Health Matters with Dra. Denise: Cold Weather

Happy February! Cold enough for you?? Many pinoys remember their first winter in Manitoba—maybe the time they got their first parka, mitts, toque, and pair of deep winter boots. “Talaga bang lumalamig ng ganyang kalamig sa Manitoba? Opo, ang lamig!

While usually the cold can be an annoying inconvenience, it can also lead to more serious frostnip, frostbite or hypothermia.

– Frostnip is a mild form of frostbite, where only the skin freezes. Skin may appear yellowish or white, but feels soft to the touch. You may feel tingling or burning in the affected area.

– With frostbite both the skin and body tissue freeze, and there is permanent damage to the affected area. You may get a loss of feeling in the affected body part and get white, gray or blistered fingers, toes, ear lobes or nose tip.

– Hypothermia occurs when your body loses heat faster than it can produce it, causing a dangerously low body temperature; it is life-threatening and requires immediate medical attention. It occurs as your body temperature goes below 35 C (95 F) [Normal body temp is ~37 C (98.6 F)]. Hypothermia victims may experience uncontrollable shivering, drowsiness or exhaustion, confusion, fumbling hands, memory loss, or slurred speech. Infants may have bright red cold skin and very low energy. A person with severe hypothermia may be unconscious and may not seem to have a pulse or to be breathing.

Anyone not dressed properly for the weather is at risk. However, vulnerable groups at increased risk of frostbite and hypothermia include the elderly, infants and children, people with chronic medical conditions, newcomers to Canada, homeless people, people living in poorly insulated homes, outdoor workers and outdoor sports enthusiasts.

Immediate management

If you see someone with frostnip, remove the person from the cold to avoid frostbite. Warm the affected area gradually using body heat or warm water, and don’t re-expose it to the cold.

Get medical help immediately if someone has frostbite. Keep the person warm and dry, apply warm water to the frostbitten area(s), and cover exposed skin.

Avoid exposing the area affected by frostnip/frostbite to direct heat or rubbing/massaging it. This can damage the skin.

If you think someone may have hypothermia–especially if the body temperature is below 35 C (95 F), immediately call 911, and get medical help. Get the person to a warm location, and remove any wet clothing. Warm the centre of their body first – chest, neck, head and groin-using an electric blanket or skin-to-skin contact under a layer of dry blankets, clothing or other covering. Give warm, non-alcoholic beverages if s/he is conscious. Keep the person wrapped in a warm dry blanket, even if body temperature begins to rise.

Be prepared

• Check weather forecasts often; stay alert for weather warnings.
• Have a plan for power outages during the winter season. See: Keep an emergency kit at home in case of bad weather/a power outage. See:
• Make an emergency plan so family members know how to get in touch with each other.
• Checking to ensure your home’s heating system is working properly. Keep your thermostat at 12 C (55 F) or higher, even if you’re out of town, as lower temps can result in frozen pipes. You can help keep the heat in your home by keeping walls and attics well insulated, using caulking and weather-stripping on windows and doors, and installing storm windows or covering your windows with clear plastic.
• Check road conditions by calling Manitoba Highways at 511 or visiting
• Winterize your vehicle: keep your gas tank full, use winter tires and keep a well-stocked winter safety kit in your car. See:
• Regularly check on older/more vulnerable neighbours or relatives to make sure they have enough food, clothing and heat during the colder months.
• Remember the signs of frostbite and hypothermia, and who to call if you need help.
Stay warm
• Dress in warm, dry layers. Wear winter boots with good foot traction, a lined coat, mitts or gloves, a warm hat that covers your ears and scarf or neck warmer that can cover your nose.
• Keep your home warm with a properly installed and maintained heat source. If you can’t heat your home because of a power outage or other issue:
• Dress in layers, as you would if you were outdoors.
• Cover yourself with a blanket. Put your feet up if you can, as the air is colder near the floor.
• Keep moving. Try not to sit for more than an hour. Get up and walk around; make a hot drink. If walking is difficult, try moving your arms and legs while sitting or wiggling your fingers and toes.
• Stay with a friend/family member if you can. See if your community has warming shelters and how they can be accessed.
Stay safe
• Don’t overdo outdoor activity. Older adults and very young children should avoid prolonged outdoor exposure.
• Pay attention to your body. Be aware of the signs of frostbite and hypothermia; don’t ignore shivering — the first sign your body is losing heat. Persistent shivering is a signal to seek warmth.
• While walking, watch snow and ice to avoid falls. Consider using sand/an ice-melter on walkways around your home.
• Never leave infants/young children unattended. Make sure they are dressed for weather conditions.
• Never leave a fire or portable heat source unattended, check your smoke alarms regularly, and have a fire extinguisher nearby if possible. Never use your range/oven to heat your home. Only use the recommended fuel for portable heaters; using the wrong fuel can cause an explosion. Avoid burning paper, green wood or pine branches, since kindling can float up and cause a roof to catch fire.
• Have a properly installed carbon monoxide detector in your home. Properly maintain any fuel burning equipment such as furnaces, water heaters, boilers, stoves and other appliances that run on fuels such as wood, oil, propane or natural gas. See:
• Avoid traveling by car in bad weather or when roads are very slippery.
• Avoid unsafe areas, such as thin ice, or other hazards by sticking to the approved path when participating in outdoor activities.
• Enjoy winter activities with a friend. In an emergency, another person to offer immediate assistance could save a life.
• Avoid alcohol before going out in the cold. Alcohol increases blood flow to the arms and legs so can increase your risk of hypothermia. You may feel warm even though you’re losing heat.
• Bring house pets inside and animals/livestock to sheltered areas with non-frozen drinking water.

Kung may tinanim, may aanihin; health starts at home! Alagaan ninyo ang katawan at kalusugan ninyo! Take care, and mind your health!

About Dr. Denise Koh

Dr. Denise Koh is Manitoba’s Chief Occupational Medical Officer and Medical Officer of Health in Environmental Health and Emergency Preparedness. She is a Public Health specialist with additional training and experience in Family Medicine and Occupational Medicine. Follow her writing at: