All Commandos take part in exercises in Arctic environments at some point in their career as the UKs Cold Weather Warfare Specialists.
Being able to survive these elements as well as skiing exceptionally long distances carrying crushing weight is taught and practiced in this unforgiving environment.
Before fledgling Commandos deploy to Norway they regularly use inhospitable parts of Scotland as a beat and training ground.
Scotland, due to its varied weather and unforgiving terrain, is seen as a good proving ground to test and evaluate student’s ability to progress to ‘full on’ Arctic environment.
If you can survive Scotland in winter you can survive anywhere, so the adage goes.
Make no mistake, Scotland’s Munros can change in character almost at the flick of a switch. With this in mind we carry on with our series of Cold Weather Injuries that can and will occur if care is not taken.
Frostbite
Frostbite is a freezing or partial freezing of the body, usually the extremities, such the face hands and fee.
Frostbite is divided into two categories: superficial frostbite (known as frostnip) and deep frostbite. The only difference between the injuries is how deep they are and how they respond to self help treatment.
If you have been following previous articles you will be aware that when the body is exposed to extreme cold its natural defence is to constrict blood flow to the extremities to conserve heat and function of the bodies vital organs. This makes it harder than normal to heat the hands and feet in particular and they become prone to freezing.
Frostnip
Frostnip occurs when the skin starts to freeze. Ice crystals will start to freeze between layers of tissue. It is a temporary condition. You need to recognise it early to treat it.
If you can quickly rewarm it normal colour and sensation will return within 30 mins then there will not be any lasting damage.
The affected area will need to be monitored as it may be susceptible in the short term for further bouts of frostnip.
Signs And Symptoms
It occurs on exposed skin.
Numbness and blanching of the skin. It can look like white blocks on the affected area.
There may a cessation in feeling of cold or pain and discomfort.
The above is only temporary if treated quickly.
Frostnip will not progress to full blown frostbite if treated.
Treatment
The only way to treat Frostnip in the field is to rewarm the affected area, usually with direct body heat. Rewarming fingers, ears, nose etc. is pretty straightforward.
Simply press the cold part against a warm part of the body. An affected finger can be rewarmed inside the palm of your hand inside a mitt. You can do the same inside gloves but it is harder.
It is advisable to always have a spare pair of hand wear. One pair gloves and one pair warm mitts to guard against loss and also to assist in rewarming.
Treating frostnip on toes is more problematic. This takes self discipline to wiggle them and exercise them to get blood pumping. The next stage up is placing them under a partner’s armpit!! Hard to do on the hill when moving…
As long as full feeling returns within 30 mins there will be no lasting damage. It was pretty common when I was a Marine on gruelling exercises within the Arctic Circle and was seen as part and parcel of cold weather operations.
Onset of Frostnip is a warning sign that the conditions for more serious cold weather injuries are present.
Deep Frostbite
In deep frostbite the tissues are frozen and the blood supplies to the affected area severely impaired or even absent. This can affect muscle, tendon, nerves and bone and can lead to tissue loss.
Deep frostbite is more likely found after exposure to very low temperatures but can occur in less cold conditions as a result of prolonged exposure. This can be exacerbated by factors such as wet gloves or socks.
Signs and symptoms
Deep freezing injury extends deeper than the skin into the subcutis and musculature. The frozen part of the body is pale, hard and numb. The skin and musculature above the bone cannot be moved. The hardness is the result of tissue freezing to ice in the exposed area.
Early signs are:
· Affected part will feel very cold. May be painful
· If freezing continues tingling sensation followed by numbness
· Complete loss of feeling when part is moved
· Visual inspection reveals white blanched area blending into pink tissue. No clear demarcation and this still feels pliable
Later signs:
· Tissue becomes very white and wax-like in appearance. Usually distinct line demarcation between white and pink tissue.
· Total loss of sensation with hardened wooden feel to skin.
· Eventually (Usually after re-warming) skin may become bruised in appearance with the formation of blisters.
Treatment
If detected early then frostnip is the likely diagnosis and re-warming in the field should begin.
If the condition has not improved within 30 mins then a diagnosis of frostbite should be suspected and evacuation considered.
Shelter from the wind. Make sure patient is properly dressed.
Re-warm the affected part with the gloved hand or by placing in the armpit or under clothing.
DO NOT:
Rub the affected part.
Apply direct heat from vehicle exhaust, heater, stove or open fire.
Massage with snow.
Burst any blisters, as this will introduce infection.
If the condition is thought to be worse than frostnip, then re-warming should not be attempted in the field unless it can be guaranteed that the casualty will not be re-exposed to freezing temperatures and that during subsequent evacuation the affected part can be protected from further trauma. If frozen tissue is allowed to thaw and re-freeze then the outcome is considerably worsened. If the avoidance of the freeze-thaw-freeze cannot be guaranteed and self-rescue is the only option then the casualty may be allowed to walk or ski without re-warming the affected part.
It should always be remembered that frostbite is associated with whole body cooling and hypothermia must be given priority in the treatment. Always be aware that other less noticeable areas of the body may be affected by FCI. Consider other members of the party – if one is affected there is a high likelihood that others may also be victims.
Prevention
Handle equipment correctly. Do not handle metal with bare hands in cold weather for example.
Dress in accordance with weather.
Exercise face, fingers & toes.
Seek shelter before you are exhausted.
Eat & drink well. Hot drink and food is preferable.
Brush snow from clothing.
Keep feet clean & dry.
Carry spare socks & gloves.
If you shave, shave in the evening so as your skin has protective oils on it in the morning for that days activities.
If in a group keep an eye on each other for signs of cold weather injuries to exposed parts of the face etc.
Understand the wind-chill factor.
The hills in the winter are a fantastic playground but just because you are “only” in Scotland do not fall into a false sense of security. Take care of the little things and the big things take care of themselves.
Remember if you can walk the Munros confidently in all seasons you are well prepared to travel in any environment anywhere in the world.
Until next month happy walking and stay safe.
