By Chuck Nottingham
"You'll shoot your eye out!" isn't the only danger in Jean Shepherd's holiday classic "A Christmas Story."
Besides Red Ryder BB-gun ricochets, menacing bullies, theme-crazed teachers, anti-profanity soap, Santa and elves with attitudes, and the Bumpus' turkey-attack dogs lurks the sub-zero hazard of freezing one's tongue to the school flag-pole. Ouch!
Frost-bite is far from a fond winter memory. When skin or underlying tissues freeze, even after full recovery, once-frozen parts are ever after more susceptible to cold. In severe cases, cells die, gangrene may follow, and amputation may be necessary.
Like heat-burns, frostbite has three degree of severity:
"Frost-nip" is the first degree like sunburn at the other end of the spectrum. Lighter skin turns white, while darker skin turns grey. Frosted surfaces lose feeling and stiffen, but deeper layers of skin and tissue are still warm and soft.
Second-degree frostbite often needs medical attention due to blistering. Both whitened and greyish skin sometimes take on blue tinges. Although under-tissue remains undamaged, all layers of skin are frozen hard to the touch.
"Deep frost-bite" can be life-threatening and always requires medical treatment. Third-degree freezing involves both skin and musculature beneath.
Frostbite can happen fast on the Hi-Line, so tiny tots outdoors and those of us advanced in years both most vulnerable to frostbite should be examined closely when temperatures drop below 32EF or when winds boost effects of the cold. Equally at risk are folks with circulatory problems due to diabetes, atherosclerosis, or beta-blocker drugs.
Ears, noses, hands and feet are extremities most often exposed and where circulation is often poorest. Next places most common for frostbite are cheeks and chins.
First aid:
Move victims from the cold and wind to warm shelters.
Check for hypothermia cooling of the body's core. Hypothermia is a more serious threat to life, and must be treated first. When victims suffer from hypothermia, warming hands and feet first can be deadly.
Warm extremities slowly by skin-to-skin contact the victim's own or a warmhearted volunteer.
Chemically-activated heat pouches are good winter first-aid to keep on hand.
Fingers and toes may be immersed in warm water American Red Cross recommends 100E to 105EF. Immerse extremities for 20-30 minutes despite pain which is usual as frozen tissues rewarm. Use warm cloths to soak skin difficult to immerse.
After surface skin is thawed, bandage with sterile dressings to retain warmth and prevent further damage. Gently separate toes and fingers by sterile gauze in between, but avoid moving frostbitten parts.
For frostbite other than "frost-nip," get medical attention as soon as possible.
Never thaw skin that cannot be kept warm. According to Dr. C. Everett Koop at University of Maryland School of Medicine, "Refreezing may make tissue damage even worse."
Never expose frostbitten skin to radiating heat sources, such as fires, stoves, electric heating pads, hair driers, etc.
Never rub frozen skin. Any massaging, even with warm cloths or hands, can further damage frozen skin. The old "remedy" of rubbing with snow is very harmful.
Prevention:
Avoid smoking or drinking alcohol out-of-doors in winter, as both restrict circulation to skin and extremities.
Dress warmly in Montana. Boots should keep feet dry and be roomy enough for two pairs of wool socks. Mittens usually warm better than gloves. In bitter cold or winds, cover faces with scarves or ski-masks.
And always avoid sub-zero skin-to-metal, like tongues on flagpoles.
