The Importance of Recognising Cold Injury in the Armed Forces

Cold injuries, such as non-freezing cold injuries present significant risks in cold weather environments, particularly for those serving in the armed forces. These injuries result from prolonged or intermittent exposure to low temperatures and can severely impact body temperature and skin tissues. Recognising these injuries promptly is critical, not only for the immediate health and safety of military personnel but also for their long-term wellbeing.

This piece highlights the importance of awareness, early detection, and the necessary steps to take following exposure to cold conditions. Understanding these elements is crucial for ensuring armed forces members are adequately protected and supported in cold environments.

Understanding Cold Injuries

In the armed forces, personnel are frequently exposed to extreme weather conditions, making understanding the distinctions between different types of cold injuries vital. Freezing and non-freezing cold injuries are two primary categories that can significantly affect health and operational effectiveness.

Freezing Cold Injuries

These occur when skin and other tissues freeze, commonly known as frostbite. It typically affects extremities such as fingers, toes, ears and the nose, which are more susceptible to temperature drops. Early signs include numbness, loss of colour, and hardening of the skin. If untreated, frostbite can lead to severe and permanent damage to skin tissues, necessitating medical intervention.

Non-Freezing Cold Injuries

Unlike frostbite, non-freezing injuries, , result from prolonged exposure to cold but not freezing temperatures. These conditions are insidious and can damage skin and underlying tissues without actual ice forming in the skin. Symptoms include swelling, pain and changes in skin colour. Keeping the body warm and dry is key in preventing these injuries, as wet conditions can impact their severity.

Hypothermia

Hypothermia - a drop in core body temperature - is another serious risk associated with cold exposure. It can manifest rapidly, impairing cognitive and physical functions, requiring immediate action to restore body temperature.

Risk Factors in the Armed Forces

Members of the armed forces are uniquely susceptible to cold injuries due to the nature of their duties, which often involve prolonged or intermittent exposure to harsh conditions. Understanding these risk factors is essential for prevention and ensuring personnel remain healthy and operationally effective in cold environments.

1. Environmental exposure: military operations can take place in diverse climates, from arctic conditions to wet, windy environments. Such settings increase the risk of both freezing and non-freezing cold injuries. Soldiers may face prolonged exposure to cold weather without adequate shelter, increasing their susceptibility to these conditions.
2. Inadequate clothing and gear: proper cold weather clothing is essential for keeping the body warm and dry. Insufficient or inappropriate gear can leave personnel vulnerable to the cold, as it fails to maintain core temperature or protect against wet conditions. The lack of suitable clothing can rapidly accelerate the onset of cold injuries.
3. Wet conditions: exposure to moisture, whether from perspiration, wet clothing or environmental factors, significantly heightens the risk of non-freezing cold injuries. Wet skin loses heat faster than dry skin, making maintaining body temperature challenging in cold weather.
4. Physical fatigue and dehydration: exhaustion can impair the body's ability to generate heat, making fatigued soldiers more prone to cold injuries. Similarly, dehydration - often overlooked in cold environments - can contribute to decreased blood circulation, further lowering the body's resistance to cold.
5. Previous cold injuries: individuals who have previously suffered from cold injuries are at a higher risk of subsequent incidents. Past injuries can result in long-term sensitivity and decreased blood flow to affected areas, increasing susceptibility.
6. Lack of acclimatisation: soldiers not adequately acclimatised to cold environments may experience a greater risk of cold injuries. Acclimatisation allows the body to adjust to colder temperatures over time, improving its ability to maintain core temperature and circulation in cold conditions.

Recognition and Immediate Actions

Early recognition of cold injuries is crucial in the armed forces, where rapid response can prevent long-term damage and ensure the safety and readiness of personnel. Knowing the signs and immediate steps to take is essential for all members operating in cold environments.

Recognising the Symptoms:

1. Frostbite: look for the telltale signs of frostbite, including loss of feeling in affected areas, skin appearing waxy, hard or discoloured (white, grey or bluish). The extremities are most commonly affected, so paying particular attention to fingers, toes, ears and the nose is critical.
2. Non-freezing cold injuries: be alert for symptoms such as prolonged numbness, tingling or pain in the extremities, skin that appears red and then turns pale, or swelling. These signs might develop over days and can be subtle at first.
3. Hypothermia: recognise the early symptoms, including uncontrollable shivering, slurred speech, clumsy movements, fatigue and confusion. As hypothermia progresses, shivering may stop; this is a sign that the condition is worsening and requires immediate action.

Immediate Actions:

1. Move to a warm area: the first step is to remove the person from the cold environment, if possible, or shield them from the elements to prevent further exposure.
2. Remove wet clothing: wet clothing accelerates heat loss. Replace wet garments with dry, warm clothing to help restore body temperature.
3. Gentle rewarming: for frostbite, gently warm the affected areas. Do not rub or apply direct heat, as this can cause further damage. Use body heat or warm water (not hot) for rewarming.
4. Avoid walking on frostbitten feet: walking can cause more damage to frostbitten tissues. Keep the affected areas elevated to reduce swelling.
5. Seek medical attention: all suspected cases of frostbite, non-freezing cold injuries and hypothermia require professional medical evaluation as soon as possible. Early medical intervention can significantly impact the outcome.
6. Stay hydrated and energised: provide warm, sweet beverages (avoiding caffeine and alcohol) to help increase the body's energy production and warmth. High-energy foods can also aid in warming the body.

Medical Assistance

Immediate and appropriate medical assistance is crucial when dealing with cold injuries in the armed forces. Early intervention can prevent the progression of injuries and lead to better recovery outcomes. Here are key points regarding medical assistance for cold injuries:

1. Immediate care: if a cold injury is suspected, the affected individual should receive first aid as outlined in the recognition and immediate actions section. This includes moving to a warmer area, removing wet clothing, and gently rewarming the affected parts of the body.
2. Professional evaluation: all cases of suspected cold injuries should be professionally evaluated as soon as possible. Medical professionals can assess the severity of the injury, provide necessary treatment, and recommend further care, including hospitalisation if required.
3. Follow-up care: ongoing care may be necessary for severe cold injuries. This can include physical therapy, medication, and other treatments to promote healing and manage symptoms. Service members should follow all medical advice and attend all scheduled appointments.
4. Reporting and documentation: it is essential to document the incident and medical care received. This documentation is crucial for medical follow-up and can be important for any legal claims related to the injury.

Legal Rights

Service members who have suffered cold injuries due to conditions encountered while serving may have legal rights to compensation and support. Understanding these rights is important:

1. Legal assistance: individuals affected by cold injuries should consider seeking legal assistance to understand their rights and options. Legal professionals specialising in personal injury and military cases can provide valuable guidance.
2. Compensation claims: if the cold injury occurred due to negligence or lack of proper equipment, the affected service member might be entitled to compensation. This can include costs for medical treatment, rehabilitation and loss of earnings.
3. JMW’s role: JMW Solicitors can offer expert legal advice and support to armed forces personnel who have suffered cold injuries. We can assist with assessing the case, filing a claim, and navigating the legal process to seek the compensation and support deserved.
4. Confidentiality and support: legal processes can be daunting, but JMW provides a confidential and supportive environment to discuss the circumstances of the injury and explore legal avenues. Our expertise can help ensure that service members are fully aware of their rights and receive the necessary legal representation.