Kids in winter on sleds

A high-impact winter storm carrying wind chills as low as -13 degrees hit the region recently. The need to protect pets and stay indoors is paramount, but according to public health experts, the most vulnerable among us are also the youngest.

Dr. Lewis First is a pediatric hospitalist at the University of Vermont Children’s Hospital. He says that children are at greatest risk for frostbite because they lose heat from their skin more rapidly than adults. This, combined with the fact that they are reluctant to stop playing out in the cold, makes them particularly susceptible to harsh winter conditions.

“Frostbite is literally frozen body tissue — usually skin but sometimes it can involve even deeper tissues such as muscles and bones. It occurs when ice crystals form in the skin and deeper tissues. Air temperature, length of time in the cold, wind chill, dampness, and the type of clothing that is being worn can determine the severity of frostbite,” says First.

According to First, the mildest and earliest form of frostbite is called “frostnip.” It affects small areas of the exposed body such as the cheeks, nose, ears, fingers, and toes, leaving them red and tingly. If treated when it occurs, it does not result in permanent tissue damage.

Full blown frostbite requires medical attention.

“This is characterized by skin that may be initially red but then turns white, waxy, numb and hard. The skin will burn, become numb, blisters or sores may appear on the skin and as tissue dies from frostbite, the skin will turn black and become what we call necrotic,” says First.

Here are Dr. First’s recommendations if you notice frostbite:

— Bring your child inside. Remove all wet clothing and put on dry ones. Do not try to thaw out frostbite unless you are in a warm place—ideally the emergency department. If their feet are affected, carry them and don’t have them walk.

— Wrap your child in warm blankets, but do not use direct heat such as a heating pad — this may burn the numb skin. Don’t rub frostbitten skin and do not rub snow on it. Provide a warm drink to help them warm up.

— If only a small area is red and tingly (frostnip) you can put the chilled body part in warm, not hot, water for 15 to 20 minutes (so the skin doesn’t burn or blister from the heat) until normal sensation occurs and the skin appears pink. If you think it’s more than frostnip, don’t rewarm the skin yourself. If rewarming at home doesn’t help or makes things worse, seek emergency medical assistance.

— Put sterile dressings (or at least clean cotton or gauze) over the area where there may be blistering but try not to pop the blisters, and you can do the same between fingers and toes if they are affected. Please seek emergency care.

But Dr. First says the best way to treat frostbite is to prevent it from occurring in the first place.

To prevent frostbite, First recommends these steps:

— Dress your child in layers and only remove layers if your children are too hot. Choose fabrics other than cotton since cotton does not keep you very warm — thermal or woolen underwear is a great first layer. Heavy socks and waterproof boots are a must.

— Keep their heads covered to prevent loss of lots of body heat off the top of their heads — along with scarves, face masks (not just masks to cover the mouth during the pandemic), ear muffs, mittens or gloves.

— Keep your child hydrated to keep blood circulating to the end tissues like tips of fingers and toes.

— Set time limits on outdoor play in the cold. When children come inside, get them out of their wet clothing or shoes as soon as possible.

— Then give them a warm snack or drink.

He says that if your children begin to shiver or their teeth chatter and if they feel dizzy or weak, or if they can’t feel their fingers, toes, cheeks, ears or nose, then they need to come in and warm up right away.

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