By Ellen Goldbaum

David M. Holmes, MD, clinical associate professor of family medicine, has plenty of advice on how to ride out the storm safely. Holmes directs the Jacobs School’s global health education program and is an expert in wilderness medicine; he also leads UB medical students on medical relief trips to remote parts of the world. He sees patients at UBMD Family Medicine.

Staying indoors is obvious, but can’t be emphasized enough. Older adults and young children are more sensitive to temperature changes in the environment and can lose body heat fast, faster than average adults. As a result, they are more susceptible to hypothermia. Normal body temperature is 98.6°F. However, if it drops, even just a few degrees to 95°F or lower, it can cause many health problems, such as heart attacks, kidney and liver damage, and death. Therefore, it is important during extreme cold snaps to keep your home warm.

The National Institute on Aging (NIA) has good recommendations for older adults, which are also applicable to all age groups. They include:

• Set the thermostat to 68°F or higher, assuming no outage has occurred. Lower temperatures indoors could gradually create chilly conditions and if sustained for long periods could even lead to hypothermia. (Resources that might help with heating bills are available through the National Energy Assistance Referral service at 1-866-674-6327.)
• Close off rooms not in use.
• Keep the basement door closed.
• Keep blinds and curtains closed to decrease heat loss through windows. If there are gaps around the windows, use weather stripping or caulk to keep the cold air out.
• Stuff towels or rags in cracks under doors to prevent drafts.
• Stay in rooms with southern-facing exposure.

• Dress warmly even indoors. Wear socks and slippers.
• When going to sleep, wear long underwear and use extra covers.
• Eat enough food to keep weight up. Food provides the body with energy for producing its own heat.
• Drink plenty of water and non-alcoholic drinks to prevent dehydration since cold air is very dry.
• Alcoholic drinks can cause the loss of body heat, so drink moderately or not at all.
• Wear layers of loose-fitting, lightweight, warm clothing, but remove layers to avoid overheating, perspiration and subsequent chill.
• Stay in touch with family or friends to check in during the storm.
• Shoveling is never recommended for older adults and those with underlying health conditions. The combination of overexertion and cold puts older people at high risk for heart attacks when shoveling snow.

• Bundle up with layers of warm clothes, including a warm hat that covers the ears and warm wool mittens, which keep hands warmer than gloves.
• Dressing in layers is always best because the air in between the layers provides added insulation.
• Consider wearing a COVID-19 face mask outside as it reduces loss of warm air from the mouth and nose.
• Consider wearing a scarf around the neck and face so that only the eyes are exposed.
  

It depends on wind chill. A temperature of zero degrees Fahrenheit and a wind speed of 15 mph makes it feel like -19 degrees. Under this condition, frostbite can occur in 30 minutes. If the temperature is -20 degrees and wind speed is 15 mph, then the wind-chill temp is -45 degrees and frostbite can take place in 10 minutes. With expected wind speeds this storm of 40 to 50 mph and gusts even higher, frostbite could happen much sooner.

Frostbite is an injury to the body that is caused by freezing. It results in a loss of feeling (numbness, tingling), aching and loss of color in the affected areas. It usually affects toes, fingers, nose, ears, cheeks and chin. It can permanently damage body tissues and in severe cases may lead to the need for amputation. Never rub an area of the body that may have frostbite, as that may cause skin damage.

Hypothermia is a medical emergency when the body loses heat faster than it can produce it. Drinking alcohol and being wet can cause hypothermia to occur more quickly. Increased body fat adds extra insulation (one of the few health benefits of obesity).

Being wet is a significant problem since water conducts heat away from the body 25 times faster than air. Therefore, hypothermia develops much more quickly. According to the U.S. Coast Guard, if you fall into water that is 33-40 degrees, you’ll likely become exhausted or unconscious in 15-30 minutes and likely will die in 30-90 minutes.

Symptoms of hypothermia are:

• Feeling cold to the touch especially in hands and feet, pale skin, shivering, slower speech, slurring words, confusion, making irrational decisions (such as going outside with few clothes on), problems with balance.
• Symptoms of advanced hypothermia include slow heartbeat, shallow breathing, and loss of consciousness. Call 9-1-1 immediately if anyone has these symptoms.
• Before medical help arrives, try to warm the person with blankets and coats and warm liquids, such as hot chocolate.

If someone is on home dialysis and/or oxygen, it’s important to have a back-up generator in case the power goes out. It’s also important for people on oxygen to have a back-up oxygen tank that doesn’t require electricity for use. They should register with the power company ahead of time so that they can get priority in restoring service. If the restoration of power is delayed beyond 2-3 days, or there is increased shortness of breath, the patient should be taken to the nearest emergency room, either by someone who has a vehicle with all-wheel drive or call 9-1-1 for an ambulance.