Everyone urged to prepare to reduce exposure risks

With temperatures expected to plummet in the next few days, Spokane Regional Health District is issuing a Health Advisory to warn the community about the dangers of exposure to cold conditions. Exposure to cold temperatures, whether indoors or outside, can cause serious or life-threatening health problems. Infants and the elderly are particularly at risk, but anyone can be affected. Extreme cold provides a dangerous situation that can result in health emergencies in susceptible people, such as those without shelter or who are stranded, or who live in a home that is poorly insulated or without heat.

"Taking preventive action is the best defense against extreme cold-weather conditions," said Bill Edstrom Epidemiologist for the Spokane Regional Health District. "By preparing for winter emergencies, the risks of weather-related health problems can be reduced. Knowing what to do is an important part of protecting your health and the health of others."

When winter temperatures drop significantly below normal, staying warm and safe can become a challenge. To avoid hypothermia and frostbite the following steps should be taken:

Limit exposure When the weather is extremely cold, and especially if there are high winds, try to stay indoors. Make any trips outside as brief as possible.

Dress Warmly and Stay Dry Adults and children should wear several layers of water-resistant, loose-fitting clothing along with a hat, mittens or gloves, and a scarf or knit mask to cover face and mouth. Wet clothing chills the body rapidly. Excess sweating will increase heat loss, so remove extra layers of clothing whenever you feel too warm.

Plan Ahead

• Have emergency supply kits for home and office
• Avoid prolonged exposure to the cold; seek a warm shelter
• Prepare your home for winter

Monitor Body Temperature Infants less than one year old should never sleep in a cold room, because (1) infants lose body heat more easily than adults; and (2) unlike adults, infants can't make enough body heat by shivering. Provide warm clothing for infants and try to maintain a warm indoor temperature. If the temperature cannot be maintained, make temporary arrangements to stay elsewhere.

Check on vulnerable people

• Check on elderly friends and neighbors frequently to ensure that their homes are adequately heated.
• Homeless people should seek shelter; outreach workers should monitor clients for exposure to the cold

Eat and Drink Wisely Eating well-balanced meals will help you stay warmer. Do not drink alcoholic or caffeinated beverages-they cause your body to lose heat more rapidly. Instead, drink warm, sweet beverages or broth to help maintain your body temperature. If you have any dietary restrictions, talk to your doctor.

Avoid Exertion Cold weather puts an extra strain on the heart. If you have heart disease or high blood pressure, follow your doctor's advice about shoveling snow or performing other hard work in the cold. Otherwise, if you have to do heavy outdoor chores, dress warmly and work slowly. Remember, your body is already working hard just to stay warm, so don't overdo it.

Understand Wind Chill The Wind Chill index is the temperature your body feels when the air temperature is combined with wind speed. It is based on the rate of heat loss from exposed skin caused by the effects of wind and cold. As the speed of the wind increases, it can carry heat away from your body much more quickly, causing skin temperature to drop. When there are high winds, serious weather-related health problems are more likely, even when temperatures are only cool.

Serious health problems can result from prolonged exposure to the cold. The most common cold-related problems are hypothermia and frostbite.

Hypothermia With prolonged exposure to cold temperatures, your body can begin to lose heat faster than it can be produced. The result is hypothermia, or abnormally low body temperature. Body temperature that is too low affects the brain, making the victim unable to think clearly or move well. This makes hypothermia particularly dangerous because a person may not know it is happening. Hypothermia is most likely at very cold temperatures, but it can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or submersion in cold water.

Victims of hypothermia are often (1) elderly people with inadequate food, clothing, or heating; (2) babies sleeping in cold bedrooms; (3) people who remain outdoors for long periods-the homeless, hikers, hunters, etc.; and (4) people who drink alcohol or use illicit drugs.

Recognizing the warnings signs of hypothermia:

• Adults: shivering, exhaustion, confusion, memory loss, slurred speech, drowsiness
• Infants: bright red, cold skin, very low energy

What to do if you notice any of these signs:

Hypothermia is a serious medical condition and requires emergency medical assistance. Take the person's temperature; if it is below 95°, the situation is an emergency-get medical attention immediately. If medical care is not available, begin warming the person, as follows: Get the victim into a warm room or shelter. If the victim has on any wet clothing, remove it. Warm the center of the body first-chest, neck, head, and groin-using an electric blanket, if available. Use skin-to-skin contact under loose, dry layers of blankets, clothing, towels, or sheets.

Frostbite Frostbite is an injury to the body caused by freezing. Frostbite causes a loss of feeling and color in affected areas. The risk of frostbite is increased in people with reduced blood circulation and among people who are not dressed properly for extremely cold temperatures.

Recognizing frostbite

• White or grayish-yellow skin area
• Skin that feels unusually firm or waxy, numbness (a victim is often unaware of frostbite until someone else points it out because the frozen tissues are numb).

What to do about frostbite:

At the first signs of redness or pain in any skin area, get out of the cold or protect any exposed skin-frostbite may be beginning. If you detect symptoms of frostbite, seek medical care. If (1) there is frostbite but no sign of hypothermia and (2) immediate medical care is not available, proceed as follows: Get into a warm room as soon as possible. Unless absolutely necessary, do not walk on frostbitten feet or toes.

Immerse the affected area in warm-not hot-water (the temperature should be comfortable to the touch for unaffected parts of the body). Or, warm the affected area using body heat, for example, the heat of an armpit can be used to warm frostbitten fingers. Do not rub the frostbitten area or massage it at all. Don't use a heating pad or the heat of a stove, fireplace, or radiator for warming. Affected areas are numb and can be easily burned.

These procedures are not substitutes for proper medical care. Hypothermia is a medical emergency and frostbite should be evaluated by a health care provider.

Carbon Monoxide Poisoning Another risk during cold weather is that of carbon monoxide poisoning, which can happen during power outages when people attempt to heat their environments with sources of heat not intended for indoor space heating purposes. More information on carbon monoxide poisoning and extreme cold can be found at: www.cdc.gov