Frostnip Bundling Up and Thawing Out
FROSTNIP Bundling Up and Thawing Out
You expect your child to be rosy-cheeked after playing outside in cold weather, but sometimes Jack Frost's nip is more serious than playful. When cheeks and fingertips turn bright pink, your child may just be a bit chilled. But overexposure to subfreezing temperatures and wet weather can lead directly to frostbite.
If your child has serious frostbite, you'll want her to get immediate medical attention, according to Susan Fuchs, M.D., assistant professor of pediatrics at the University of Pittsburgh School of Medicine and attending physician in the emergency department at the Children's Hospital of Pittsburgh. Frost-bitten skin is actually frozen and must be carefully thawed to avoid permanent damage. (See page 188.) And because kids are different from adults in their surface-to-body ratio and metabolism, they are more likely than adults to get frostbitten skin, according to Dr. Fuchs.
But often, an alert parent can detect the early warning signs. And when you find that your child is getting numb fingers and cheeks, it's essential to bring her indoors and get her warmed up before mild frostnip turns into frostbite.
So next time you meet winter weather or a windchill factor that makes you shiver, here are some hints to help you protect your child.
Treatment
Know the signs. Frostnip, the beginnings of frostbite, most often nips the cheeks, the tip of the nose and ears and the fingers and toes, says Dr. Fuchs, leaving them white and somewhat numb.
When your children are playing outside in the cold, call them in at regular intervals to warm them up with a hot drink and check for sodden mittens or freezing noses and cheeks. ''Children don't understand what numb skin means, and they may be unwilling to suspend play activities to warm up,'' says W. Steven Pray, Ph.D., a registered pharmacist and professor of pharmaceutics at Southwestern Oklahoma State University School of Pharmacy in Weatherford. This is where Mom or Dad steps in.
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| When to See the Doctor When to See the Doctor If your child is frostbitten, prompt treatment is crucial to avoid infection or possible loss of fingers or toes. You also need to be on the alert for hypothermia, a drop in body temperature caused by prolonged exposure to cold. Frostbite. ''If your child's skin appears white and waxy and feels numb and hard, like a wooden stump, take him to an emergency room as soon as you get him into dry clothes,'' says Karen Houpt, M.D., assistant professor of dermatology at the University of Texas Southwestern Medical Center in Dallas. If the feet are frostbitten, carry your child, says W. Steven Pray, Ph.D., a registered pharmacist and professor of pharmaceutics at Southwestern Oklahoma State University School of Pharmacy in Weatherford. Walking on frostbitten feet can damage them, he says. Don't rub frostbitten skin, adds Dr. Pray--and never rub snow on frostbitten skin. ''Don't attempt to thaw a frostbitten area if there's any possibility that it may refreeze,'' says Dr. Pray. ''If the tissues refreeze, the amount of skin damage increases.'' Hypothermia. When the body's temperature drops below 95°, it's a medical emergency that should be treated promptly by a physician, says Marcia Walhout, R.N., a clinical nurse specialist in the emergency depart-ment of Butterworth Hospital in Grand Rapids, Michigan, who has treated many hypothermia patients. How can you recognize it? ''A child exhibiting any strange behavior after exposure to extreme cold for an extended period of time needs medical attention,'' says Susan Fuchs, M.D., assistant professor of pediatrics at the University of Pittsburgh School of Medicine and attending physician in the emergency department at the Children's Hospital of Pittsburgh. Signs to look for include confusion, disorientation, sleepiness, apathy or paleness. ''If you suspect hypothermia, remove any cold, wet clothing and replace with dry clothing or warm blankets,'' says Dr. Fuchs. Be sure the arms, legs and head are covered, and get your child to the emergency room of the nearest hospital as quickly as possible. |
Take off the togs. ''As soon as you get your child indoors, remove all her wet clothing,'' recommends Marcia Walhout, R.N., a clinical nurse specialist in the emergency department of Butterworth Hospital in Grand Rapids, Michigan, who has treated many hypothermia patients. Wet clothes draw heat from the body, she notes--and the sooner you can get them off, the quicker your child will warm up.
Warm up slowly. One of the best ways to warm chilled body parts is in warm water. ''Fill a sink or tub with water just above body temperature--about 104° to 108°F,'' says Karen Houpt, M.D., assistant professor of dermatology at the University of Texas Southwestern Medical Center in Dallas. If the fingers or toes are chilled, ask your child to keep her hands or feet in the sink or tub until full feeling returns. This can take up to 15 to 20 minutes.
But don't let your child control the water temperature, because she may burn herself without knowing it. ''Higher temperatures can cause severe burns, because numb hands won't feel the heat,'' says Dr. Fuchs.
Handle with care. If you suspect frostbite, you can change your child's clothing and get her dry--but don't rub your child's hands or feet to help warm them. '' When the skin is frozen there are actually tiny ice crystals inside,'' explains Walhout. ''Rubbing the skin may cause those ice crystals to damage the cells, like little razors,'' she says.
Preventive Care
Choose the right fabrics. If you live in a cold climate, you'll probably find it worth your while to invest in special cold-weather gear for your children. Good choices include clothing made of polypropylene or other man-made fabrics that wick moisture away from the skin, water-resistant gloves or mittens, and wool or polypropylene socks, says Brian Delaney, who operates Whiteface Inn Cross-Country Ski Touring Center in Lake Placid, New York. Also choose snow boots with removable liners that can be dried out, suggests Delaney, who often takes his four young children on snowy outings.
Go for the layered look. ''Clothes worn in layers help trap the warmth,'' says Dr. Fuchs. Start with long underwear, then add a turtleneck and sweater under a water-resistant jacket. Because of the insulating effect of the trapped layers of air, this will keep your child a lot warmer than a heavy coat on top of a shirt.
Cover up. Pay special attention to extremities, says Dr. Pray. Mittens will keep small fingers warmer than gloves, and feet will stay warmer with wool or polypropylene socks. To help prevent frostbite above the neck, put a hat and scarf or a neck gaiter on your child, or a balaclava, a knitted mask that covers the face except for the eyes and mouth.
Consider windchill. Don't assume that your outdoor thermometer tells the whole story. ''It's not just temperature that determines how dangerous the cold is,'' says Walhout. '' Whipping wind causes the body to lose heat quickly.''
Try the buddy system. Assign each child a buddy and tell them to watch their buddy's ears, nose and cheeks for changes in color, says Dr. Fuchs. '' Your child may not know when her lips lose color, but her friend might see it,'' she says. ''And a buddy may just be able to step in when it's critical.''
