To Your Health: Frostbite is no joke

By Ann Backus, MS

We have already had some pretty cold days with low temperatures and gale warnings on the Northeast Coast. By this time lobstermen should have switched to polypropylene and insulated gloves and socks when they are hauling. Your first layer should be poly and the second an insulating layer. The goal is to wick moisture away from hands and feet and also insulate hands and feet from a wet and windy environment.

Frostnip occurs when the fingers, toes, nose or ear lobes become discolored and tingly. These areas are not well vascularized (i.e., not well supplied with blood) and therefore will become cold earlier than other parts of the body. Frostnip is first degree frostbite and is self-treatable, but the affected part should be rewarmed right away, slowly, in warm (not hot) water.

Treat frostnip as a warning sign. If frostnip is not addressed and the fingers or toes are allowed to become colder, frostbite can set in. Frostbite is a serious condition. In second degree frostbite, the fingers or toes turn white and look waxy. They are usually stiff. This stage is sometimes termed “superficial frostbite” because the damage is happening in the surface tissues as ice crystals form. It is not a condition to be taken lightly; this stage of frostbite requires medical attention.

The third degree is extremely serious. The fingers or toes become purple to black and gangrene occurs, which means that deep tissue damage has taken place. Numbness is also a symptom at this stage and medical attention is mandatory.

Temperatures below 32°F and high wind speeds that lower the wind chill temperature are the most well-known conditions for frostnip and frostbite. The National Weather Service provides wind chill charts that predict how many minutes it would take for frostbite to occur. For example, if the temperature is 10°F and the wind speed is 15 mph it would take longer than 30 minutes for frostbite to set in, but for a temperature of 0°F and wind speed of 15 mph, frostbite to exposed skin would happen in just 30 minutes.

Fishermen’s work environment presents additional hazards. Wet skin loses heat more rapidly than dry skin, so is more vulnerable to frostbite. Metal gear — davits and traps — are apt to be colder than the ambient temperature. Standing around while steaming makes it harder for the body to maintain its normal body temperature, and failure to remain hydrated also affects core temperature. Shivering indicates that the body’s core temperature has dropped.

The Cleveland Clinic lists a number of circulatory and vascular-related diseases which may predispose someone to frostbite., such as diabetes that is not well-controlled, Raynaud’s disease, peripheral vascular disease and peripheral neuropathy. Other diseases include hypothyroidism, arthritis and malnutrition. Former and current smokers are also at risk as smoking reduces blood flow to the extremities. It should be noted that consumption of alcohol also increases vulnerability to frostbite.

The do’s and don’ts of frostbite care:

Do get out of the cold and replace wet clothing with dry

Do raise your internal temperature by wrapping in a blanket

Do warm the affected areas slowly with warm (not hot) water

Do elevate the feet or hands

Do leave blisters alone

Do seek medical attention if you suspect stage two frostbite

Do hydrate with water

Don’t rub feet or fingers as this increases tissue damage – remember there are ice crystals present

Don’t walk on frostbitten feet

Don’t use direct heat (heating pad, etc.)

Don’t smoke or drink alcohol

Don’t thaw affected areas if there is a chance that they could refreeze; seek medical attention.