1. Enable Nuclear Deterrence & Community Wellness through an Integrated Health Care System
341st Medical Group
UNCLASSIFIED
FRT AUGUST TRAINING
Maj Gacioch
FRT Team Chief
Part 1: Cold Weather Injuries

2. Enable Nuclear Deterrence & Community Wellness through an Integrated Health Care System
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UNCLASSIFIED
Cold Weather
Colddecreases your ability to think andweakens your will
to do anything except to get warm. Coldis an insidious
enemy; as it numbs the mind, it subdues the will to
survive. Coldmakes it very easy to forget your ultimate
goal – to survive.
FM 21-76 (Survival), Pg 15-1
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Typical Victim of a Cold
Weather Injury
 Male
 A1C or below
 20 years old (approximately)
 From a warm climate
 Less than 18 months time in service
 Uses tobacco, alcohol or medications
 Neglects proper foot care
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General Protection
 Use multiple layers, loose enough to trap air
 Cover your head (can lose 40-45% of body heat from
head, and even more from neck, wrists and ankles
 Outermost layer should be wind/water resistant
 Consider higher protein/fat foods for calories
 Consider portable heaters, glove warmers, etc
 C- Keep clothing clean
 O- Avoid overheating
 L- Wear clothes loose and in layers
 D- Keep clothing dry
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Factors Increasing Risks
The body is better at losing heat than producing it
 Taking certain drugs or medications such as alcohol,
nicotine, caffeine, and medication that inhibit the
body's response to the cold or impairs judgment
 Having a cold or certain diseases, such as diabetes,
heart, vascular, and thyroid problems (may make a
person more susceptible to the winter elements)
 Male sex (♂ have far greater mortality from cold than
♀, perhaps due to inherent risk-taking activities, body-
fat composition or other physiological differences)
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Hypothermia
 DEFINITION: lowering of body temperature at a rate
faster than the body can produce heat
 Initial symptom is shivering, sign is progressive pallor
of skin in extremities
 At 96 degees F – shivering progresses to the point of
being uncontrollable. Patient can’t care for self
 At 95-90 degees F – sluggish thinking, irrational
reasoning, & false perception of warmth. Weak pulse
 At 90 – 86 degees F or less symptoms include muscle
rigidity, unconsciousness & barely detectable signs of
life (inaudible heart beat & pulse, unreactive pupils,
very slow respirations
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Mild
Moderate
Severe

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UNCLASSIFIED
UNCLASSIFIED
Frostbite
 DEFINITION: Freezing of tissues. Light frostbite
produces areas of dull, whitish, pallor that are numb
when cold and burn when rewarmed “chillblains”
 Tend to occur on thin skin (face, feet & hands).
Counter effect by covering, wiggling (making faces)
and periodically exposing to heat.
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Severe Frostbite
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Trenchfoot
 Exposure for many hours or days to wet/damp at
near freezing temperatures
 Presents as pins & needles sensation  tingling 
numbness  pain
 Skin appears wet, soggy, wet, white & shriveled. As
damage occurs  red  bluish  black in color.
Walking becomes difficult. Muscles & tendons 
become damaged. If persists long enough  can
progress to gangrene and possibly amputation.
 Prevention is keeping feet warm and dry.
Change socks frequently!
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Trench Foot
(Mild to Severe)
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Trenchfoot Treatment
 prevent further exposure
 dry carefully
 DO NOT break blisters, apply lotions, massage,
expose to heat, or allow to walk on injury
 rewarm by exposing to warm air
 clean and wrap loosely
 elevate feet to reduce swelling
 evacuate for medical treatment
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Cold Weather Survival
 DO
 Periodically check self/buddy for frostbite.
 Rewarm frostbite
 Keep injured areas from refreezing
 DON’T
 Rub injuries with snow
 drink Alcoholic beverages
 Thaw out deep frostbite if away from definitive care
(better to leave it frozen)
 Smoke
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More Advanced Care
 If the person is conscious give hot, sweetened fluids
(honey, dextrose or sugar)
 To treat hypothermia rewarm the whole body, starting
with the trunk only in warm water (100-110 degrees F)
then slowly stimulating peripheral blood flow
 Do not warm too rapidly
– BEWARE “afterdrop”
 If warm-water submersion is not available, use
naked-buddy treatment in a sleeping bag
– BEWARE: monitor buddy for hypothermia
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Other Cold Weather Risks
 Dehydration – fluid loss to expiration & sweating
 Cold Diuresis – cold increases urinary output so
increase fluids 2L > normal amounts; Urine = Lt yellow
 Constipation –add fruit/fiber to induce BMs regularly
 Sunburn – skin is exposed to reflected rays from every
direction. Aggravated at high altitude.
 Snow Blindness – ultraviolet rays reflected from snow cause
sunburn to the eyes
 Eyes feel gritty  Pain that increases with eye movement 
eyes become teary and reddened  headaches (often)
Use sunglasses on bright days!
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Carbon Monoxide Poisoning
 When oxygen in the body is replaced by carbon
monoxide
 colorless, odorless, tasteless gas resulting from
incomplete combustion
 Inadequate ventilation
from engines, stoves,
and/or heaters
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UNCLASSIFIED
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Carbon Monoxide Poisoning
Symptoms
 headache
 dizziness
 weakness
 excessive yawning
 ringing in ears
 confusion
 nausea
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 bright red lips, eyelids
 grayish tint in dark-
skinned people
 drowsiness
 unconsciousness
 possibly death
Treatment
–move to fresh air immediately
––provide mouth-to-mouth resuscitation if victim is not breathing
-Use supplemental oxygen, if available
-Transport ASAP

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Valley Forge, December 1777