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Understanding Wind Chill: The Science of Cold Air Perception
Wind chill, often referred to as "apparent temperature" in cold conditions, represents the combined effect of ambient air temperature and wind speed on human heat loss. While your thermometer might read a seemingly manageable temperature, the presence of wind can make it feel dramatically colder—potentially reaching dangerous levels that threaten human health and safety. Understanding wind chill is essential for anyone living in or traveling to cold climates, as it directly impacts outdoor activity planning, appropriate clothing selection, and cold-weather emergency preparedness.
The human body continuously generates heat through metabolic processes, maintaining a core temperature around 98.6°F (37°C). In cold environments, this warmth radiates outward, creating a thin insulating layer of warmed air immediately surrounding the skin—your body's natural thermal barrier. Without wind, this boundary layer provides crucial protection against cold air. However, wind disrupts this protective envelope, continuously stripping away the warm air and exposing skin directly to cold atmospheric temperatures. The stronger the wind, the more rapidly this protective layer is removed, accelerating heat loss and creating the sensation of increasingly colder conditions.
The Three Mechanisms of Heat Loss
The human body loses heat through three primary physical mechanisms:
How Wind Accelerates Heat Loss
Consider a calm winter day at 32°F (0°C). The thin layer of air next to your skin warms to approximately 90-95°F (32-35°C), creating a stable temperature gradient. This boundary layer—typically just 1-3 millimeters thick—significantly reduces the temperature differential between your skin and the environment, slowing heat loss.
Now introduce a 20 mph (32 km/h) wind. This moving air mass violently disrupts the boundary layer, stripping it away in milliseconds and exposing your skin directly to 32°F air. Your body desperately attempts to regenerate the protective warm layer, but the persistent wind continuously removes it faster than it can form. This creates a cycle of rapid heat loss, with your skin temperature dropping and your metabolic rate increasing to compensate. The perceived temperature—the wind chill—can plummet to 19°F (-7°C), despite the actual air temperature remaining unchanged at 32°F.
Physiological Response and Perception: As convective heat loss accelerates, specialized thermoreceptors in your skin detect the rapid temperature drop and send urgent signals to your brain. Your body responds by constricting peripheral blood vessels (vasoconstriction) to preserve core temperature, redirecting warm blood away from extremities toward vital organs. This adaptive response, while protective for internal organs, leaves fingers, toes, ears, and nose vulnerable to cold injury. Simultaneously, your brain interprets the combination of skin cooling rate and actual temperature as a single integrated sensation—the "feels like" temperature that wind chill represents. This explains why you instinctively perceive the environment as much colder than the thermometer suggests when wind is present.
Wind Chill Calculation Methods and Formula Development
Quantifying the complex interaction between wind speed, air temperature, and human heat loss has challenged scientists and meteorologists for over a century. The first systematic attempt to measure wind chill occurred in the 1940s when Antarctic explorers Paul Siple and Charles Passel conducted groundbreaking experiments, measuring the freezing time of water in plastic cylinders under various wind and temperature conditions. While pioneering, their original formula had significant limitations—it didn't accurately represent heat loss from human skin, overestimated cooling effects at low temperatures, and produced values that were difficult for the public to interpret practically.
Recognizing these shortcomings, the National Weather Service (NWS) and Environment Canada collaborated on extensive research in the late 1990s and early 2000s. This joint project involved clinical trials with human subjects exposed to controlled cold and wind conditions, advanced thermal modeling of facial heat loss, and comprehensive validation against real-world frostbite occurrence data. The result was a significantly improved wind chill model implemented in 2001, which forms the basis for modern wind chill forecasts across North America and many other regions worldwide.
The National Weather Service Wind Chill Formula (2001 Model)
This calculator uses the internationally recognized formula developed by the Joint Action Group for Temperature Indices (JAG/TI), officially adopted by the U.S. National Weather Service and Environment Canada:
Variable Definitions:
• WC = Wind Chill Temperature (°F) - The perceived "feels like" temperature
• T = Ambient Air Temperature (°F) - Measured in shade at standard height
• V = Wind Speed (mph) - Measured at 10 meters (33 feet) above ground level
Model Specifications and Assumptions
• Based on facial heat loss model: Specifically calibrated to represent exposed facial skin, the most vulnerable and commonly exposed body part in cold weather
• Standard body parameters: Assumes average adult walking speed of 3 mph (4.8 km/h), typical winter clothing on body core, and normal metabolic heat generation
• Wind measurement height: Wind speed standardized to 10-meter elevation (typical weather station height), automatically adjusted from ground-level observations
• Shaded conditions: Formula assumes shade or overcast conditions; direct sunlight can moderate wind chill effects by 10-18°F depending on sun angle
Validity Range - Temperature
Wind chill calculations are valid for air temperatures at or below 50°F (10°C). Above this threshold, convective cooling is negligible, and the formula becomes unreliable. At moderate temperatures, actual and perceived temperatures converge.
Validity Range - Wind Speed
Formula is calibrated for wind speeds above 3 mph (5 km/h). Below this threshold, air movement is insufficient to significantly disrupt the thermal boundary layer. At extremely high winds (>60 mph), the formula may slightly underestimate actual cooling effects.
International and Alternative Wind Chill Models
While the NWS/Environment Canada formula is widely adopted, some regions use alternative approaches:
Frostbite: Understanding Cold-Induced Tissue Damage
Frostbite represents one of the most serious consequences of cold exposure, occurring when skin and underlying tissues literally freeze due to prolonged exposure to temperatures below 32°F (0°C). This cold-induced injury develops through a two-phase process: first, ice crystals form within cells and extracellular spaces, physically rupturing cell membranes and damaging tissue structure; second, as blood vessels constrict to preserve core body heat, blood flow to extremities becomes severely reduced or completely arrested, leading to ischemic injury (tissue damage from oxygen deprivation). The combination of direct freezing injury and circulatory compromise can result in permanent tissue loss, ranging from superficial skin damage to complete loss of fingers, toes, ears, or nose.
High-Risk Populations
Outdoor Workers: Construction workers, utility repair crews, postal carriers, and agricultural workers face repeated cold exposure.
Winter Sports Enthusiasts: Skiers, snowboarders, ice climbers, and snowmobilers experience wind chill amplification during high-speed movement.
Homeless Individuals: Lacking adequate shelter and cold-weather gear, experiencing 20-40 times higher frostbite risk.
Military Personnel: Extended field operations in extreme climates with limited warming opportunities.
Vulnerability Factors
Peripheral Vascular Disease: Reduced blood flow to extremities accelerates frostbite development.
Diabetes: Neuropathy reduces cold sensation awareness; impaired circulation increases risk.
Raynaud's Phenomenon: Exaggerated vasoconstriction in fingers and toes promotes rapid cold injury.
Previous Cold Injury: Damaged tissue more susceptible to refreezing; permanent cold sensitivity common.
Alcohol/Drug Intoxication: Impairs judgment, causes vasodilation (false warmth), reduces shivering response.
Critical Time-to-Frostbite at Various Wind Chill Temperatures:
Times apply to exposed skin under wind chill conditions. Individual susceptibility varies.
Clinical Classification and Progressive Stages
Medical professionals classify frostbite severity using a four-degree system analogous to burn classifications. Understanding these stages helps individuals recognize injury severity and urgency of medical intervention:
First-Degree Frostbite (Frostnip)
SuperficialTissue Involvement: Outer layers of skin (epidermis) only, no deeper tissue freezing
Clinical Features:
- • Initial sensation: Tingling, stinging, or burning pain followed by complete numbness
- • Appearance: Pale, waxy, or grayish-yellow discoloration of skin; firm to touch but tissue beneath remains soft
- • Upon rewarming: Skin becomes red, swollen, and painful (hyperemia); no blister formation
- • Recovery timeline: 7-10 days; skin may peel similar to sunburn
Prognosis: Excellent - Complete recovery expected with no permanent damage
Second-Degree Frostbite (Superficial)
Partial ThicknessTissue Involvement: Full thickness of skin (epidermis and dermis), ice crystal formation in skin layers
Clinical Features:
- • Initial appearance: Frozen, hard, white/gray skin; no sensation; tissue feels woody
- • Rewarming phase (24-48 hours): Clear or milky fluid-filled blisters form, surrounded by edema and erythema
- • Pain level: Severe burning and throbbing pain during rewarming; persistent sensitivity for weeks
- • Healing process: Blisters dry and form dark, hardened eschar that sloughs off over 3-4 weeks
Prognosis: Good - Tissue survival likely, but permanent cold sensitivity and altered sensation common; nail deformities possible
Third-Degree Frostbite (Deep)
Full ThicknessTissue Involvement: Skin, subcutaneous tissue, and potentially muscle; complete tissue freezing
Clinical Features:
- • Initial appearance: Completely frozen, mottled, blue-gray or purple discoloration; rock-hard consistency
- • Rewarming phase (48-72 hours): Blood-filled (hemorrhagic) blisters appear; severe edema extends beyond injury site
- • Vascular damage: Thrombosis (clot formation) in capillaries and small vessels; tissue ischemia
- • Recovery timeline: 4-6 weeks; black eschar formation with clear demarcation line between viable and necrotic tissue
- • Complications: Growth plate damage in children, chronic ulceration, arthritis in affected joints
Prognosis: Guarded - Significant tissue loss likely; surgical debridement often required; permanent functional impairment and chronic pain common
Fourth-Degree Frostbite (Complete)
Through All LayersTissue Involvement: Skin, fat, muscle, tendons, nerves, bone - complete freezing through all tissue layers
Clinical Features:
- • Initial appearance: Hard, cold, completely insensate; may have dark purple or black discoloration immediately
- • Rewarming: Little to no pain (nerves completely damaged); tissue remains cold and lifeless
- • Vascular assessment: Complete absence of blood flow; no capillary refill; no pulse in distal vessels
- • Mummification: Over weeks, tissue desiccates and becomes mummified; clear black demarcation with proximal tissue
- • Bone involvement: Joint destruction, osteomyelitis (bone infection), pathological fractures
Prognosis: Poor - Tissue is non-viable; amputation almost always required; determination of amputation level may require 4-8 weeks as demarcation clarifies
Modern Imaging for Frostbite Assessment:
Advanced medical imaging techniques now help predict tissue viability and guide treatment decisions:
- • Technetium-99m bone scans: Identify areas of viable tissue perfusion within 48 hours of injury
- • MRI with angiography: Visualizes vascular patency and extent of tissue edema; helps predict amputation levels
- • Infrared thermography: Non-invasive assessment of skin temperature and blood flow patterns
Comprehensive Frostbite Prevention Strategies
Preventing frostbite requires a multi-faceted approach combining appropriate clothing, environmental awareness, behavioral modifications, and recognition of early warning signs. The most effective prevention strategy is avoiding prolonged cold exposure when wind chill temperatures fall into dangerous ranges. However, when outdoor activity is necessary or unavoidable, the following evidence-based protective measures dramatically reduce frostbite risk:
Clothing and Protective Equipment
Behavioral and Activity Measures
Recognition and Response
Critical Temperature Thresholds - When to Avoid Outdoor Exposure:
Hypothermia: Systemic Cold-Induced Core Temperature Decline
Hypothermia represents a life-threatening medical emergency occurring when the body's core temperature drops below 95°F (35°C), compromising normal metabolic function and organ system performance. Unlike frostbite, which causes localized tissue damage, hypothermia affects the entire body systemically—disrupting cardiovascular function, neurological processing, respiratory efficiency, and cellular metabolism. The condition develops when environmental heat loss exceeds the body's capacity to generate and conserve warmth through shivering thermogenesis, metabolic activity, and behavioral adaptations. Wind chill dramatically accelerates hypothermia development by stripping away the body's protective thermal boundary layer, increasing convective heat loss rates by 200-400% compared to calm conditions at the same air temperature.
Primary Causes of Hypothermia
High-Risk Demographics
Urban Hypothermia vs. Wilderness Hypothermia:
Urban hypothermia typically affects vulnerable populations (homeless, elderly, intoxicated) in moderately cold temperatures (32-50°F) over hours to days. Wilderness hypothermia develops in outdoor enthusiasts exposed to severe cold, wind, and precipitation in remote locations, often progressing rapidly within 1-3 hours.
Mild Hypothermia (90-95°F / 32-35°C)
Stage 1Pathophysiology: Body activates maximum compensatory mechanisms to preserve core temperature. Peripheral vasoconstriction redirects blood to vital organs; shivering thermogenesis increases metabolic heat production 2-5x baseline. Stress hormones (epinephrine, norepinephrine) surge, mobilizing energy reserves.
Clinical Manifestations:
Cardiovascular:
- • Tachycardia (rapid heart rate): 100-120 bpm
- • Increased blood pressure: systolic may rise 15-30 mmHg
- • Peripheral vasoconstriction: cold, pale extremities
Neurological/Behavioral:
- • Intense shivering (involuntary muscle contractions)
- • Mild confusion, impaired judgment, apathy
- • Difficulty with complex tasks, slowed reaction time
Respiratory:
- • Tachypnea (rapid breathing): 18-24 breaths/min
- • Hyperventilation from cold stress response
Renal:
- • Cold diuresis: increased urine production (1-2 L/hour)
- • Dehydration risk from excessive fluid loss
Treatment: Passive rewarming (dry clothing, blankets, warm environment); warm, sweet beverages if fully conscious; active movement; prognosis excellent with appropriate intervention
Moderate Hypothermia (82-90°F / 28-32°C)
Stage 2Pathophysiology: Compensatory mechanisms begin failing. Shivering diminishes then ceases below 86°F (30°C) as muscle glycogen depletes. Metabolic rate decreases 6-7% per 1°C drop, reducing cellular oxygen consumption but impairing organ function. Brain cooling affects judgment, coordination, consciousness.
Clinical Manifestations:
Cardiovascular:
- • Progressive bradycardia (slow heart rate): 50-80 bpm
- • Cardiac arrhythmias emerge (atrial fibrillation common)
- • Blood pressure decreases, hypotension develops
Neurological/Behavioral:
- • Severe confusion, disorientation, amnesia
- • Slurred speech, dysarthria
- • Ataxia: loss of coordination, stumbling gait
- • Diminished or absent shivering
Muscular:
- • Muscle rigidity, decreased fine motor control
- • Unable to perform self-rescue tasks (zip clothing, light matches)
Respiratory:
- • Hypoventilation: shallow, slow breathing 10-16/min
- • Decreased oxygen delivery to tissues
Treatment: Medical emergency—active external rewarming (forced warm air blankets, heating pads to trunk); warm IV fluids; continuous cardiac monitoring; avoid rough handling (can trigger fatal arrhythmias); hospitalization required
Severe Hypothermia (Below 82°F / 28°C)
Stage 3-4Pathophysiology: Critical organ system failure. Severe bradycardia (<40 bpm) with life-threatening arrhythmias (ventricular fibrillation risk extremely high below 82°F). Respiratory depression progresses to apnea. Brain activity severely depressed, approaching metabolic coma state. Paradoxical responses emerge from hypothalamic dysfunction.
Clinical Manifestations:
Life-Threatening Cardiovascular Collapse:
- • Severe bradycardia or cardiac arrest
- • Ventricular fibrillation highly likely (>70% mortality without intervention)
- • Osborn J waves on ECG (pathognomonic finding)
- • Profound hypotension, pulse may be impalpable
Neurological Shutdown:
- • Unconsciousness, unresponsive to stimuli
- • Fixed, dilated pupils (mimicking death)
- • Absent reflexes
- • Paradoxical undressing: Terminal hypothalamic dysfunction causes sensation of intense heat; victims remove clothing despite freezing conditions—found in 25-50% of fatal hypothermia cases
- • Terminal burrowing (hide-and-die syndrome): Primitive brainstem-driven behavior causing victim to seek small, enclosed spaces (under beds, in closets, beneath brush)—reflects autonomic attempt to reduce surface area
Respiratory Failure:
- • Severe hypoventilation: <4-8 breaths per minute
- • Pulmonary edema development
- • Respiratory arrest imminent below 75°F (24°C)
Metabolic Derangement:
- • Severe acidosis, hyperkalemia
- • Coagulopathy: blood clotting impaired
- • Pancreatitis, liver dysfunction
Treatment: Critical medical emergency—advanced life support required; active internal rewarming (warm IV fluids, heated humidified oxygen, extracorporeal rewarming with heart-lung machine/ECMO); CPR continued until core temperature >86°F (30°C)—"not dead until warm and dead"; survival possible even after prolonged cardiac arrest due to protective hypothermic metabolic suppression
Emergency Response for Suspected Hypothermia:
Temperature-Specific Cold Weather Clothing Guidelines
Appropriate cold-weather clothing represents your primary defense against both frostbite and hypothermia. Clothing requirements vary dramatically based on ambient temperature, wind chill, duration of exposure, activity level, and individual physiology. The following evidence-based guidelines provide specific clothing recommendations stratified by temperature ranges, helping you select optimal protection for prevailing conditions. Remember that these recommendations assume moderate activity levels and dry conditions—adjust accordingly for strenuous exercise (which generates additional metabolic heat) or wet/windy conditions (which dramatically accelerate heat loss).
The Three-Layer System for Cold Weather Protection
Base Layer (Moisture Management)
Purpose: Wick perspiration away from skin, maintaining dry microclimate
Materials: Merino wool (natural, odor-resistant), synthetic polyester/polypropylene (fast-drying, durable)
Avoid: Cotton ("killer fiber")—retains moisture, loses 90% insulation when wet
Middle Layer (Insulation)
Purpose: Trap warm air in loft structure, provide thermal insulation
Materials: Fleece (breathable, retains warmth when damp), down (highest warmth-to-weight ratio, compressible), synthetic insulation (maintains loft when wet)
Outer Layer (Weather Protection)
Purpose: Block wind and precipitation, prevent convective heat loss
Materials: Waterproof-breathable membranes (Gore-Tex, eVent), windproof soft shells, DWR-treated fabrics
32°F to 15°F (0°C to -10°C) — Moderate Cold
LOW RISKRisk Assessment: Frostbite unlikely in healthy individuals with adequate clothing. Hypothermia possible after several hours of exposure if inadequately dressed or wet. Suitable for most winter outdoor activities with proper preparation.
Core Body Clothing:
- • Base layer: Lightweight synthetic or merino wool shirt and long underwear bottoms
- • Mid layer: Fleece pullover or light insulated jacket (100-200g insulation)
- • Outer layer: Wind-resistant jacket and pants; water resistance recommended if precipitation expected
Extremities Protection:
- • Head: Fleece or wool beanie covering ears
- • Hands: Insulated gloves (200-400g insulation); mittens optional for very cold-sensitive individuals
- • Feet: Wool or synthetic blend socks (avoid cotton); insulated boots rated to 0°F
- • Face: Generally unnecessary; neck gaiter or scarf optional for wind protection
Activity Modifications:
Most outdoor activities safe with standard precautions. Adjust layers based on exertion level—remove insulation during strenuous activity to prevent sweating, add layers during rest stops.
15°F to -15°F (-10°C to -26°C) — Significant Cold
MODERATE RISKRisk Assessment: Hypothermia risk increases with prolonged exposure (>2-3 hours) if inadequately protected. Frostbite possible on exposed facial skin and poorly protected extremities after 30-60 minutes in windy conditions. Three-layer system essential; all skin coverage recommended.
Core Body Clothing:
- • Base layer: Midweight synthetic or merino wool top and bottom (200-260 g/m²)
- • Mid layers (plural): Fleece jacket PLUS lightweight synthetic/down vest or jacket (200-400g insulation total)
- • Outer layer: Windproof, waterproof hard shell jacket and insulated pants with reinforced seat/knees
Extremities Protection:
- • Head: Thick fleece or wool hat; consider balaclava or face mask if windy
- • Hands: Insulated mittens (400-600g insulation) preferred over gloves; liner gloves underneath for dexterity when needed
- • Feet: Thick wool/synthetic blend socks (consider sock liner system); insulated boots rated to -20°F minimum; boot must not be tight (constriction impedes circulation)
- • Face: Neck gaiter, buff, or balaclava covering nose, cheeks, and neck; ski goggles if windy to protect eyes
Activity Modifications:
Limit continuous outdoor exposure to 2-3 hours; take warming breaks in heated shelter every 60-90 minutes. Monitor extremities regularly for numbness. Avoid activities causing heavy sweating (increases hypothermia risk via wet clothing). High-energy snacks and warm beverages essential.
-15°F to -40°F (-26°C to -40°C) — Severe Cold
HIGH RISKRisk Assessment: Frostbite probable within 10-30 minutes on any exposed skin. Hypothermia risk significant even with proper clothing after 60-90 minutes of exposure. Outdoor activities should be limited to essential tasks only. Emergency preparedness critical—vehicle breakdown or injury can quickly become life-threatening.
Core Body Clothing:
- • Base layer: Heavyweight expedition-weight thermal underwear (260-300 g/m²)
- • Mid layers: Heavy fleece or wool sweater PLUS insulated jacket (400-800g down or synthetic fill)
- • Outer layer: Expedition-grade parka with hood and insulated waterproof pants; consider one-piece insulated coveralls for stationary outdoor work
Extremities Protection:
- • Head: Insulated winter hat with ear flaps or full balaclava; fur-lined hood on parka (fur breaks up wind better than synthetic trim)
- • Hands: Expedition-grade mittens (600-1000g insulation) with removable liner gloves; consider chemical hand warmers; backup pair in case of wet exposure
- • Feet: Vapor barrier liner sock + thick wool sock; expedition boots rated to -40°F or colder; consider overboots or mukluks for stationary activities
- • Face: Full face coverage mandatory—neoprene face mask or fleece balaclava covering all facial skin; ski goggles essential to prevent corneal frostbite
Critical Safety Measures:
- • Never venture outdoors alone—buddy system mandatory
- • Warming breaks in heated shelter every 20-30 minutes; check extremities and face for frostnip/frostbite
- • Emergency shelter kit in vehicle: sleeping bag, extra clothing, high-calorie food, chemical warmers, emergency beacon
- • Inform others of travel plans, expected return time, route
- • Strongly consider postponing non-essential outdoor activities
Below -40°F (-40°C) — Extreme Cold
EXTREME DANGERIf Outdoor Exposure Absolutely Unavoidable:
- • ALL clothing recommendations from -15°F to -40°F range apply
- • Add: Expedition-grade parka rated to -60°F or colder; insulated coveralls over standard clothing layers
- • Add: Arctic-rated boots (-100°F rating); vapor barrier boot liners; multiple sock layers with chemical toe warmers
- • Add: Arctic-grade mittens with multiple liner systems; chemical hand warmers mandatory; spare mittens essential
- • Complete facial coverage: Multiple layers including neoprene mask + wool balaclava + fur-lined parka hood; ski goggles with heated lens or dual-pane anti-fog design
- • Limit outdoor exposure to absolute minimum duration (under 15 minutes whenever possible)
- • Immediate access to heated shelter essential—never travel beyond immediate vicinity of warmth source
Survival Precautions:
- • Vehicle winterization critical: Full tank of gas, winter-grade antifreeze, emergency kit with sleeping bag rated to -40°F, 72-hour food supply, chemical warmers, candles, matches, emergency beacon
- • Communication devices fully charged with backup power sources
- • If vehicle becomes disabled, STAY WITH VEHICLE—do not attempt to walk for help except to reach visible shelter within 100 yards
- • Run vehicle engine 10 minutes per hour for heat (ensure exhaust pipe not blocked by snow—carbon monoxide poisoning risk)
Critical Clothing Dos and Don'ts
✓ DO:
- • Choose clothing slightly loose-fitting—tight garments restrict circulation
- • Layer strategically—easy to remove/add layers as activity level changes
- • Keep spare dry clothing accessible—wet clothing loses 90% of insulating value
- • Protect high heat-loss areas: head (40-50% of heat loss), neck, wrists, ankles
- • Use mittens over gloves when possible—fingers together retain heat better
- • Wear moisture-wicking materials next to skin
✗ DON'T:
- • Wear cotton in cold conditions—"cotton kills" when it becomes wet/sweaty
- • Overdress causing excessive sweating—dampness dramatically increases heat loss
- • Ignore early cold symptoms (numbness, tingling)—seek immediate warming
- • Wear tight boots or constrictive footwear—impedes circulation
- • Touch metal with bare skin at extreme cold—instant cold injury
- • Assume you're adequately dressed based on temperature alone—wind chill is critical factor
Additional Cold Weather Safety Tips
Before Going Outside
- • Check weather forecast and wind chill
- • Tell someone where you're going
- • Eat a proper meal for energy
- • Stay hydrated
While Outside
- • Keep moving to maintain circulation
- • Take breaks in warm areas
- • Watch for signs of frostbite/hypothermia
- • Don't ignore warning signs
What to Avoid
- • Don't drink alcohol (impairs judgment)
- • Avoid sweating (wet clothes lose insulation)
- • Don't touch cold metal with bare skin
- • Avoid tight clothing/footwear
Emergency Signs
- • Numbness or color changes in skin
- • Excessive shivering or confusion
- • Slurred speech or drowsiness
- • Seek medical help immediately