From years of operating in harsh environments and almost dying from the cold in Iraq I’ve learned a couple things. I’m not a Doc, EMT, or Medic, but have been training and working in crappy areas most of my career. Cold injuries are one of the first things you learn as a Marine that I forgot, and it almost killed me.
The Iraqi desert gets cold at night. In 2003 I was part of the invasion force of Iraq. My Marine Unit was given one job take Baghdad. About half way there we stopped for the night because it was too dark to move. We didn’t want to move through towns with our lights on and it was too dark to run with NVGs (Night Vision Goggles). It was so dark I literally couldn’t see my hand in front of my face. We were living in the back of our 7-ton truck with sandbags stacked on the outside for cover. After a couple hours of trying to sleep, I fell out of the truck (yes actually fell when I tried to move) to use the bathroom.
I came back and decided not try and get back into the truck because pain is a great teacher. I was wearing 3 layers, body armor, helmet, and everything else I had to stay warm. I thought it was enough. We had been moving for days with little to no sleep, so as soon as I sat down on the ground to rest, I fell asleep.
The morning came and one of my Marines lovingly kicked me as he walked by to wake me up. I was actually frozen solid. I couldn’t get up or feel my arms or legs. My body had given up shivering and I was just about done. Luckily my Marines actually do love me and helped me to my feet and I got a bear hug from three of them for about 15 minutes until I started shivering again.
Cold injuries to watch out for are frostbite and hypothermia. Frostbite is the less severe, and affects mostly your extremities. When it’s cold and your hands start looking red, it’s the beginning of frostbite. Your body has decided that there isn’t enough warmth to go around so it gives up your hands, feet, arms, and legs to keep your brain and chest warm.
As frostbit continues to get worst, the affected areas will go from being red to white, and maybe blue. Check for capillary refill to confirm there is a problem. After changing color there may be blistering and swelling. There will be no doubt that there is a problem.
The only treatment is to stop and get warm. None of the “tricks” or old wise tails work. You don’t warm the affected area, you have to warm the entire body to bet the body temperature back to normal. If someone has frostbite, get them to a sheltered area and have them warm up by either putting on more clothing or using another’s body heat (I hope that person is better looking then my Marines).
Hypothermia is more dangerous then frostbite, but has the same treatment. The person affected needs to get out of the cold and get their body temperature back to normal. And it needs to be done slowly, just like frostbite.
Signs of hypothermia include a person unable to get warm, shivering uncontrollably, drowsiness, slurred speech, and they can appear to be drunk. While the person is still shivering it’s not life threatening but is headed that way. Shivering is your body’s natural way to create heat. If someone stops shivering, but has not regained a normal body temperature, then you have a problem. The body has given up trying to get warm and is shutting down to conserve what energy is left to try and survive as long as possible. This person needs immediate medical attention. You may not be able to get them warm without help, and if you can’t get them warm, they will die.
It doesn’t have to be below freezing and snowing to have a cold injury. Temperatures as high as 55° Fahrenheit have been known to cause injury. Being wet can seriously move things along. Being tired, unfit, and length of exposure to the cold are also factors.
I was lucky to have people around that could help me; you may not be that lucky, so pay attention.