ROSELAND FIRST AID SQUADWELCOME
FIRST AID TIPS
Your response to an emergency often determines the impact the situation will have on those around you. Knowing what to do saves lives. This easy-to-use guide is organized by event type and gives you the best course of action to take in each situation and because we live in uncertain times, this guide also includes information on how to survive homeland attacks and acts of domestic terrorism, including survival tactics in the event of chemical or biological contamination.

WINTER EMERGENCIES


RUNNING IN COLD CONDITIONS
Falling temperatures and fewer daylight hours don't mean that your outdoor running routine has to go into hibernation for the winter. Running through the cold weather can help shake those winter blues, improve your energy level, and guarantee that you'll be in better shape once bathing suit season rolls around. Follow these tips for cold weather running:Falling temperatures and fewer daylight hours don't mean that your outdoor running routine has to go into hibernation for the winter. Running through the cold weather can help shake those winter blues, improve your energy level, and guarantee that you'll be in better shape once bathing suit season rolls around.
Follow these tips for cold weather running:

Pay Attention to Temperature and Wind Chill
If the wind is strong, it penetrates your clothes and removes the insulating layer of warm air around you. Your movement also creates wind chill because it increases air movement past your body. If the temperature dips below zero or the wind chill is below minus 20, hit the treadmill instead.

Protect Your Hands and Feet
As much as 30% of your body heat escapes through your hands and feet. On mild days, wear running gloves that wick moisture away. Mittens are a better choice on colder days because your fingers will share their body heat. You can also tuck disposable heat packets into your mittens. Add a wicking sock liner under a warm polar fleece or wool sock, but make sure you have enough room in your running shoes to accommodate these thicker socks.
More: How to Keep Your Feet Warm on Cold Runs
Cold Weather Running Socks

Dress in Layers
Start with a thin layer of synthetic material such as polypropylene, which wicks sweat from your body. Stay away from cotton because it holds the moisture and will keep you wet. An outer, breathable layer of nylon or Gore-Tex will help protect you against wind and precipitation, while still letting out heat and moisture to prevent overheating and chilling. If it's really cold out, you'll need a middle layer, such as polar fleece, for added insulation.
More: Tips on Dressing for Winter Running

.Avoid Overdressing
You're going to warm up once you get moving, so you should feel a little bit chilly when you start your run. A good rule of thumb: Dress as if it's 20 degrees warmer outside than it really is.

Don't Forget Your Head
About 40% of your body heat is lost through your head. Wearing a hat will help prevent heat loss, so your circulatory system will have more heat to distribute to the rest of the body. When it's really cold, wear a face mask or a scarf over your mouth to warm the air you breathe and protect your face.

Watch for Frostbite
On really cold days, make sure you monitor your fingers, toes, ears, and nose. They may feel numb at first, but they should warm up a few minutes into your run. If you notice a patch of hard, pale, cold skin, you may have frostbite. Get out of the cold immediately and slowly warm the affected area. If numbness continues, seek emergency care..

Check With Your Doctor
Cold air can trigger chest pain or asthma attacks in some people. Before braving the elements, talk to your doctor if you have any medical conditions or concerns about exercising outdoors.

Get Some Shades
The glare from snow can cause snow blindness, so wear sunglasses (polarized lenses are best) to avoid this problem.

Don't Stay in Wet Clothes
If you get wet from rain, snow, or sweat in cold temperatures, you're at an increased risk for hypothermia, a lowering of your body temperature. If you're wet, change your clothes and get to warm shelter as quickly as possible. If you suspect hypothermia -- characterized by intense shivering, loss of coordination, slurred speech, and fatigue -- get emergency treatment immediately.

Stay Hydrated
Despite the cold weather, you'll still heat up and lose fluids through sweat. Cold air also has a drying effect, which can increase the risk of dehydration. Make sure you drink water or a sports drink before, during, and after your run.

Take It Easy When It's Frigid.
You're at greater risk for a pulled muscle when running in the cold, so warm up slowly and run easy on very cold days. Save your tough workouts for milder days or indoors.

Be Visible
It's best to avoid running in the dark but, if you have to run at night, wear reflective gear and light-colored clothing. Dress in bright colors if you're running in the snow.

Run Into the Wind
If you head out into the wind, it will be at your back at the end of your workout, when you're sweaty and could catch a chill.


HYPOTHERMIA
Hypothermia  is a decrease in the core body temperature to a level where normal muscular and brain functions are impaired.

Conditions Leading to Hypothermia:
•Cold temperatures
•Improper clothing and equipment
•Wetness
•Fatigue, exhaustion
•Dehydration
•Poor food intake
•No knowledge of hypothermia
•Alcohol intake - causes vasodilation leading to increased heat loss

What are "hypothermia" temperatures?
Any temperature less than 98.6 degrees can be linked to hypothermia (ex. hypothermia in the elderly in cold houses) or peripheral circulation problems such as trench foot and frostbite.

Signs and Symptoms of Hypothermia

Watch for the "-Umbles"
stumbles
mumbles
fumbles
grumbles
These signs and symoms ptshow changes in motor coordination and levels of consciousness

Mild Hypothermia - core temperature 98.6 - 96 degrees F
•Shivering - not under voluntary control
•Can't do complex motor functions (ice climbing or skiing) can still walk & talk
•Vasoconstriction to periphery

Moderate Hypothermia - core temperature 95 - 93 degrees F
•Dazed consciousness
•Loss of fine motor coordination - particularly in hands - can't zip up parka, due to restricted peripheral blood flow
•Slurred speech
•Violent shivering
•Irrational behavior - Paradoxical Undressing - person starts to take off clothing, unaware s/he is cold
•"I don't care attitude" - flattened affect

Severe Hypothermia - core temperature 92 - 86 degrees and below (immediately life threatening)
•Shivering occurs in waves, violent then pause, pauses get longer until shivering finally ceases - because the heat output from burning glycogen in the muscles is not sufficient
to counteract the continually dropping core temperature, the body shuts down on shivering to conserve glucose
•Person falls to the ground, can't walk, curls up into a fetal position to conserve heat
•Muscle rigidity develops
•Skin is pale
•Pupils dilate
•Pulse rate decreases
•at 90 degrees the body tries to move into hibernation, shutting down all peripheral blood flow and reducing breathing rate and heart rate.
•at 86 degrees the body is in a state of "metabolic icebox." The person looks dead but is still alive.

Treating Hypothermia
The basic principles of rewarming a hypothermic victim are to conserve the heat they have and replace the body fuel they are burning up to generate that heat. If a person is shivering, they have the ability to rewarm themselves at a rate of 2 degrees C per hour.

Mild - Moderate Hypothermia
Consider calling 9-1-1.
1. Reduce Heat Loss
•Additional layers of clothing
•Dry clothing
•Increased physical activity
•Shelter
2. Add Fuel & Fluids
It is essential to keep a hypothermic person adequately hydrated and fueled.
Things to avoid:
•Alcohol - a vasodilator - increases peripheral heat loss
•Caffeine - a diuretic - causes water loss increasing dehydration
•Tobacco/nicotine - a vasoconstrictor, increases risk of frostbite
3. Add Heat
•Fire or other external heat source
•Body to body contact.

Severe Hypothermia
1. Call 9-1-1. This is a medical emergency.


Cold Injuries
Tissue temperature in cold weather is regulated by two factors, the external temperature and the internal heat flow. All cold injuries described below are intimately connected with the degree of peripheral circulation. As peripheral circulation is reduced to prevent heat loss to the core these conditions are more likely to occur.

Factors influencing cold injuries
•Low ambient temperature
•Wind chill - increases rate of freezing dramatically
•Moisture - wet skin freezes at a higher temp than dry
•Insulation
•Contact with metal or supercooled liquids (white gas)
•Exposed skin
•Vasodilation
•Vasoconstriction
•Previous cold injuries
•Constricting garments
•Local pressure
•Cramped position
•Body type
•Dehydration
•Women do better in cold than men (greater subcutaneous body fat)
•Caloric intake
•Diabetes, some medications
•Alcohol
•Caffeine, nicotine



Cold Response
•Circulation is reduced to the area to prevent heat loss.
•The area may be pale, cold.
•It may have sensation or be numb.



Frostnip
•Freezing of top layers of skin tissue
•It is generally reversible
•White, waxy skin, top layer feels hard, rubbery but deeper tissue is still soft
•Numbness
•Most typically seen on cheeks, earlobes, fingers, and toes

Treatment
•Rewarm the area gently, generally by blowing warm air on it or placing the area against a warm body part (partner's stomach or armpit)
•Do not rub the area - this can damage the effected tissue by having ice crystals tear the cell



Frostbite
•Skin is white and "wooden" feel all the way through
•Superficial frostbite includes all layers of skin
•Numbness, possible anesthesia
•Deep frostbite can include freezing of muscle and/or bone, it is very difficult to rewarm the appendage without some damage occurring

Treatment
•Superficial frostbite may be rewarmed as frostnip if only a small area is involved
•If deep frostbite, see below for rewarming technique. Call 9-1-1 or transport to hospital is rewarming is required.

Rewarming is accomplished by immersion of the effected part into a water bath of 105 - 110 degrees F. No hotter or additional damage will result. This is the temperature which is warm to your skin. Monitor the temperature carefully with a thermometer. Remove constricting clothing. Place the appendage in the water and continue to monitor the water temperature. This temperature will drop so that additional warm water will need to be added to maintain the 105 - 110 degrees. Do not add this warm water directly to the injury. The water will need to be circulated fairly constantly to maintain even temperature. The effected appendage should be immersed for 25 - 40 minutes. Thawing is complete when the part is pliable and color and sensation has returned. Once the area is rewarmed, there can be significant pain. Discontinue the warm water bath when thawing is complete.
•Do not use dry heat to rewarm. It cannot be effectively maintained at 105 - 110 degrees and
can cause burns further damaging the tissues.
•Once rewarming is complete the injured area should be wrapped in sterile gauze and
protected from movement and further cold.
•Once a body part has been rewarmed it cannot be used for anything. Also it is essential that the
part can be kept from refreezing. Refreezing after rewarming causes extensive tissue damage
and may result in loss of tissue. If you cannot guarantee that the tissue will stay warm, do not
rewarm it. Mountaineers have walked out on frozen feet to have them rewarmed after getting out
with no tissue loss. Once the tissue is frozen the major harm has been done. Keeping it frozen
will not cause significant additional damage.



Trench Foot - Immersion Foot

Trench foot is caused by prolonged exposure of the feet to cool, wet conditions. This can occur at temperatures as high as 60 degrees F if the feet are constantly wet. This can happen with wet feet in winter conditions or wet feet in much warmed conditions (ex. sea kayaking). The mechanism of injury is as follows: wet feet lose heat 25x faster than dry, therefore the body uses vasoconstriction to shut down peripheral circulation in the foot to prevent heat loss. Skin tissue begins to die because of lack of oxygen and nutrients and due to buildup of toxic products. The skin is initially reddened with numbness, tingling pain, and itching then becomes pale and mottled and finally dark purple, grey or blue. The effected tissue generally dies and sluffs off. In severe cases trench foot can involve the toes, heels, or the entire foot. If circulation is impaired for > 6 hours there will be permanent damage to tissue. If circulation is impaired for > 24 hours the victim may lose the entire foot. Trench Foot cuases permanent damage to the circulatory system making the person more prone to cold related injuries in that area. A similar phenomenon can occur when hands are kept wet for long periods of time such as kayaking with wet gloves or pogies. The damage to the circulatory system is known as Reynaud's Phenomenon.

Treatment and Prevention of Trench foot

•Includes careful washing and drying of the feet, gentle rewarming and slight elevation. Since the tissue is not frozen as in severe frostbite it is more susceptible to damage by walking on it. Cases of trench foot should not walk out; they should be evacuated by litter. Pain and itching are common complaints. Give Ibuprofen or other pain medication.
•Prevention is the best approach to dealing with trench foot. Keep feet dry by wearing appropriate footwear. Check your feet regularly to see if they are wet. If your feet get wet (through sweating or immersion), stop and dry your feet and put on dry socks. Periodic air drying, elevation, and massage will also help. Change socks at least once a day and do not sleep with wet socks. Be careful of tight socks which can further impair peripheral circulation. Foot powder with aluminum hydroxide can help. High altitude mountaineers will put antiperspirant on their feet for a week before the trip. The active ingredient, aluminum hydroxide will keep your feet from sweating for up to a month and their are no confirmed contraindications for wearing antiperspirant. [Some studies have shown links between alumnium in the body and Alzheimers.] Vapor barrier socks may increase the possibility of trenchfoot. When you are active and you are wearing a vapor barrier sock, you must carefully monitor how you sweat. If you are someone who sweats a lot with activity, your foot and polypropylene liner sock may be totally soaked before the body shuts down sweating. Having this liquid water next to the skin is going to lead to increased heat loss. If you don’t sweat much, your body may shut down perspiration at the foot before it gets actually wet. This is when the vapor barrier system is working. You must experiment to determine if vapor barrier systems will work for you.


Chillblains
•Caused by repeated exposure of bare skin to temperatures below 60 degrees
•Redness and itching of the effected area
•Particularly found on cheeks and ears, fingers and toes
•Women and young children are the most susceptible
•The cold exposure causes damage to the peripheral capillary beds, this damage is permanent and the redness and itching will return with exposure



Snowblindness
•Sunburn of the eyes
•Prevention by wearing good sunglasses with side shields or goggles. Eye protection from sun is just as necessary on cloudy or overcast days as it is in full sunlight when you are on snow. Snow
blindness can even occur during a snow storm if the cloud cover is thin.

Symptoms
•Occur 8-12 hours after exposure
•Eyes feel dry and irritated, then feel as if they are full of sand, moving or blinking becomes extremely painful, exposure to light hurts the eyes, eyelids may swell, eye redness, and
excessive tearing

Treatment
•Cold compresses and dark environment
•Do not rub eyes


Avoiding Frostbite and Cold related Injuries
•"Buddy system" - keep a regular watch on each other's faces, cheeks, ears for signs of frostnip/frostbite
•Keep a regular "self check" for cold areas, wet feet, numbness or anesthesia
•If at any time you discover a cold injury, stop and rewarm the area (unless doing so places you at greater risk).