Wintertime Dangers: Frostbite, wearing coats with car seats

What is frostbite?

Frostbite is literally the freezing of body tissue (usually skin). Fingers, toes, ears, and the nose are the areas most vulnerable to frostbite.

There are three degrees of frostbite, including:

    - Frostnip, which usually affects the face, ears, or fingertips. While the skin may feel numb, frostnip does not lead to permanent tissue damage.
     - Superficial frostbite, in which the outer skin is affected.
     - Deep frostbite, in which the skin and underlying tissue freezes. Permanent damage is possible, depending on how long and how deeply the tissue is frozen.

Frostbite is caused by either prolonged exposure to cold temperatures or shorter exposure to extremely cold temperatures.

What are the symptoms?
Many people with frostnip or frostbite experience numbness. A "pins and needles" sensation, severe pain, itching, and burning are all common when the affected area is warmed and blood starts flowing again.

Skin may look white, grayish-yellow, or even black with severe frostbite, and it may feel hard, waxy, and numb. Blistering is also common.

Who is at risk? Anyone can end up with frostbite if exposed to frigid conditions for too long. Naturally, those who work outside in the cold or engage in cold-weather sports may be vulnerable if they aren't adequately prepared.

But some people are also more susceptible to extremely cold weather than others, including:

    The very young and the very old.
    Diabetes patients and people with other medical conditions associated with poor circulation.
    People with heart conditions who take beta-blockers, which decrease the flow of blood to the skin.
    Those who smoke and/or drink alcohol while exposed to cold weather.

Wearing wet clothes, not wearing enough clothes, and exposure to high winds increase vulnerability. Even people who think they are prepared for the cold weather may not be. 

What are the treatments for frostnip/frostbite?
Get out of the cold and get out of wet clothing as soon as possible and remove all constrictive jewelry and clothing. Then immerse the affected area in warm, but not hot, water. Warm water is the gentlest and safest way to warm frostbitten skin. 

If water is not available, warm the tissue with body heat. For example, warm your hands by tucking them into your armpits and warm your nose, ears, or face by covering them with dry hands.


    Thaw the frostbitten tissue if there is a chance that it will refreeze before you get medical attention, as this increases the likelihood of permanent damage.
    Rub or massage frostbitten skin or disturb blisters, which can further damage tissue.
    Use direct dry heat, like heating pads or a campfire to thaw frostbitten tissue.

Many people with frostbite may also be experiencing hypothermia (body temperature that is too low), which can be deadly. This is why it is so important to seek medical attention immediately.

How can I stay safe?

Extreme cold, high winds, wet clothing, and poor planning all contribute to cold-weather injury.

     - Check the weather forecast before going outside.
     - Wear adequate clothing, wear several layers of clothing, with the innermost layer being a fabric that wicks moisture from the skin. The outer layer should serve as a windbreaker.
     - Mittens provide more protection than gloves. Wearing two pairs of socks is advised, with wool recommended for the outer later. And don't forget a hat and scarf that covers the ears.
     - Get moving. Increasing physical activity will help your body stay warm. Wiggle fingers and toes if they start to feel numb.
     - Don't drink alcohol before or during cold weather exposure, since alcohol may prevent you from realizing that your body is becoming too cold.
     - Don't smoke. Smoking constricts blood vessels and increases the risk for frostbite.

Dangers of Car Seats and Coats

As temperatures start to dip we bundle our children up to prepare them for the elements, but even with good intentions, a bulky coat and a car seat is a dangerous combination.

We all want to keep our children warm while traveling in the car, but there are ways to safely transport children in the cold weather while still keeping them warm.

As a general rule, winter coats should not be worn underneath the harness of a car seat. A bulky coat under a child seat harness can result in the harness being too loose to be effective in a crash. Here is a simple way to check if your child's coat is too big and bulky to wear under their harness:

    Put the coat on your child, sit them in the child seat and fasten the harness. Tighten the harness until you can no longer pinch any of the harness webbing with your thumb and forefinger.

    Without loosening the harness, remove your child from the child seat.

    Take the coat off, and put your child back in the child seat and buckle the harness straps, which are still adjusted as they were when he was wearing the coat.

    If you can now pinch the webbing between your thumb and forefinger, then the coat is too bulky to be worn under the harness.

If you find that the coat can not be safely worn under the harness, here are a couple things you can do to keep your child safe and warm in his/her child seat:

    After securing your child in his/her child seat, turn the coat around and put it on backward with their arms through the arm holes and the back of the coat acting like a blanket

    Lay a blanket over your child to keep him/her warm.

One of the most common misuse conditions seen in child seats is that the harness is too loose and wearing a big winter coat under the harness is just one of the potential causes.

It is very important that the harness is tight enough that you can't pinch the webbing between your thumb and forefinger. Extra slack in the harness can be very dangerous; it can lead to too much excursion or even ejection during a crash.

These tips should help keep your precious little ones safe and warm this winter.

Tips for Parents

Still, when it's 10 degrees outside, you're not likely to bring your child outside without any coat at all. Here are some tips that might work for you:

     - Cover them up. On a cold but not freezing day, you might want to replace your child's coat with a blanket once you get to the car. 
     - Try a poncho. If you sew, or you can purchase a car seat poncho that goes over the straps in the front and over the car seat in the back. 
     - Layer. While even the thinnest winter coats are unsafe to wear under a car seat's straps, you can dress your child in a fleece jacket or a sweatshirt, covered by a coat. In the car, just take off the coat but keep on the thinner layer underneath to take the chill off until the car warms up.
    - Don't ditch the coat. Instead, after buckling in your child, put your child's arms through the sleeves and let her wear the coat backwards.
     - Use car seat covers for infant seats. Just make sure to choose the kind that only have material over the harness, rather than those that go under the baby. 

At the end of the day, no one will pretend that it's not easier to just strap your child in with her coat on. Yes, it's frustrating and time consuming to juggle kids and diaper bags and keys and coats for a short drive to the store. But the fact is, most crashes happen close to home. 

So next time you go out on a cold winter day, find an alternative to squeezing your child's winter coat into the harness. Your child's safety is at stake.

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