a baby
• Being an older adult
• Drinking alcohol
• Being in outdoor conditions, such as high altitudes or windy, wet weather, or being immersed in cold water
• Not being dressed properly, having wet skin, or wearing wet clothing
• Being tired or dehydrated
• Being exposed to cold temperatures in your workplace, such as working in cold-storage units
• Having certain health risks

Many people get cold hands or feet, which often are bothersome but not a serious health problem. You are more likely to feel cold easily if you:

• Do not have much body fat. Fat under the skin helps keep you warm. People who have low body fat may be more likely to get hypothermia. Babies, older or ill adults, or malnourished people have low body fat.
• Smoke cigarettes or drink caffeine. Nicotine (from tobacco) and caffeine cause narrowing of the blood vessels in the hands and feet. When blood vessels are narrowed, less blood flows to these areas, causing the hands and feet to feel cold.
• Are under a lot of stress or feel tired. Chronic stress or anxiety can cause your nervous system to release adrenaline, which acts to narrow the blood vessels that supply blood to the hands and feet.
• Have a medical condition, such as hypothyroidism or Raynaud's phenomenon, that makes you feel or react more strongly to cold temperatures.

If you have already been exposed to the cold, first aid measures can warm you up and may even save your life.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

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Last updated:	July 05, 2007
Author:	Jan Nissl, RN, BS
Reviewed By:	William M. Green, MD - Emergency Medicine, H. Michael O'Connor, MD - Emergency Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer