When I was a police officer in Los Angeles County a few years ago, the state mandated I take regular first aid training for common scenarios like CPR and less common scenarios like delivering a baby out in the field. When I moved to St. Paul, Minnesota in the winter of 2013, I discovered Californian training had left me ill-prepared for a very specific situation: the winter of 2013. Thankfully, my friends and neighbors quickly taught me the finer points of surviving a Twin Cities snow storm, stressing the importance of proper cold-weather first aid. They told me that extreme cold is something to take seriously and first aid could save a life—including my own. The same is true for workers braving the elements all over the country this winter.
Workers face two major threats when working in low temperature environments: hypothermia and frostbite. Frostbite is a serious injury that happens when skin and the tissues beneath it become frozen. Extremities such as your fingers, toes, ears, and nose are especially susceptible. If a coworker appears to be suffering from frostbite, the number one thing is to get them to a warm place and then to professional medical help right away. If they are suffering from frostbite, treat the area with warm (not hot) water for around 30 to 45 minutes. Don’t put them near a fire because the loss of sensation could result in your coworker being burned without knowing it. Once an area appears rewarmed, it’s extremely important to keep it from refreezing. Refreezing is massively dangerous and can result in permanent damage. In fact, it’s better to delay warming if there’s a chance a refreeze could occur before you make it to permanent shelter.
Hypothermia occurs when someone’s core body temperature drops below 98 degrees F, or about 35.5 degrees Celsius. Severe hypothermia occurs when the body's temperature drops below 92 degrees F or 33 degrees Celsius. Mild hypothermia can result in shivering and loss of fine motor skills. More severe forms can render a person pale & confused and cause slurred speech, total loss of motor control, dilated pupils, and violent shivering followed by total body shutdown. If not treated immediately, it can be fatal.
For a coworker suffering hypothermia, the most important thing is to get them to shelter and get them emergency medical attention. While waiting for help to arrive, you can use rewarming techniques on the person, such as using another person’s body heat to warm them up. Do not put them in hot water; rapid rewarming can cause heart problems. Add dry layers onto them, help them increase movement, give them something hot to drink that isn’t alcohol or coffee, and have them eat something fatty and sugary. Encourage them to urinate, because a full bladder conducts heat away from the body. Apply heat to major arteries in the neck, groin, armpits and palms, using hot water bottles or warm towels. Check out OSHA's Cold Stress Guide for more information.
While professional emergency medical response is always the goal, quick thinking by fellow workers can mean the difference between life and death for coworkers suffering exposure to extreme low temperatures. As a former first responder, I can attest to the fact that help is coming as quickly as possible. Unfortunately, depending on weather and traffic conditions, that speed can vary greatly. By staying educated and engaged, you can be a hero to your coworkers and their family too.