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Winter Advice: Beware Hypothermia

Winter can be fun. Think of skiing, sledding, and snowboarding. Winter can be annoying. Think of dead car batteries and shoveling the walk. And winter can be dangerous. Think of, and be prepared for, hypothermia and frostbite.

 It's not just the back country hiker or winter fisherman who's at risk for cold-weather problems. Anyone who doesn't dress warmly enough or gets overheated then chilled while outside risks developing hypothermia. 

Hypothermia, or abnormally low body temperature, occurs any time your body loses more heat than it generates.

Heat loss can be caused by air or by water. Water conducts heat away from the body 25 times faster than the air. If you get wet, the air temperature doesn't have to be low to send your body temperature plummeting. Even mild, 60 degree days can pose a danger if you fall in the water, or get drenched from the rain or sweat. 

And if the water is cold, your chance of survival sinks. The passengers of the ill-fated ship Titanic donned flotation belts before they jumped in water. The belts kept their heads above water, but the chilly 28 degree water spelled their doom. About 1,500 people died in that tragedy, most from hypothermia.

The warning signs

Warning signs of hypothermia in adults include shivering, confusion, slurred speech, and fumbling. In infants, the signs include bright red, cold skin and lethargy.

Most healthy people who develop mild cases of hypothermia recover quickly. The key is to get out of the cold and into warm, dry clothing and blankets. Warm, sweet drinks—but NO alcohol—also are good at raising your core body temperature.

Normal body temperature is 98.6 degrees Fahrenheit. Hypothermia becomes critical when the body's core temperature drops below 90 degrees Fahrenheit. When that happens, hypothermia becomes a medical emergency.

In severe cases, a person with hypothermia may fall unconscious. The skin may be dark and puffy, and the muscles rigid.

Frostbite is a condition in which skin and body tissue literally freeze. Frostbite often can, but doesn't have to, accompany hypothermia. Frostbite most often affects the extremities—nose, ears, cheeks, chin, fingers, toes—and can leave permanent damage. The risk of frostbite is greater for people with reduced blood circulation and for anyone who doesn't dress appropriately for the cold.

Warning signs of frostbite include a white or grayish-yellow skin color, skin that feels waxy, and numbness.

How susceptible are you?

These factors can affect how susceptible you are to heat loss:

  • Age. Infants and elderly people are at increased risk for hypothermia because they have difficulty regulating their body temperature. For the elderly, it's debatable whether that difficulty is innate or caused by a combination of immobility and medications. If you're 65 or older, check the temperature in your home often during very cold weather. Check on elderly friends and neighbors during cold weather. Infants should not sleep in cold bedrooms. They should wear warm clothing to sleep in and be covered with a blanket.

  • Trauma. Blood loss from trauma can impair heat generation.

  • Drugs or alcohol. Alcohol is a vasodilator, promoting heat loss from the body. And if a person's judgment is impaired by alcohol or other substances, he or she may stay in a threatening winter situation too long.


To prevent hypothermia, avoid conditions that cause heat loss. Wear clothing that prevents body heat from escaping; layered clothing is especially good because you can remove and add layers as you warm up and cool down. The outermost layer should be wind resistant to reduce loss of body heat to the wind. Eat well, including plenty of carbohydrates such as pasta, potatoes, and bread for fuel. And stay dry. That includes avoiding getting gasoline on your skin while adding fuel to your car.

Pay attention to your own body. Don't ignore shivering—it's one of the first signs of danger that your body is losing heat. If you continue to shiver, go indoors.

If someone you're with outdoors is shivering, acting disoriented, or apathetic, it could be the early signs of hypothermia. Other signs include slurred speech and clumsy movements. Get the person indoors and begin warming the person with dry clothing and blankets.

First aid for hypothermia

If you suspect that someone has frostbite, first check to see if the person also shows signs of hypothermia. Hypothermia is a more serious condition and should be treated immediately.

If the person does not show signs of hypothermia, here's what to do for frostbite if medical care isn't immediately available, according to the Centers for Disease Control and Prevention:

  • Get the person into a warm room as soon as possible.

  • Unless absolutely necessary, do not allow the person to walk on frostbitten feet or toes. Walking can increase 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.