U.S. ARMY COMBAT READINESS CENTER
Fort Rucker, Alabama
When it comes to injury prevention, it often pays for leaders to target their efforts at the highest risk group. So who’s at the greatest risk for a cold injury? While anyone can become a cold-weather casualty, the typical victim looks like this:
- Male
- About 20 years old
- E-4 or below
- Less than 18 months in service
- From a warm climate
- Uses tobacco, alcohol and/or medications
- Neglects proper foot care
Look around your squad, platoon, company, battery or troop and see if you have any Soldiers that fit that description because they are at risk. Identify and pay special attention to them now, before you go to the field or deploy.
Some chilling information
Now that we have an idea of who is most likely to get hurt, let’s briefly discuss cold injuries and what we can do to prevent them. You’ve probably noticed that some folks get very red in the face when they exercise. That’s the body’s cooling mechanism shunting blood to your skin so the blood can be readily cooled. But did you know the shunting process also works the opposite way? In cold environments, as much as 99 percent of the surface blood flow can be shifted back inside you to keep your vital organs warm.
However, this protective mechanism can be defeated by what we do. For instance, dehydration decreases the amount of blood that is circulating, thus hindering the body’s heating mechanisms. That’s why it’s so important to ensure we stay hydrated. Pushing fluids can be forgotten in a cold environment. This is especially true if you have to get out of a warm tent when it’s below zero and trudge through the snow to go to the latrine.
In cold weather, you may be tempted to drink less to reduce your need to leave your nice, warm tent. However, this can set you up for dehydration and even a heat injury. That’s right, a heat injury! When you are performing hard, physical work in a cold environment and wearing all of your protective equipment, it’s easy for you to start sweating and become overheated. You can end up exhausted and sweaty, and then rapidly cool off in the cold. It’s no wonder the typical cold injury victim is a young, first-term, male Soldier. Who usually gets detailed to put up the GP mediums?
In addition to the demographics listed above (young, first-term males), there are other significant risk factors. If you have a history of cold injuries, you are obviously at risk because you’ve already shown you are susceptible. In addition, if you are not physically fit, you are more likely to be injured; thus the Army’s emphasis on physical fitness.
Poor or inadequate nutrition also can quickly take its toll. When you’re in a cold environment, your body has a greater metabolic demand because you’re burning more calories trying to stay warm. If you need 3,000 calories per day in a controlled environment, you may need up to 4,500 calories in a cold environment just to maintain your body weight. Eating meals will also increase water consumption, which will be a hedge against dehydration.
Too little activity also can be a risk factor. While overheating is a risk when you are working hard, lack of activity can cause you to have cold injuries because of poor circulation in the extremities. Using those large muscle groups will ensure good circulation and heating, so get up and do 20 side-straddle hops.
Alcohol and tobacco, as well as caffeine, can also make it harder for you to stay warm. These substances all affect your body’s ability to dilate and constrict the blood vessels, which can defeat your body’s built-in heating and cooling mechanisms. Prescription and over-the-counter medications can also adversely affect your body’s heating and cooling, so it is important to let your doctor know if you will be exposed to cold weather. If you are a leader, you need to create a healthy work environment where Soldiers are steered away from behaviors such as tobacco use and excessive alcohol consumption.
Injury-prevention guidelines
Keep the following tips in mind to avoid becoming a cold-weather casualty.
- Dress in layers and avoid tight-fitting clothing. This will improve your circulation and provide layers of air between layers of clothing to help insulate you.
- Change your socks frequently to ensure your feet stay dry. This is going to require that you actually take off your boots and socks and change the latter, maybe even the former. If you are a squad leader, you may have to closely observe your Soldiers to ensure compliance.
- Protect your face and ears. These areas often suffer frostbite because of exposure and decreased blood flow. Wear the appropriate gloves, especially when you’re handling petroleum, oil and lubricant products, and avoid touching cold metal or fuel.
- Eat often and drink warm, non-caffeinated beverages. Soup is super! Use the buddy system. Seek medical attention for yourself and your buddy before symptoms become severe. As cold skin gets numb, subtle damage can progress and become a severe injury.
Unfortunately, cold-weather injuries continue to happen to Soldiers even though they are preventable. It is the responsibility of every leader to know the risk factors and use that information to mitigate an injury. Soldiers should also notify their leaders and battle buddies of any of these risk factors for a cold-weather injury. In turn, leaders must know their Soldiers who are at an increased risk due to medical conditions, medications or a prior cold-weather injury. Readiness Through Safety!
FYI
The following cold injuries require immediate medical attention, so don’t delay if you or your buddy exhibits any of the following symptoms:
- Hypothermia. Shivering, an altered sense of consciousness and uncoordinated movements. Hypothermia can be fatal if treatment is not given immediately.
- Frostbite. Loss of feeling or a tingling sensation in the affected area along with white, gray, red, yellow or waxy-looking skin. The frozen tissue will feel solid to the touch.
- Trench foot. Numbness in the feet accompanied by burning sensations and shooting pain. Severely affected tissue will appear pale and slightly blue. Trench foot can lead to gangrene.
- Chilblain. Reddened, slightly swollen skin accompanied by a prickly or burning sensation. Left untreated, chilblain can lead to more severe cold injuries.
For more information on preventing cold-weather injuries, see: