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BellaOnline's Pediatrics Editor


Hypothermia, Frostbite and Frostnip

Guest Author - Gwenn Schurgin O'Keeffe, M.D, F.A.A.P

Last year's record setting snowfall did little to curb our enthusiasm when this season's first snowflakes fell in early November. With snow barely touching the ground, New Englanders of all ages rushed to find their winter clothes and prepare for endless outdoor adventures. Yards normally covered by grass instantly became white wonderlands adorned with ski tracks, sleds, and a myriad of snow people. And where there is outdoor fun there are always unexpected injuries.

The totally accumulation of that first snow fall in November was only 1 to 2 inches yet kids found ways to sled, ski, build snow people and have snowball fights. The injuries we saw ranged from concussions due to sledding accidents, a sprained ankle from falling on an icy sidewalk, a broken arm sustained during a hockey, a bruised eye from a snowball fight, a few lacerations, and even some frostnip.

Winter sports can be dangerous and cause injury in adults and children. 2002 data collected by The National SAFE KIDS Campaign reports a staggering amount of childhood injuries from winter sports. There were over 69,000 children treated in Emergency Departments for winter sports injuries including ice skating, sledding, snowmobiling, skiing, and snow boarding. Head trauma resulting in concussions occurred in approximately one quarter of ski and snowboard accidents. The total number of children injured from these sports is actually much higher since these numbers only reflect children treated in Emergency Departments. Many more children are injured each year only requiring minor first aid attention at home and are cared for by their own pediatrician.

Winter injuries fall into two groups, sport related and weather related. As if the speed of these sports and the execution of skills on ice and snow are not tricky enough, the elements of the weather alone make any winter adventure potentially dangerous. Hypothermia, frostnip and frostbite are all caused by exposure to the cold and are avoidable with proper thermal clothing and avoidance of outdoor activities during dangerous cold spells. In general, the further below zero the wind-chill falls, the shorter the time it will take for any of these cold-related injuries to occur. Massachusetts schools all follow very strict guidelines for outdoor recess. Children must have snow suits and boots to play in the snow. And, children are kept indoors during cold weather advisories and when the temperature drops below zero. Encourage your family to follow these same guidelines for home and recreational activities. So, if it's too cold for outdoor recess, than it's too cold to build a snowman or hit the slopes.

Cold-related injuries can be very serious and early identification and treatment is essential. Hypothermia develops when the body's core temperature drops below normal. The body essentially freezes and major systems stop functioning normally. Symptoms result from the body's attempt to warm up and conserve energy. Early symptoms to watch for are shivering, clumsiness, and slurred speech. If you become concerned your child may be developing hypothermia, get your child in a warm environment and seek medical attention right away.

Frostnip and frostbite are two extremes of the same problem and result from direct cooling and freezing of the skin and underlying structures. Early on the skin turns white and becomes numb and is referred to as frostnip. Frostbite is an actual freezing of the skin and outer tissues. Fingers, toes, ears and nose are the most susceptible. They may appear pale, gray or blistered and the child may complain that the skin burns or feels numb. Frostbitten areas need to be warmed up with warm water. Wrap your child in a warm blanket and give hot cocoa to warm up the inside temperature. If the symptoms do not resolve in a few minutes, call your doctor.

Almost all winter sports require specific equipment and that equipment needs to be the proper size for your child. Most outdoor stores carry a full line of equipment, including used equipment, and can help you outfit your child properly including fitting your child for a helmet. The risk if head injury with winter sports is so high that if your child won't wear the helmet, don't let him participate. And, consider having your children wear their ski helmets for other speed generated activities such as sledding. You can check for recalls of any equipment you are considering with the Consumer Product Safety Commission web site (www.cpsc.gov).

For more information on any of these topics as well as more specific safety tips for each individual sport refer to www.Aap.org , www.kidshealth.org and www.safekids.org. You can find information written just for kids and teens at www.kidshealth.org.

Finally, practice what you preach for winter safety and dress including the use of helmets. There is no better way to reinforce to a child what is important than a parent willing to follow the same rules and, yes, ski helmets do come in adult sizes!

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Content copyright © 2015 by Gwenn Schurgin O'Keeffe, M.D, F.A.A.P. All rights reserved.
This content was written by Gwenn Schurgin O'Keeffe, M.D, F.A.A.P. If you wish to use this content in any manner, you need written permission. Contact BellaOnline Administration for details.


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