Environmental Cold Injuries

Facts

  • Individuals participating in activities during cold, wet, or windy conditions are at risk for environmental cold injuries

  • Athletic trainer should know the risk factors, signs and symptoms of cold injuries as well as how to treat them appropriately

  • Cold injuries more common with:

    • Individuals with previous cold injuries

    • Individuals that are dehydrated/lower caloric intake/fatigued

    • Race - Black individuals

    • Lower body fat/muscle mass

    • Physical training/fitness level

    • Gender - Females

    • Appropriate clothing layers

    • Age - over 50 or prepubescent

  • Environment plays a major factor

    • Wind, rain, immersion

    • Cold acclimatization

Types of cold injuries

  • Hypothermia

    • Decrease in core body temp below 95F (35C)

    • Mild → Severe

    • Rewarm by applying heat to trunk first

  • Frostbite

    • Freezing of body tissues

    • Stages depend on tissue freezing

    • Rule out hypothermia and rewarm slowly

  • Chilblain

    • Pernio

    • Associated with extended exposure (1–5 hours) to cold, wet conditions

    • Exaggerated or uncharacteristic inflammatory response to cold exposure

  • Immersion

    • Trench foot

    • Prolonged exposure (12hrs-4days), cold and wet conditions

    • Tissue, nerve, blood vessel damage

    • Treat by making sure area is clean and dry and then rewarm

Prevention

  • Comprehensive PPE – identify risk factors (predisposing conditions - EIB, Raynauds, cardiovascular disease, etc)

  • Minimize risk during conditions that make an individual more susceptible

  • Ensure that appropriate and adequately trained individuals are on site

  • Educate athletes & coaches

  • Encourage and educate proper hydration and balanced diet

  • Plans for managing athletes with cold injuries

  • Appropriate clothing and layering

  • Provide appropriate options to rewarm

  • Sideline supplies (hot packs etc)