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6 Frostbite frostbite is both a general and medical term given to areas of local cold injury Unlike <br /> systemic hypothermia,frostbite rarely occurs unless the ambient temperatures are less than freezing <br /> ' and usually less than 20F Symptoms of frostbite are a sudden blanching or whitening of the skin, the <br /> skin has a waxy or white appearance and is firm to the touch, tissues are cold, pale, and solid <br /> ' Prevention of cold related illness can be aided by educating workers on recognizing the symptoms of <br /> frostbite and hypothermia and by identifying and limiting known risk factors The workers should be <br /> provided with enclosed, heated environments on or adjacent to the site, dry changes of clothing, and warm <br /> ' drinks <br /> To monitor the worker for cold related illnesses, start(ora!) temperature recording at the job site <br /> 0 At the field team leader's discretion when suspicion is based on changes in a worker's performance <br /> or mental status <br /> ■ At a worker's request <br /> m As screening measure,two times per shift, under unusually hazardous conditions (e g , wind-chill less <br /> than 20°F, or wind-chill less than 30°F with precipitation) <br /> ' ■ As a screening measure whenever any one worker on the site develops hypothermia <br /> Workers developing moderate hypothermia (a core temperature of 92'F) should not return to work for at <br /> ' least 48 hours <br /> Table 3 Pro ressive Clinical 5 m toms of Hypothermia <br /> Core <br /> Temperature <br /> (0 F Symptoms <br />' 99 6 Normal rectal temperature <br /> 968 Metabolic rate increases <br /> 950 Maximum shivering__ <br /> 932 Victim conscious and responsive <br /> 91 4 Severe hypothermia <br /> 896 - 878 Consciousness clouded, blood pressure difficult to obtain, pupils dilated but react <br /> tto light, shivering ceases <br /> 860 -842 Progressive loss of consciousness muscular rigidity increases, pulse and blood <br /> pressure difficult to get respiratog rate decreases <br />' 788 Victim seldom conscious <br /> 644 Lowest accidental hy2othermia victim to recover <br /> 1 <br /> FLUOR DANIEL GTI 90 <br /> 1 <br />