Cold Weather Injuries Prevention Training
* This slide deck was prepared for adaption and local use by units/installation personnel
when conducting cold injury prevention training.
The information presented in these slides and notes sections (as posted) has been approved
by the Disease Epidemiology Program (DEP) of the U.S. Army Public Health Center (APHC)
as
of February 2019
.
The DEP can be contacted at 410-436-9286 for
technical consultation regarding cold injury prevention.
The requirement for Army Cold Weather Injury Prevention training is established by the
Army Medical Command – the current (2013) policy memorandum is at
.
This presentation material includes images from Defense Imagery Management Operations Center,
and slides from U.S. Army Safety Center,
Additional information links and resources may be obtained from APHC at:https://phc.amedd.army.mil/topics/discond/cip/Pages/Cold-Weather-Casualties-and-Injuries.aspxhttps://safety.army.mil/https://www.dimoc.mil/https://www.us.army.mil/suite/doc/41860392
C
o
l
d
W
e
a
t
h
e
r
I
n
j
u
r
i
e
s
:
P
r
e
v
e
n
t
i
o
n
,
I
d
e
n
t
i
f
i
c
a
t
i
o
n
,
a
n
d
T
r
e
a
t
m
e
n
t
S
l
i
d
e
S
e
t
f
o
r
U
n
i
t
/
I
n
s
t
a
l
l
a
t
i
o
n
T
r
a
i
n
i
n
g
A
p
p
l
i
c
a
t
i
o
n
s
*
UNCLASSIFIED
1
UNCLASSIFIED
2
C
o
l
d
W
e
a
t
h
e
r
I
n
j
u
r
i
e
s
:
P
r
e
v
e
n
t
i
o
n
,
I
d
e
n
t
i
f
i
c
a
t
i
o
n
,
a
n
d
T
r
e
a
t
m
e
n
t
P
r
e
s
e
n
t
e
r
’
s
N
a
m
e
P
r
e
s
e
n
t
e
r
’
s
C
o
m
m
a
n
d
L
o
c
a
l
C
o
n
t
a
c
t
I
n
f
o
r
m
a
t
i
o
n
insert date
UNCLASSIFIED
3
P
r
e
v
e
n
t
i
o
n
o
f
c
o
l
d
i
n
j
u
r
i
e
s
i
s
a
C
o
m
m
a
n
d
a
n
d
I
n
d
i
v
i
d
u
a
l
R
e
s
p
o
n
s
i
b
i
l
i
t
y
A
L
L
C
O
L
D
W
E
A
T
H
E
R
I
N
J
U
R
I
E
S
A
R
E
P
R
E
V
E
N
T
A
B
L
E
!
!
!
I
n
t
r
o
d
u
c
t
i
o
n
UNCLASSIFIED
4
•
Susceptibility Factors
•
Cold Weather Injuries
–
Description
–
Identification
–
Treatment
–
Prevention
•
Conclusion
O
u
t
l
i
n
e
UNCLASSIFIED
5
T
y
p
i
c
a
l
V
i
c
t
i
m
o
f
a
C
o
l
d
W
e
a
t
h
e
r
I
n
j
u
r
y
•
Male
•
E-4 or below
•
Around 20 years old
•
From a warm climate
•
Less than 18 months time in service
•
Uses tobacco, alcohol, and/or
medications
•
Neglects proper foot care
H
o
w
e
v
e
r
,
A
N
Y
O
N
E
c
a
n
b
e
c
o
m
e
a
c
o
l
d
w
e
a
t
h
e
r
c
a
s
u
a
l
t
y
!
UNCLASSIFIED
6
•
Previous cold weather
injury
•
Inadequate nutrition
•
Alcohol or nicotine use
•
Dehydration
•
Over-activity
•
Under-activity
•
Long exposure to the cold
•
Sick or injured
•
Ethnic/geographic origin
•
Wind, cold, rain
•
Age
•
Discipline and morale
•
Physical stamina
•
Inadequate training
•
Poor clothing and
equipment
S
u
s
c
e
p
t
i
b
i
l
i
t
y
F
a
c
t
o
r
s
UNCLASSIFIED
7
•
Heat Production
–
Metabolism
–
Exercise
–
Shivering
•
Heat Loss
–
Convection
–
Conduction
–
Radiation
–
Evaporation
–
Respiration
•
When heat loss and production are in balance, body
temperature is stable
•
When heat loss is greater, either in an area of the body
(finger, toes) or in the body core, cooling occurs
•
When cooling is too great, cold weather injury can occur
B
o
d
y
T
e
m
p
e
r
a
t
u
r
e
R
e
g
u
l
a
t
i
o
n
UNCLASSIFIED
8
•
Hypothermia
•
Frostbite
•
Non-freezing cold injuries
–
Chilblains
–
Immersion/Trench
Foot
•
Injuries related to cold
exposure
–
Dehydration
–
Sunburn
–
Snow Blindness
–
Carbon Monoxide
Poisoning
T
y
p
e
s
o
f
C
o
l
d
I
n
j
u
r
i
e
s
UNCLASSIFIED
9
•
M
E
D
I
C
A
L
E
M
E
R
G
E
N
C
Y
;
l
i
f
e
t
h
r
e
a
t
e
n
i
n
g
c
o
n
d
i
t
i
o
n
•
Severe body heat loss-body temp falls below 95
o
F
•
Occurs when:
–
cold conditions are severe
–
conditions are windy, clothing is wet, and/or the
individual is inactive
–
extended water exposure or immersion
•
1 hour or less when water temp is below 45
o
F
•
prolonged exposure in slightly cool water (e.g. 60
o
F)
•
thunderstorms, hail, rain and accompanying winds
H
y
p
o
t
h
e
r
m
i
a
UNCLASSIFIED
10
•
Initial Symptoms
–
shivering
–
dizzy, drowsy
–
withdrawn behavior
–
irritability
–
confusion
–
slowed, slurred
speech
–
altered vision
–
stumbling
•
Severe Stages
–
stops shivering
–
desire to lie down
and sleep
–
heartbeat and
breathing are faint
or undetectable
–
unconsciousness
followed by DEATH
H
y
p
o
t
h
e
r
m
i
a
The “umbles”-
stumbles, mumbles,
fumbles, and grumbles
UNCLASSIFIED
11
•
Treatment
–
prevent further cold exposure
–
evacuate immediately if severe hypothermia
–
remove wet clothing
–
rewarm with body-to-body contact or in a warmed
sleeping bag
–
warm, sweet liquids if conscious
–
give CPR if needed
H
y
p
o
t
h
e
r
m
i
a
UNCLASSIFIED
12
•
P
r
e
v
e
n
t
i
o
n
–
wear uniform properly (layers worn loosely)
–
stay dry
–
keep active
–
eat properly and often
–
warm liquids and water
–
warming tents
–
get plenty of rest
–
buddy watch/observation/NCO checks
H
y
p
o
t
h
e
r
m
i
a
UNCLASSIFIED
13
H
y
p
o
t
h
e
r
m
i
a
S
y
m
p
t
o
m
s
UNCLASSIFIED
14
•
Air temps below 32
o
F
–
skin freezes at 28
o
F
•
Superficial frostbite (mild)
–
freezing of skin surface
•
Deep frostbite (severe)
–
freezing of skin and flesh, may include bone
•
Hands, fingers, feet, toes, ears, chin, nose, groin area
F
r
o
s
t
b
i
t
e
UNCLASSIFIED
15
F
r
o
s
t
b
i
t
e
•
Symptoms
–
initially redness in light skin or grayish in dark skin
–
tingling, stinging sensation
–
turns numb, yellowish, waxy or gray color
–
feels cold, stiff, woody
–
blisters may develop
UNCLASSIFIED
16
F
r
o
s
t
b
i
t
e
•
Treatment
–
remove from cold and prevent further heat loss
–
remove constricting clothing and jewelry
–
rewarm affected area evenly with body heat until pain
returns
•
when skin thaws it hurts!!
•
do not rewarm a frostbite injury if it could refreeze
during evacuation or if victim must walk for medical
treatment
–
do not massage affected parts or rub with snow
–
evacuate for medical treatment
UNCLASSIFIED
17
F
r
o
s
t
b
i
t
e
•
Prevention
–
wear uniform properly
(layers and loosely)
–
keep socks and clothing
dry (use poly
pro/thermax liner socks
and foot powder/ change
insoles also)
–
protect yourself from
wind
–
drink hot fluids and eat
often
–
keep active
–
insulate yourself from
the ground (sleeping
pad/tree branches, etc.)
–
“Buddy System”
–
warm with body heat
–
avoid skin contact with
super-cooled metals
or fuel
–
seek medical aid for all
suspected cases
UNCLASSIFIED
18
•
Nonfreezing cold injury
•
Cold, wet conditions (between 32-60
o
F, high humidity)
•
Repeated, prolonged exposure of bare skin
•
Can develop in only a few hours
•
Ears, nose, cheeks, fingers, and toes
C
h
i
l
b
l
a
i
n
s
UNCLASSIFIED
19
C
h
i
l
b
l
a
i
n
s
•
Symptoms:
–
initially pale and colorless
–
worsens to achy, prickly sensation then numbness
–
red, swollen, hot, itchy, tender skin upon rewarming
–
blistering in severe cases
UNCLASSIFIED
20
C
h
i
l
b
l
a
i
n
s
•
Treatment
–
prevent further exposure
–
wash, dry gently
–
rewarm (apply body heat)
–
don’t massage or rub
–
dry sterile dressing
–
seek medical aid
UNCLASSIFIED
21
C
h
i
l
b
l
a
i
n
s
•
Prevention
–
keep dry and warm
–
cover exposed skin
–
wear uniform properly
–
use the “Buddy
System”
UNCLASSIFIED
22
T
r
e
n
c
h
/
I
m
m
e
r
s
i
o
n
F
o
o
t
•
Potentially crippling, nonfreezing injury (temps from 32
o
F-
50
o
F)
•
Prolonged exposure of skin to moisture (12 or more
hours, days)
•
High risk during wet weather, in wet areas, or when sweat
accumulates in boots or gloves
UNCLASSIFIED
23
T
r
e
n
c
h
/
I
m
m
e
r
s
i
o
n
F
o
o
t
•
Symptoms
–
initially appears wet, soggy, white, shriveled
–
sensations of pins and needles, tingling, numbness,
and then pain
–
skin discoloration-red, bluish, or black
–
becomes cold, swollen, and waxy in appearance
–
may develop blisters, open weeping, or bleeding
–
in extreme cases, flesh dies
UNCLASSIFIED
24
T
r
e
n
c
h
/
I
m
m
e
r
s
i
o
n
F
o
o
t
•
Treatment
–
prevent further exposure
–
dry carefully
–
DO NOT break blisters, apply lotions, massage,
expose to heat, or allow to walk on injury
–
rewarm with body heat
–
clean and wrap loosely
–
elevate feet to reduce swelling
–
evacuate for medical treatment
UNCLASSIFIED
25
T
r
e
n
c
h
/
I
m
m
e
r
s
i
o
n
F
o
o
t
•
Prevention
–
keep feet dry
–
change socks and apply
foot powder at least every
8 hours or whenever wet
–
bring extra boots to field
–
no blousing bands
–
report all suspected cases to
leadership
UNCLASSIFIED
26
D
e
h
y
d
r
a
t
i
o
n
•
A condition caused by the excessive loss of water from
the body
•
May increase the risk of hypothermia due to impaired
ability to keep active and generate body heat
UNCLASSIFIED
27
D
e
h
y
d
r
a
t
i
o
n
•
Symptoms
–
dark urine
–
headache
–
dizziness, nausea
–
weakness
–
dry mouth, tongue,
throat, lips
–
lack of appetite
–
stomach cramps or
vomiting
–
irritability
–
decreased amount of
urine being produced
–
mental sluggishness
–
increased or rapid
heartbeat
–
lethargy
UNCLASSIFIED
28
D
e
h
y
d
r
a
t
i
o
n
•
Treatment
–
drink WATER or other warm liquids
–
do not eat snow
–
rest
UNCLASSIFIED
29
D
e
h
y
d
r
a
t
i
o
n
•
Prevention
–
drink minimum of 3 canteens of water daily if inactive
and 5-6 quarts if active
–
monitor urine color
–
do not wait until you are thirsty
–
drink hot liquids for warmth
UNCLASSIFIED
30
S
u
n
b
u
r
n
•
Burning of the skin due to
overexposure to the sun
and UV light
•
Contributing factors
–
fair skin, light hair
–
exposed skin
–
reflective qualities of
the snow
–
high altitudes
•
Symptoms
–
redness of skin, slight
swelling (1
st
degree)
–
prolonged exposure
(2
nd
degree)
•
pain and blistering
•
chills, fever,
headache
UNCLASSIFIED
31
S
u
n
b
u
r
n
•
Treatment
–
soothing skin creams
in mild cases
–
in severe cases, seek
medical attention
–
aspirin for pain
•
Prevention
–
cover exposed skin
with clothing
–
sunscreen, lip balm
–
limit exposure of skin
to the environment
UNCLASSIFIED
32
•
When oxygen in the body is
replaced by carbon
monoxide
–
colorless, odorless,
tasteless gas resulting
from incomplete
combustion
•
Inadequate ventilation from
engines, stoves, heaters
C
a
r
b
o
n
M
o
n
o
x
i
d
e
P
o
i
s
o
n
i
n
g
UNCLASSIFIED
33
C
a
r
b
o
n
M
o
n
o
x
i
d
e
P
o
i
s
o
n
i
n
g
•
Symptoms
–
headache
–
dizziness
–
weakness
–
excessive yawning
–
ringing in ears
–
confusion
–
nausea
–
bright red lips, eyelids
–
drowsiness
–
unconsciousness
–
possibly death
UNCLASSIFIED
34
C
a
r
b
o
n
M
o
n
o
x
i
d
e
P
o
i
s
o
n
i
n
g
•
Treatment
–
move to fresh air immediately
–
seek medical aid promptly
–
provide mouth-to-mouth resuscitation if victim is not
breathing
UNCLASSIFIED
35
C
a
r
b
o
n
M
o
n
o
x
i
d
e
P
o
i
s
o
n
i
n
g
•
Prevention
–
ensure proper ventilation
–
don’t use unvented heaters or engines
–
ensure heaters are regularly serviced
–
turn heaters off when not needed (during sleep)
–
never sleep in vehicle with engine running
–
never wrap poncho around vehicle exhaust to collect
heat
UNCLASSIFIED
36
S
n
o
w
B
l
i
n
d
n
e
s
s
•
Inflammation and sensitivity
of the eyes caused by
ultraviolet rays of the sun
reflected by the snow or ice
•
Symptoms
–
gritty feeling in eyes
–
redness and tearing
–
eye movement will
cause pain
–
headache
UNCLASSIFIED
37
S
n
o
w
B
l
i
n
d
n
e
s
s
•
Treatment
–
remove from sunlight
–
blindfold both eyes or
cover with cool, wet
bandages
–
seek medical attention
–
recovery may take 2-3
days
•
Prevention
–
eye protection
•
dark, UV protective
glasses
•
field expedient-cut
narrow slits in MRE
cardboard and tie
around head
–
do not wait for
discomfort to begin
UNCLASSIFIED
38
C
o
n
c
l
u
s
i
o
n
•
Dress properly
•
Drink plenty of fluids
•
Eat right
•
Keep in shape
•
Get plenty of rest
•
Minimize periods of
inactivity
•
Maintain a positive attitude
UNCLASSIFIED
39
R
e
f
e
r
e
n
c
e
s
a
n
d
R
e
s
o
u
r
c
e
s
•
TB MED 508 Prevention and Management of Cold Weather Injuries
•
TC 21-3 Soldier’s Handbook for Individual Operations and Survival in
Cold-Weather Areas
•
FM 21-10 Field Hygiene and Sanitation
•
FM 4-25.11 First Aid
•
U.S. Army Public Health Center Cold Weather Injury Prevention
webpage:
https://phc.amedd.army.mil/topics/discond/cip/Pages/Cold-
Weather-Casualties-and-Injuries.aspx
•
U.S. Army Research Institute of Environmental Medicine Guidance
downloads:
http://www.usariem.army.mil/index.cfm/publications/guidance
UNCLASSIFIED
40
R
e
f
e
r
e
n
c
e
s
a
n
d
R
e
s
o
u
r
c
e
s
•
Individuals interested in heat illness and CWI on-line training that
produces a certificate:
–
Central Army Registry (CAR) Virtual Mission Preparation Course
(Hot/Cold Weather Injury)
–
Go to:
https://rdl.train.army.mil
–
Log in with CAC
–
In the “Search the CAR” field in the upper left, paste “553G D01
Virtual Mission Preparation Course (Hot/Cold Weather Injury
Prevention)”
–
Click on the blue hyperlink
–
EAMS-A may be required, which should lead to a page
describing the training
–
Scroll down and click on the “View” button at the bottom
UNCLASSIFIED
41
Q
u
e
s
t
i
o
n
s
?
There are notes to many of the slides in this slide deck that provide additional details for the presenter.
-----------------------------------------
Last updated by APHC: Feb 2019 (replaces previous version dated Apr 2016)
Slidedeck: Updated footer with slide numbers and classification; slide formatting changes for consistency.
Slide 1: first sentence updated to read “cold injury prevention training” (removed “and illness”); updated organization names from APHC (Prov) to APHC, Injury Prevention Program (IPD) to Disease Epidemiology Program (DEP); updated DEP phone number; updated Defense Imagery, ASC and APHC links.
Slide 39: updated organization name to U.S. Army Public Health Center, and link for Cold Weather Injury Prevention webpage
Slide 40: new slide with additional training resource
-----------------------------------------
Last updated by PHC: April 2016 (replaces previous version dated March 2014)
Slide 1- changed date to April 2016; updated organization name from USAPHC to APHC (Prov)
Slide 26 – Dehydration, changed first bullet to “A condition caused by the excessive loss of water from the body”, changed second bullet to “May increase the risk of hypothermia due to impaired ability to keep active and generate body heat”
Slide 27 deleted “unconsciousness”
Slide 28 deleted “avoid caffeinated liquids (sodas, coffee, tea)”, delete “Avoid coffee, sodas, cocoa, tea and other caffeinated beverages b/c they act as a diuretic, removing fluids from the body” from the notes section
Slide 29 deleted “(non-caffeine)”
This slide deck focuses on preventing, identifying, and treating cold weather injuries. It emphasizes the responsibility of both individuals and commands in preventing cold injuries, highlighting factors contributing to susceptibility and methods for regulation body temperature in cold environments.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
Slide Set for Unit/Installation Training Applications* Cold Weather Injuries: Prevention, Identification, and Treatment * This slide deck was prepared for adaption and local use by units/installation personnel when conducting cold injury prevention training. The information presented in these slides and notes sections (as posted) has been approved by the Disease Epidemiology Program (DEP) of the U.S. Army Public Health Center (APHC) asof February 2019. The DEP can be contacted at 410-436-9286 for technical consultation regarding cold injury prevention. The requirement for Army Cold Weather Injury Prevention training is established by the Army Medical Command the current (2013) policy memorandum is at https://www.us.army.mil/suite/doc/41860392. This presentation material includes images from Defense Imagery Management Operations Center, https://www.dimoc.mil/ and slides from U.S. Army Safety Center, https://safety.army.mil/ Additional information links and resources may be obtained from APHC at: https://phc.amedd.army.mil/topics/discond/cip/Pages/Cold-Weather-Casualties-and-Injuries.aspx UNCLASSIFIED 1
Cold Weather Injuries: Prevention, Identification, and Treatment Presenter s Name Presenter s Command Local Contact Information insert date UNCLASSIFIED 2
Introduction Prevention of cold injuries is a Command and Individual Responsibility ALL COLD WEATHER INJURIES ARE PREVENTABLE!!! UNCLASSIFIED 3
Outline Susceptibility Factors Cold Weather Injuries Description Identification Treatment Prevention Conclusion UNCLASSIFIED 4
Typical Victim of a Cold Weather Injury Male E-4 or below Around 20 years old From a warm climate Less than 18 months time in service Uses tobacco, alcohol, and/or medications Neglects proper foot care However, ANYONE can become a cold weather casualty! UNCLASSIFIED 5
Susceptibility Factors Previous cold weather injury Inadequate nutrition Alcohol or nicotine use Dehydration Over-activity Under-activity Long exposure to the cold Sick or injured Ethnic/geographic origin Wind, cold, rain Age Discipline and morale Physical stamina Inadequate training Poor clothing and equipment UNCLASSIFIED 6
Body Temperature Regulation Heat Production Metabolism Exercise Shivering Heat Loss Convection Conduction Radiation Evaporation Respiration When heat loss and production are in balance, body temperature is stable When heat loss is greater, either in an area of the body (finger, toes) or in the body core, cooling occurs When cooling is too great, cold weather injury can occur UNCLASSIFIED 7
Types of Cold Injuries Hypothermia Frostbite Non-freezing cold injuries Chilblains Immersion/Trench Foot Injuries related to cold exposure Dehydration Sunburn Snow Blindness Carbon Monoxide Poisoning UNCLASSIFIED 8
Hypothermia MEDICAL EMERGENCY; life threatening condition Severe body heat loss-body temp falls below 95oF Occurs when: cold conditions are severe conditions are windy, clothing is wet, and/or the individual is inactive extended water exposure or immersion 1 hour or less when water temp is below 45oF prolonged exposure in slightly cool water (e.g. 60oF) thunderstorms, hail, rain and accompanying winds UNCLASSIFIED 9
The umbles- stumbles, mumbles, fumbles, and grumbles Hypothermia Initial Symptoms shivering dizzy, drowsy withdrawn behavior irritability confusion slowed, slurred speech altered vision stumbling Severe Stages stops shivering desire to lie down and sleep heartbeat and breathing are faint or undetectable unconsciousness followed by DEATH UNCLASSIFIED 10
Hypothermia Treatment prevent further cold exposure evacuate immediately if severe hypothermia remove wet clothing rewarm with body-to-body contact or in a warmed sleeping bag warm, sweet liquids if conscious give CPR if needed UNCLASSIFIED 11
Hypothermia Prevention wear uniform properly (layers worn loosely) stay dry keep active eat properly and often warm liquids and water warming tents get plenty of rest buddy watch/observation/NCO checks UNCLASSIFIED 12
Hypothermia Symptoms OBSERVABLE IN OTHERS Slowing of pace. Intense shivering. Poor coordination. BODY TEMP SYMPTOMS FELT BY YOURSELF (Early Stage) 98.6 95.0 Intense and uncontrollable shivering; ability to perform complex tasks impaired. Fatigue. Uncontrollable fits of shivering. Immobile, fumbling hands. Stumbling. Poor articulation. Feeling of deep cold or numbness. Disorientation. Decrease in shivering. Stiffening of muscles. Exhaustion, inability to get up after a rest. Blueness of skin. Slow, irregular, or weak pulse. Drowsiness. (Moderate Stage) 95.0 91.4 Violent shivering persists, difficulty in speaking, sluggish thinking, amnesia begins to appear. Shivering decreases; replaced by muscular rigidity and erratic, jerky movements; thinking not clear but maintains posture. Stumbling, lunching gait. Thickness of speech. Poor judgment. Irrationality, incoherence. Memory lapses, amnesia. Hallucinations. Loss of contact with environment. (Severe Stages) 91.4 87.8 87.8 85.2 Victim becomes irrational, loses contact with environment, drifts into stupor; muscular rigidity continues; pulse and respiration slowed. Blueness of skin. Decreased heart and respiratory rate. Dilation of pupils. Weak or irregular pulse. Stupor. Unconsciousness. 85.2 78.8 Unconsciousness; does not respond to spoken words; most reflexes cease to function; heartbeat becomes erratic. Failure of cardiac and respiratory control centers in brain; cardiac fibrillation; probable edema and hemorrhage in lungs; apparent death. 78.8 UNCLASSIFIED 13
Frostbite Air temps below 32oF skin freezes at 28oF Superficial frostbite (mild) freezing of skin surface Deep frostbite (severe) freezing of skin and flesh, may include bone Hands, fingers, feet, toes, ears, chin, nose, groin area UNCLASSIFIED 14
Frostbite Symptoms initially redness in light skin or grayish in dark skin tingling, stinging sensation turns numb, yellowish, waxy or gray color feels cold, stiff, woody blisters may develop UNCLASSIFIED 15
Frostbite Treatment remove from cold and prevent further heat loss remove constricting clothing and jewelry rewarm affected area evenly with body heat until pain returns when skin thaws it hurts!! do not rewarm a frostbite injury if it could refreeze during evacuation or if victim must walk for medical treatment do not massage affected parts or rub with snow evacuate for medical treatment UNCLASSIFIED 16
Frostbite Prevention wear uniform properly (layers and loosely) keep socks and clothing dry (use poly pro/thermax liner socks and foot powder/ change insoles also) protect yourself from wind drink hot fluids and eat often keep active insulate yourself from the ground (sleeping pad/tree branches, etc.) Buddy System warm with body heat avoid skin contact with super-cooled metals or fuel seek medical aid for all suspected cases UNCLASSIFIED 17
Chilblains Nonfreezing cold injury Cold, wet conditions (between 32-60oF, high humidity) Repeated, prolonged exposure of bare skin Can develop in only a few hours Ears, nose, cheeks, fingers, and toes UNCLASSIFIED 18
Chilblains Symptoms: initially pale and colorless worsens to achy, prickly sensation then numbness red, swollen, hot, itchy, tender skin upon rewarming blistering in severe cases UNCLASSIFIED 19
Chilblains Treatment prevent further exposure wash, dry gently rewarm (apply body heat) don t massage or rub dry sterile dressing seek medical aid UNCLASSIFIED 20
Chilblains Prevention keep dry and warm cover exposed skin wear uniform properly use the Buddy System UNCLASSIFIED 21
Trench/Immersion Foot Potentially crippling, nonfreezing injury (temps from 32oF- 50oF) Prolonged exposure of skin to moisture (12 or more hours, days) High risk during wet weather, in wet areas, or when sweat accumulates in boots or gloves UNCLASSIFIED 22
Trench/Immersion Foot Symptoms initially appears wet, soggy, white, shriveled sensations of pins and needles, tingling, numbness, and then pain skin discoloration-red, bluish, or black becomes cold, swollen, and waxy in appearance may develop blisters, open weeping, or bleeding in extreme cases, flesh dies UNCLASSIFIED 23
Trench/Immersion Foot Treatment prevent further exposure dry carefully DO NOT break blisters, apply lotions, massage, expose to heat, or allow to walk on injury rewarm with body heat clean and wrap loosely elevate feet to reduce swelling evacuate for medical treatment UNCLASSIFIED 24
Trench/Immersion Foot Prevention keep feet dry change socks and apply foot powder at least every 8 hours or whenever wet bring extra boots to field no blousing bands report all suspected cases to leadership UNCLASSIFIED 25
Dehydration A condition caused by the excessive loss of water from the body May increase the risk of hypothermia due to impaired ability to keep active and generate body heat UNCLASSIFIED 26
Dehydration Symptoms dark urine headache dizziness, nausea weakness dry mouth, tongue, throat, lips lack of appetite stomach cramps or vomiting irritability decreased amount of urine being produced mental sluggishness increased or rapid heartbeat lethargy UNCLASSIFIED 27
Dehydration Treatment drink WATER or other warm liquids do not eat snow rest UNCLASSIFIED 28
Dehydration Prevention drink minimum of 3 canteens of water daily if inactive and 5-6 quarts if active monitor urine color do not wait until you are thirsty drink hot liquids for warmth UNCLASSIFIED 29
Sunburn Burning of the skin due to overexposure to the sun and UV light Contributing factors fair skin, light hair exposed skin reflective qualities of the snow high altitudes Symptoms redness of skin, slight swelling (1st degree) prolonged exposure (2nd degree) pain and blistering chills, fever, headache UNCLASSIFIED 30
Sunburn Treatment soothing skin creams in mild cases in severe cases, seek medical attention aspirin for pain Prevention cover exposed skin with clothing sunscreen, lip balm limit exposure of skin to the environment UNCLASSIFIED 31
Carbon Monoxide Poisoning When oxygen in the body is replaced by carbon monoxide colorless, odorless, tasteless gas resulting from incomplete combustion Inadequate ventilation from engines, stoves, heaters UNCLASSIFIED 32
Carbon Monoxide Poisoning Symptoms headache dizziness weakness excessive yawning ringing in ears confusion nausea bright red lips, eyelids drowsiness unconsciousness possibly death UNCLASSIFIED 33
Carbon Monoxide Poisoning Treatment move to fresh air immediately seek medical aid promptly provide mouth-to-mouth resuscitation if victim is not breathing UNCLASSIFIED 34
Carbon Monoxide Poisoning Prevention ensure proper ventilation don t use unvented heaters or engines ensure heaters are regularly serviced turn heaters off when not needed (during sleep) never sleep in vehicle with engine running never wrap poncho around vehicle exhaust to collect heat UNCLASSIFIED 35
Snow Blindness Inflammation and sensitivity of the eyes caused by ultraviolet rays of the sun reflected by the snow or ice Symptoms gritty feeling in eyes redness and tearing eye movement will cause pain headache UNCLASSIFIED 36
Snow Blindness Treatment remove from sunlight blindfold both eyes or cover with cool, wet bandages seek medical attention recovery may take 2-3 days Prevention eye protection dark, UV protective glasses field expedient-cut narrow slits in MRE cardboard and tie around head do not wait for discomfort to begin UNCLASSIFIED 37
Conclusion Dress properly Drink plenty of fluids Eat right Keep in shape Get plenty of rest Minimize periods of inactivity Maintain a positive attitude UNCLASSIFIED 38
References and Resources TB MED 508 Prevention and Management of Cold Weather Injuries TC 21-3 Soldier s Handbook for Individual Operations and Survival in Cold-Weather Areas FM 21-10 Field Hygiene and Sanitation FM 4-25.11 First Aid U.S. Army Public Health Center Cold Weather Injury Prevention webpage: https://phc.amedd.army.mil/topics/discond/cip/Pages/Cold- Weather-Casualties-and-Injuries.aspx U.S. Army Research Institute of Environmental Medicine Guidance downloads: http://www.usariem.army.mil/index.cfm/publications/guidance UNCLASSIFIED 39
References and Resources Individuals interested in heat illness and CWI on-line training that produces a certificate: Central Army Registry (CAR) Virtual Mission Preparation Course (Hot/Cold Weather Injury) Go to: https://rdl.train.army.mil Log in with CAC In the Search the CAR field in the upper left, paste 553G D01 Virtual Mission Preparation Course (Hot/Cold Weather Injury Prevention) Click on the blue hyperlink EAMS-A may be required, which should lead to a page describing the training Scroll down and click on the View button at the bottom UNCLASSIFIED 40
Questions? UNCLASSIFIED 41
