Seems like a no-brainer question: Are there more in Denver or in Antarctica?
It came up when a group of emergency medical technicians who work in Antarctica came to Colorado for a burn and workshop.
The Antarctica group, already smirking because mid-November temperatures in Denver were markedly colder than they were in Antarctica (where it’s spring), just shrugged when University of Colorado Hospital clinical nurse educator, asked how many they see.
The answer: Not that many.
“We see some frostnip,” one of the EMTs said at last.
So, listen up, Colorado. Turns out that Denver has more cases of than Antarctica. Partly, that’s because there are more people here, but it’s also because in Antarctica, people routinely dress for the weather.
“They bundle up,” Saubli said.
“The people we’re seeing with frostbite (in Denver) aren’t prepared. They’re drunk, and they don’t realize they’re cold. Or they’re snowmobiling and get stuck, or in a car accident in the mountains without the supplies to bundle up. That happens a lot, and it can happen to anyone.
“The number of annual cases has been going up.”
Last year, University of Colorado Hospital’s burn trauma unit treated 19 in-patient cases of frostbite. From January to March this year, the unit saw 14 in-patient cases of frostbite. Early November’s cold snap resulted in at least four more cases.
“And that doesn’t count the outpatient visits,” Saubli said; there are more outpatient than inpatient visits.
Frostbite injuries are treated at the burn center because both frostbite and burns involve soft- tissue injuries. Wound care for burns and frostbite can be very similar. (That’s why the Antarctic EMTs spent a fair amount of time practicing diagnosis and treatment of burns.)
In Denver and other urban areas where temperatures regularly drop below freezing, and can fall below zero for days, frostbite poses a real danger, especially to men over age 40 who’ve been drinking alcohol — excessively.
“We treat a lot of alcoholics for frostbite,” Saubli said.
“They’ve been drinking, and your blood vessels dilate when you’re drunk, so you don’t realize that you’re dangerously cold. You don’t realize you need a jacket. The first sign of trouble is that you’re not shivering, which is a physical response that helps you warm up.”
In Denver or in the backcountry, frostbite can happen in 30 minutes or less. If the temperature is minus-5 or less, and the wind is blowing, frostbite can start in less than half an hour — less, if the wind is strong.
“Your hands and feet are most at risk, along with any other exposed flesh,” Saubli reminded the Antarctica EMTs, showing images of miserable people with purple noses and fingers that looked like claws dipped in black paint.
The relatively new drug , which was developed to treat blood clots in stroke and heart attack patients, can halt or reverse frostbite damage if administered within 24 to 48 hours of the injury. It works by dissolving what doctors theorize are clots caused by tiny ice crystals that form in blood cells and soft tissue, and prevent blood from circulating.
To protect yourself, dress in layers, as the Antarctic EMTs do. Those many layers trap air, helping retain body heat, and prevent external moisture, like splashes from a Zodiac boat bouncing on icy Antarctic waters, from seeping down to your skin.
Make sure boots and clothing are snug but not constricting enough to hamper circulation.
If you start shivering, tingling or notice numbness, it’s time to get warm, preferably by going indoors.
Frostnip (a deceptively benign term) affects earlobes, cheeks, fingers, nose and toes. The affected skin turns pale and tingles or goes numb. Ice crystals dissolve once the skin warms.
Most cases of frostbite affect the hands and feet, with about 10 percent of frostbite cases extending to nose, cheeks, ears and other extremities. The skin turns white or gray, and looks waxy. Blisters develop, ballooning around fingers and toes.
Once the flesh under those blisters starts to discolor, amputation becomes a possibility, although T-PA may help if treatment comes in time.
If you know you’ll be out in very cold conditions, like snowmobiling or cross-country skiing in the backcountry, pack lunch and the : A map of the area and a compass for navigation; sunglasses and sunscreen; extra clothing for insulation; a headlamp or flashlight; first-aid supplies; a fire-starter (waterproof matches, lighter and candle); extra food; extra water; an emergency shelter (a space blanket can do); and a repair kit and tools.
“Remember, it doesn’t take long,” Saubli warned.
“At negative-5 to negative-10 degrees, with a 35-mile-per-hour wind, it can happen in 10 minutes.”
Claire Martin: 303-954-1477, cmartin@denverpost.com or twitter.com/byclairemartin
