Cold Weather Policies

Who has updated their cold weather policy and procedures during this cold front across the US?

Frostbite occurs when tissue freezes, affecting exposed skin like the nose, ears, and cheeks, as well as hands and feet due to vasoconstriction. Early symptoms in hands and feet include numbness or a "wooden" feeling, while facial frostbite may cause a burning sensation. Re-warming is painful and can lead to a loss of light touch. The risk of frostbite rises as temperatures drop, especially with wind chill below -18°F, which can freeze exposed skin in 30 minutes. Precautions and policies can help reduce risk, and wind chill apps are available for calculation.

Hypothermia occurs when core temperature drops below 95°F. Early signs include shivering, cold feelings, apathy, and impaired performance, which can be mistaken for other conditions such as a concussion, hypoglycemia or drug use. As the core temperature falls, confusion, slurred speech, and irrational behavior occur, with severe hypothermia potentially leading to cardiac arrest. Resuscitation efforts should continue until re-warming is achieved.

Risk Management

Assess environmental heat loss risk: temperature, wind, rain, solar load, immersion, altitude. Be alert to changes in these factors. Athletes should be advised to modify clothing or seek shelter. Event managers can consider shortening, moving or cancelling an event. Wind chill temperature index (WCT) integrates temperature and wind to estimate cooling power. The WCT predicts the risk of frostbite to exposed facial skin in a person moving at walking speed.

Assess athletes’ risk factors: exercise demands, fitness, fatigue, health, body fat, hydration and nutritional status.

Hypothermia - Conscious, remove wet/damp clothing and insulated with whatever warming material is available. If possible, evacuate to a warm building/car/shower. Encourage the drinking of large volumes of warm, sweet liquids to improve circulating volume and available energy for exercise

Hypothermia - Comatose, insulate and transported emergently. Field re-warming and field CPR are usually ineffective and only delay transport to a medical facility for rapid core re-warming and comprehensive care.

Frostbite: Seek shelter and insulation to maintain core temperature. Reverse vasoconstriction by re-warming. Re-warming is best accomplished with 1) body heat – the victim’s or someone else’s body heat 2) warm water 104-109 degrees F. Warmer water produces greater injury, swelling and tissue death.

References

Keller, C. Guidelines for Competition in the Cold. NFHS. 2014. nfhs.org/articles/guidelines-for-competition-in-the-cold/

Capperat, T. et al. National Athletic Trainers’ Association Position Statement: Environmental Cold Injuries. Journal of Athletic Training 2008;43(6):640–658