Section II. COLD INJURIES

OVERVIEW

Cold injuries are most likely to occur when an unprepared individual is exposed to winter temperatures. They can even occur with the proper planning and equipment. The cold weather and the type of operation in which the individual is involved impact on whether a service member is likely to be injured and to what extent. The service member's clothing, physical condition, and mental makeup are also determining factors. Well-disciplined and well-trained service members can be protected, even in the most adverse conditions.

Service members and their leaders must know the hazards of exposure to the cold. They must know the importance of personal hygiene, exercise, care of the feet and hands, and the use of protective clothing. Cold injuries may be divided into freezing and nonfreezing types. A freezing type is frostbite. The nonfreezing types are chilblains, trench foot, and immersion foot. (See FM 4-25.11.)

Frostbite can occur when the temperature is at or near freezing or colder. Frostbite can also occur when the skin is exposed to winds of less than five miles per hour and actual temperature readings of 30 F.

Trench foot (and immersion foot) results from prolonged exposure to a wet, cold condition, or the outright immersion of the feet in water with a temperature usually below 50 F.

At the upper range of temperatures, exposure of 12 hours or more will cause injury.

Shorter duration at or near 32 F will cause the same injury.

A trench foot injury is usually associated with immobilization of the feet.

WEAR UNIFORM PROPERLY

Wear the clothing your commander and leaders direct.

Wear clothing in loose layers (top and bottom). Avoid tight clothing, including tight underwear.

Keep clothing clean and dry. Remove or loosen excess clothing when working or in heated areas to prevent sweating.

Wear headgear to prevent body heat loss. The body loses large amounts of heat through the head.

Avoid spilling fuel or other liquids on clothing or skin. Evaporating liquids increase heat loss and cool the skin. Also, liquid stains on clothing will reduce the clothing's protective effects.

Change wet/damp clothes as soon as possible. Wet/damp clothing pulls heat from body.

KEEP YOUR BODY WARM

Keep moving, if possible.

Exercise your big muscles (arms, shoulders, trunk, and legs) frequently to keep warm.

If you must remain in a small area, exercise your toes, feet, fingers, and hands.

Avoid the use of alcohol as it makes your body lose heat faster.

Avoid standing directly on cold, wet ground, when possible.

Avoid tobacco products. The use of tobacco products decreases blood flow to your skin.

Eat all meals to maintain energy.

Drink plenty of water and/or warm nonalcoholic fluids. Dark yellow urine means you are not drinking enough fluids! You can dehydrate in cold climates too!

Buddies should monitor each other for cold weather injury.

PROTECT YOUR FEET

Bring several pairs of issue boot socks with you.

Keep socks clean and dry. Change wet or damp socks as soon as possible. Socks can become wet from sweating.

Apply foot powder on feet and in boots when changing socks.

Wash your feet daily, if possible.

Avoid tight socks and boots (completely lace boots up as loosely as possible).

Wear overshoes to keep boots dry.

NOTE

A decrease in physical activity reduces the exposure time necessary to produce injury. In all types of footgear, feet perspire more and are generally less well ventilated than other parts of the body. Moisture accumulates in socks, decreasing their insulating quality. The feet are susceptible to cold injury and are less frequently observed than the remainder of the body.

PROTECT YOUR HANDS

Wear gloves with inserts, or mittens with inserts.

Warm hands under clothing if they become numb.

Avoid skin contact with snow, fuel, or bare metal.

Waterproof gloves by treating with waterproofing compounds, such as snow seal.

PROTECT YOUR FACE AND EARS

Cover your face and ears with a scarf or other material, if available.

Wear your insulated cap with flaps down or wear a balaclava and secure under your chin.

Warm your face and ears by covering them with your hands. Do not rub face and ears.

Do not use face camouflage when wind chill is -10 F or below; prevents detection of cold weather injury (frostbite).

NOTE

Rubbing cold extremities can be potentially harmful. Frostbitten areas that are rubbed can cause additional injury to the affected areas.

Wear sunscreen. Solar UV exposure is doubled when you are surrounded by snow.

Exercise facial muscles.

Wear sunglasses (or goggles) (Sun, Wind, and Dust, National Stock Number [NSN] 8465-01-004-2893) to prevent snow blindness (gray lens insert for above system is NSN 8465-01-004-2891).

Wear Spectacles, Protective, Laser-Ballistic, NSN 8465-01-416-4626, or Special Protective Eyewear, Cylindrical System, NSN 8465-01-416-4626.

Improvised sunglasses (slit goggles), if actual sunglasses are not available, can be made from the field rations/MRE cardboard box or other opaque material.

PROTECT YOUR BUDDY

Watch for signs of frostbite on the service members exposed skin. The affected skin will appear as pale/gray/waxy areas (it may be hard to see these changes in poor lighting or on service members with dark skin).

Ask the service member if his feet, hands, ears, or face are numb and need re-warming.

DO NOT allow the service member to sleep directly on the ground.

To prevent carbon monoxide poisoning

DO NOT let the service member sleep in or near the exhaust of a vehicle with the engine running.

DO NOT let the service member sleep in an enclosed area where an open fire is burning

NOTE

Service members may check circulation in the fingers and the toes by pinching the nail beds and checking how fast the color returns in the beds under the nails. The slower the return to a natural color, the more serious the potential for frostbite on the fingers and the toes.

NOTE

See GTA 8-6-12 and FM 4-25.11 for information on cold injury first aid procedures. During extended activities in a cold environment, warming areas should be provided; for example, a service member performing guard duty.