EPHT – Hypothermia | Missouri Department of Health and Senior Services

Hypothermia (also known as cold-related illness or cold stress) happens when cold weather or other cold exposure causes body temperature to drop below normal. Hypothermia is dangerous and can quickly become life threatening. The Missouri Environmental Public Health Tracking (EPHT) Program shares data on cold-related deaths in Missouri.

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Get the Facts | From 2010 - 2023, there were 466 cold-related deaths in Missouri.

Be Safe, Aware, and Prepared for Cold Weather

Hypothermia can happen to anyone exposed to cold temperatures. It can happen indoors as well as outdoors, especially when someone isn’t properly clothed or lives in a poorly heated home. Hypothermia can also happen when a person becomes wet with water or sweat, even in milder temperatures.

Some people are at greater risk and may need assistance to stay safe in cold weather. People most at risk include:

infants, young children and older adults
people without adequate food, clothing and shelter
people who work or recreate outdoors
people who use alcohol or drugs
people with an underlying medical condition (such as heart disease, diabetes, dementia or other mental health condition)

Don't Wait, Call 911

If someone has signs of cold-related illness -- like bright red skin and very low energy levels in infants; or glassy stare, weakness, impaired judgement, slow speech, or fainting in adults.

Protect Adults in Need

Report older adults and adults with disabilities in need of assistance due to cold temperatures. You can make a report online or call the state's toll-free number 1-800-392-0210 anytime.

Report Online

Hypothermia Data

Data and information on cold-related deaths and associated risk factors

Warming Centers Map

Find a place to warm up during the day.

For overnight shelter, contact local emergency management or call United Way 2-1-1.

Utility Assistance

Get help with home energy costs, if you or someone you know is in need.

Signs of Hypothermia & What to Do

Warning signs of hypothermia may include:

Uncontrollable shivering. In severe cases of hypothermia, shivering stops
Numbness
Glassy stare
Apathy
Weakness
Impaired judgment
Drowsiness
Slow or slurred speech
Exhaustion
Loss of consciousness
Bright red skin and very low energy level in infants

What to Do Until Help Arrives

After calling 911 for immediate medical assistance,

Gently move the person to a warm place.
Monitor their blood pressure and breathing.
If needed, give rescue breathing and CPR.
Remove wet clothing.
Dry them off.
Take their temperature.
Warm the body core first, NOT the extremities. Warming the extremities first can cause shock. It can also drive cold blood toward the heart and lead to heart failure.
DO NOT warm the person too fast. Rapid warming may cause heart arrhythmias.

Tips for Staying Safe

Be aware of the warning signs of cold-related illness and what to do.

Heat

Stay indoors and in a warm area.
If heat is not available, go to a warming center, friend or neighbor's house, or shelter.

Water, Food and Medicine

Increase your fluid intake – regardless of your activity level. Don’t wait until you feel thirsty to drink fluids. Ensure infants and children drink adequate amounts of liquids.
- Avoid drinks containing caffeine or alcohol, because they affect how your body reacts to the cold.
- Individuals with epilepsy or heart, kidney, or liver disease, who are on fluid-restricted diets, or who have problems with fluid retention should consult a doctor before increasing liquid intake.
Eat well-balanced meals at regular intervals.
Ask your doctor whether medications you take affect your body's response to the cold.

Clothing

Wearing several layers of clothing is better than a single heavy layer. The space between the layers works as insulation to help keep you warmer.
Wear a hat. Fifty percent of all body heat is lost through the head, so wearing a hat will keep your whole body warmer.
Wear a scarf to protect your lungs, ears and face.
Wear waterproof boots.
Use ointment or lotion to prevent chapped skin.
Carry extra clothes with you such as socks, gloves, hats and jacket so you can change them if you get wet.

Outdoor Activity

Schedule outdoor activities for the warmest part of the day, usually 10 a.m. to 3 p.m. (weather permitting).
Slow down and avoid strenuous activity you're not used to doing.
- Extreme cold puts extra strain on the heart – no matter what your age or physical condition.
Take frequent breaks in a warm place.
Minimize sitting or squatting in the cold for prolonged periods of time. Sitting or squatting can hinder circulation.

Check on Others

Check regularly on friends, family, and neighbors at greatest risk of cold-related illness:
- infants and children up to 4 years of age
- people 65 years of age or older
- people working or spending time outdoors
- people who are ill or on certain medications
Use the buddy system when active or working outdoors.

Signs of Frostbite & What to Do

Frostbite is the actual freezing of the tissue or a body part. It often affects the ears, nose, fingers and toes. Warning signs of frostbite include:

Just before freezing, the skin, especially on the face, becomes bright red. Then small patches of white appear, as freezing actually occurs.
Pale or waxy white or grey skin
Numbness
Tingling or stinging sensation in the affected body part
Aching in the affected body part
Reduced blood flow

If frostbite is detected, seek medical care. If there is frostbite but no sign of hypothermia and immediate medical care is not available, do the following:

Move to a warm dry area.
Remove wet or tight fitting clothes.
Avoid walking on frostbitten toes or feet.
Gently place affected area in warm water – DO NOT use water any hotter than 105°F.
DO NOT use a heating pad, heat lamp or stove, fireplace or radiator for warming.
DO NOT rub affected area, this can cause more damage.
After warming, the injured area should be wrapped in sterile gauze, keeping the affected fingers and toes separated.
If normal sensations haven’t returned in 30 minutes, seek medical attention.

Snow Blindness

Snow blindness is a sunburn of the eyes caused by the reflection of sunlight off snow or water. It can be prevented by wearing good sunglasses with side shields or goggles. Eye protection from the sun is just as necessary on cloudy or overcast days as it is in full sunlight. Snow blindness can occur during a snowstorm if the cloud cover is thin. Symptoms usually occur within 8-12 hours of exposure and include:

Red, dry or irritated eyes
Pain when moving or blinking eyes
Pain when in bright light
Swollen eyelids
Excessive tearing

Mild cases will heal in a few days. Relief can be obtained by using cold compresses and covering the eyes. If symptoms are severe or don't improve, seek medical care. DO NOT rub the eyes.

Trench Foot

Trench Foot (also known as Immersion Foot) can happen if the feet are constantly wet, even at temperatures as high as 60°F. Wet feet lose heat 25 times faster than dry feet. It is characterized by vascular damage. Symptoms include reddening of the skin, numbness, leg cramps, swelling, tingling pain, blisters or ulcers, bleeding under the skin and gangrene. To prevent heat loss, the body constricts blood vessels to shut down circulation in the feet. The skin dies due to a lack of oxygen and nutrients. It can cause permanent damage to the circulatory system.

Treatment is similar to frostbite. Move to a warm, dry area; remove wet shoes and socks; use warm (105°F) water and seek medical assistance as soon as possible.

The National Environmental Public Health Tracking Program

Missouri Environmental Public Health Tracking (EPHT) is a program within the Missouri Department of Health and Senior Services and funded by the Centers for Disease Control and Prevention. EPHT is part of a network of people and information systems which delivers a core set of health, exposure, and hazards data, information summaries and tools to enable analysis, visualization and reporting of insights drawn from data. Those insights are intended to help data drive actions and improve community health.

EPHT – Hypothermia

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Announcements

Be Safe, Aware, and Prepared for Cold Weather

Hypothermia Data

Warming Centers Map

Utility Assistance