Emergency Preparedness

Winter Weather Related Health Concerns

What is hypothermia?
When exposed to cold temperatures, your body begins to lose heat faster than it can be produced. The result is hypothermia, or abnormally low body temperature. Body temperature that is too low affects the brain, making the victim unable to think clearly or move well. This makes hypothermia particularly dangerous because a person may not know it is happening and won't be able to do anything about it.

Hypothermia occurs most commonly at very cold environmental temperatures, but can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or submersion in cold water.

Who is most at risk for hypothermia?
Victims of hypothermia are most often:

• elderly people with inadequate food, clothing, or heating
• babies sleeping in cold bedrooms
• children left unattended
• adults under the influence of alcohol
• mentally ill individuals
• people who remain outdoors for long periods—the homeless, hikers, hunters, etc.

What are the warning signs for hypothermia?
Adults:

• shivering/exhaustion
• confusion/fumbling hands
• memory loss/slurred speech
• drowsiness

Infants:

• bright red, cold skin
• very low energy

What should I do if I see someone with warning signs of hypothermia?
If you notice signs of hypothermia, take the person's temperature. If it is below 95°, the situation is an emergency -- get medical attention immediately.

If medical care is not available, begin warming the person, as follows:

• Get the victim into a warm room or shelter.
• If the victim has on any wet clothing, remove it.
• Warm the center of the body first—chest, neck, head, and groin—using an electric blanket, if available. Or use skin-to-skin contact under loose, dry layers of blankets, clothing, towels, or sheets.
• Warm beverages can help increase the body temperature, but do NOT give alcoholic beverages. Do not try to give beverages to an unconscious person.
• After body temperature has increased, keep the person dry and wrapped in a warm blanket, including the head and neck.
• Get medical attention as soon as possible.

A person with severe hypothermia may be unconscious and may not seem to have a pulse or to be breathing. In this case, handle the victim gently, and get emergency assistance immediately. Even if the victim appears dead, CPR should be provided. CPR should continue while the victim is being warmed, until the victim responds or medical aid becomes available. In some cases, hypothermia victims who appear to be dead can be successfully resuscitated.

What is frostbite?
Frostbite is an injury to the body that is caused by freezing. Frostbite causes a loss of feeling and color in affected areas. It most often affects the nose, ears, cheeks, chin, fingers, or toes. Frostbite can permanently damage the body, and severe cases can lead to amputation.

What are the warning signs of frostbite?
At the first signs of redness or pain in any skin area, get out of the cold or protect any exposed skin—frostbite may be beginning. Any of the following signs may indicate frostbite:

• a white or grayish-yellow skin area
• skin that feels unusually firm or waxy
• numbness

Note: A victim is often unaware of frostbite until someone else points it out because the frozen tissues are numb.

What should I do if I see someone with warning signs of frostbite?
If you detect symptoms of frostbite, seek medical care. Because frostbite and hypothermia both result from exposure, first determine whether the victim also shows signs of hypothermia, as described previously. Hypothermia is a more serious medical condition and requires emergency medical assistance.

If (1) there is frostbite but no sign of hypothermia and (2) immediate medical care is not available, proceed as follows:

• Get into a warm room as soon as possible.
• Unless absolutely necessary, do not walk on frostbitten feet or toes—this increases the damage.
• Immerse the affected area in warm—not hot—water (the temperature should be comfortable to the touch for unaffected parts of the body).
• Or, warm the affected area using body heat. For example, the heat of an armpit can be used to warm frostbitten fingers.
• Do not rub the frostbitten area with snow or massage it at all. This can cause more damage.
• Don't use a heating pad, heat lamp, or the heat of a stove, fireplace, or radiator for warming. Affected areas are numb and can be easily burned.

Note: These procedures are not substitutes for proper medical care. Hypothermia is a medical emergency and frostbite should be evaluated by a health care provider. It is a good idea to take a first aid and emergency resuscitation (CPR) course to prepare for cold-weather health problems. Knowing what to do is an important part of protecting your health and the health of others.

Why are infants and older people most at risk for cold-related illness?
Infants lose body heat more easily than adults; additionally, infants can't make enough body heat by shivering. Infants less than one year old should never sleep in a cold room. Provide warm clothing and a blanket for infants and try to maintain a warm indoor temperature. If the temperature cannot be maintained, make temporary arrangements to stay elsewhere. In an emergency, you can keep an infant warm using your own body heat. If you must sleep, take precautions to prevent rolling on the baby. Pillows and other soft bedding can also present a risk of smothering; remove them from the area near the baby.

Older adults often make less body heat because of a slower metabolism and less physical activity. If you are more than 65 years of age, check the temperature in your home often during severely cold weather. Also, check on elderly friends and neighbors frequently to ensure that their homes are adequately heated.

What should I do if I get stranded in cold weather?

• Tie a brightly colored cloth to the antenna as a signal to rescuers.
• Move anything you need from the trunk into the passenger area.
• Wrap your entire body, including your head, in extra clothing, blankets, or newspapers.
• Stay awake. You will be less vulnerable to cold-related health problems.
• Run the motor (and heater) for about 10 minutes per hour, opening one window slightly to let in air. Make sure that snow is not blocking the exhaust pipe -- this will reduce the risk of carbon monoxide poisoning.
• As you sit, keep moving your arms and legs to improve your circulation and stay warmer.
• Do not eat unmelted snow because it will lower your body temperature.

What is the best clothing for cold weather?
Adults and children should wear:

• a hat
• a scarf or knit mask to cover face and mouth
• sleeves that are snug at the wrist
• mittens (they are warmer than gloves)
• water-resistant coat and shoes
• several layers of loose-fitting clothing

Be sure the outer layer of your clothing is tightly woven, preferably wind resistant, to reduce body-heat loss caused by wind. Wool, silk, or polypropylene inner layers of clothing will hold more body heat than cotton. Stay dry—wet clothing chills the body rapidly. Excess perspiration will increase heat loss, so remove extra layers of clothing whenever you feel too warm. Also, avoid getting gasoline or alcohol on your skin while de-icing and fueling your car or using a snow blower. These materials in contact with the skin greatly increase heat loss from the body.

Do not ignore shivering. It's an important first sign that the body is losing heat. Persistent shivering is a signal to return indoors.

What should I eat and drink during periods of extreme cold?
Eating well-balanced meals will help you stay warmer. Do not drink alcoholic beverages -- they cause your body to lose heat more rapidly. Instead, drink warm, sweet beverages such as hot chocolate to help maintain your body temperature. If you have any dietary restrictions, ask your doctor.

How can I heat my home safely?
If you plan to use a wood stove, fireplace, or space heater, be extremely careful. Follow the manufacturer's instructions and remember these safety tips:

• Store a multipurpose, dry chemical fire extinguisher near the area to be heated.
• Do not burn paper in a fireplace.
• Ensure adequate ventilation by opening an interior door or slightly opening a window if you must use a kerosene heater.
• Use only the type of fuel your heater is designed to use—don't substitute.
• If your heater has a damaged electrical cord or produces sparks, don't use it.
• Use fireplaces, wood stoves, and other combustion heaters only if they are properly vented to the outside and do not leak flue gas into the indoor air space. Make sure chimneys and flues are cleaned periodically.
• Do not place a space heater near things that may catch on fire, such as drapes, furniture, or bedding.

Know Your Winter Storm and Extreme Cold Terms

Familiarize yourself with these terms to help identify a winter storm hazard:

Freezing Rain: Rain that freezes when it hits the ground, creating a coating of ice on roads, walkways, trees, and power lines.

Sleet: Rain that turns to ice pellets before reaching the ground. Sleet also causes moisture on roads to freeze and become slippery.

Winter Storm Watch: A winter storm is possible in your area. Tune in to NOAA Weather Radio, commercial radio, or television for more information.

Winter Storm Warning: A winter storm is occurring or will soon occur in your area.

Blizzard Warning: Sustained winds or frequent gusts to 35 miles per hour or greater and considerable amounts of falling or blowing snow (reducing visibility to less than a quarter mile) are expected to prevail for a period of three hours or longer.

Frost/Freeze Warning: Below freezing temperatures are expected.

Before Winter Storms and Extreme Cold

Add the following supplies to your disaster supplies kit:

• Rock salt to melt ice on walkways
• Sand to improve traction
• Snow shovels and other snow removal equipment.

Prepare your home and family

• Prepare for possible isolation in your home by having sufficient heating fuel; regular fuel sources may be cut off. For example, store a good supply of dry, seasoned wood for your fireplace or wood-burning stove.
• Winterize your home to extend the life of your fuel supply by insulating walls and attics, caulking and weather-stripping doors and windows, and installing storm windows or covering windows with plastic.
• Winterize your house, barn, shed or any other structure that may provide shelter for your family, neighbors, livestock or equipment. Clear rain gutters; repair roof leaks and cut away tree branches that could fall on a house or other structure during a storm.
• Insulate pipes with insulation or newspapers and plastic and allow faucets to drip a little during cold weather to avoid freezing.
• Keep fire extinguishers on hand, and make sure everyone in your house knows how to use them. House fires pose an additional risk, as more people turn to alternate heating sources without taking the necessary safety precautions.
• Learn how to shut off water valves (in case a pipe bursts).
• Know ahead of time what you should do to help elderly or disabled friends, neighbors or employees.
• Hire a contractor to check the structural ability of the roof to sustain unusually heavy weight from the accumulation of snow - or water, if drains on flat roofs do not work.

Prepare your car
Check or have a mechanic check the following items on your car:

• Antifreeze levels - ensure they are sufficient to avoid freezing.
• Battery and ignition system - should be in top condition and battery terminals should be clean.
• Brakes - check for wear and fluid levels.
• Exhaust system - check for leaks and crimped pipes and repair or replace as necessary. Carbon monoxide is deadly and usually gives no warning.
• Fuel and air filters - replace and keep water out of the system by using additives and maintaining a full tank of gas.
• Heater and defroster - ensure they work properly.
• Lights and flashing hazard lights - check for serviceability.
• Oil - check for level and weight. Heavier oils congeal more at low temperatures and do not lubricate as well.
• Thermostat - ensure it works properly.
• Windshield wiper equipment - repair any problems and maintain proper washer fluid level.

Install good winter tires. Make sure the tires have adequate tread. All-weather radials are usually adequate for most winter conditions. However, some jurisdictions require that to drive on their roads, vehicles must be equipped with chains or snow tires with studs.

Maintain at least a half tank of gas during the winter season.

Dress for the Weather

• Wear several layers of loose fitting, lightweight, warm clothing rather than one layer of heavy clothing. The outer garments should be tightly woven and water repellent.
• Wear mittens, which are warmer than gloves.
• Wear a hat.
• Cover your mouth with a scarf to protect your lungs.

During a Winter Storm

Guidelines

• Listen to your radio, television, or NOAA Weather Radio for weather reports and emergency information.
• Eat regularly and drink ample fluids, but avoid caffeine and alcohol.
• Conserve fuel, if necessary, by keeping your residence cooler than normal. Temporarily close off heat to some rooms.
• If the pipes freeze, remove any insulation or layers of newspapers and wrap pipes in rags. Completely open all faucets and pour hot water over the pipes, starting where they were most exposed to the cold (or where the cold was most likely to penetrate).
• Maintain ventilation when using kerosene heaters to avoid build-up of toxic fumes. Refuel kerosene heaters outside and keep them at least three feet from flammable objects.

If you are outdoors

• Avoid overexertion when shoveling snow. Overexertion can bring on a heart attack—a major cause of death in the winter. If you must shovel snow, stretch before going outside.
• Cover your mouth. Protect your lungs from extremely cold air by covering your mouth when outdoors. Try not to speak unless absolutely necessary.
• Keep dry. Change wet clothing frequently to prevent a loss of body heat. Wet clothing loses all of its insulating value and transmits heat rapidly.
• Watch for signs of frostbite. These include loss of feeling and white or pale appearance in extremities such as fingers, toes, ear lobes, and the tip of the nose. If symptoms are detected, get medical help immediately.
• Watch for signs of hypothermia. These include uncontrollable shivering, memory loss, disorientation, incoherence, slurred speech, drowsiness, and apparent exhaustion.
• If symptoms of hypothermia are detected:
• get the victim to a warm location
• remove wet clothing
• put the person in dry clothing and wrap their entire body in a blanket
• warm the center of the body first
• give warm, non-alcoholic or non-caffeinated beverages if the victim is conscious
• get medical help as soon as possible.