Doctors urge steps to prevent hypothermia, frostbite after power loss

How to stay safe when it’s cold and power is out

Freezing temperatures and long power outages can quickly create dangerous health situations, emergency-room doctors said, particularly when people lose reliable heat and the risk of cold exposure builds over time. Even at temperatures that do not feel “arctic,” prolonged time in the cold can strain the body and overwork the heart, clinicians warned.

Doctors said the two biggest indoor risks during outages are hypothermia and frostbite, and they urged people to watch for warning signs rather than relying on how they feel in the moment. In guidance shared with the Associated Press, Dr. Ben Weston, an ER doctor who directs health policy for the Milwaukee County Office of Emergency Management, and Dr. Abhi Mehrotra, a University of North Carolina emergency medicine physician, outlined steps they said can lower the chance of cold-related emergencies.

Recognize hypothermia early

Doctors said hypothermia can be diagnosed based on body temperature and symptoms, citing the Cleveland Clinic. They described mild hypothermia as a core temperature of 89.6 to 95 degrees Fahrenheit (32 to 35 degrees Celsius), with symptoms that can include shivering, exhaustion, sleepiness, a weak pulse and clumsiness.

They said moderate hypothermia occurs at 82.4 to 89.6 F (28 to 32 C) and can bring symptoms such as slurred speech, a slowed heart rate, hallucinations and decreased shivering. When core temperatures drop below 82.4 F (28 C), doctors said the body begins shutting down, with signs including loss of reflexes, complete muscle stiffness, fluid in the lungs, coma and death.

Weston said people should not wait until symptoms become severe. “If someone is shivering for a long time, it’s time to get ahead of things and get them somewhere warm,” Weston said. He added that “if someone is confused or showing more severe signs, call 911 right away.”

Don’t overlook cold that sneaks up

Weston said some of the most dangerous situations happen when the temperature stays low for a long time—even in conditions that may not seem extreme. In those scenarios, he said, long-term cold exposure taxes the body, driving up blood pressure and working the heart.

He also said shivering is the body’s normal response, but it can become a workout that contributes to exhaustion over hours—especially for older adults and people with other health issues. “That additional stress and strain on the body and energy production can really push people to the limit,” Weston said, warning that people may not recognize they need help or may delay taking action by assuming they will be fine with minimal clothing.

“You think you’re going to be OK with a sweatshirt and sweatpants and it kind of creeps up on people,” Weston said.

Hydration, layers and staying dry

Doctors advised people to keep drinking water and other nonalcoholic warm drinks during cold exposure, saying it can be hard to tell when someone is dehydrated in cold weather. They also cautioned that being near a heater can further contribute to dehydration, and said hydration can help the body stay warm.

On alcohol, doctors said it can impair the body’s ability to deal with cold. Mehrotra said alcohol impairs the body’s ability to deal with cold, and Weston said it can make a person feel warmer than the temperature actually is and affect judgment.

For clothing, the North Carolina Department of Emergency Management suggested dressing in warm, loose-fitting, lightweight layers that are easy to add or remove. Doctors also urged covering the mouth with scarves to protect lungs from directly breathing extremely cold air.

Weston said people lose the most heat through the head, hands and feet and should cover those areas. He also cautioned against certain internet “hacks,” saying latex gloves under winter gloves are not ideal because they trap moisture and are not breathable.

He warned against putting cayenne pepper in socks as well, saying the pepper can irritate the skin and the tingling it causes can mask frostbite symptoms. Doctors said one reason moisture control matters is that the body loses heat through evaporation, and Weston said dry socks are among the most important things to have on.

Use heat safely—and avoid carbon monoxide

Weston and Mehrotra said people should try to limit the amount of space they are heating, recommending smaller indoor areas to contain warmth. Weston said that can mean closing doors and keeping a heater in one room, and Mehrotra said people could even set up a tent indoors or get into a sleeping bag to make an even more confined space to trap body heat.

Both doctors emphasized safety around heat sources. They said to keep heaters away from flammable items and to avoid using gas stoves, ovens or other carbon monoxide–emitting heat sources indoors.

Mehrotra and Weston said carbon monoxide is odorless and colorless and is among the most common killers during cold snaps. They also advised that if anyone in the home shows symptoms of carbon monoxide poisoning—such as nausea and headaches—people should get outside for fresh air.

Check on people most at risk

Doctors said cold spells affect some groups more than others. Mehrotra said young children, older adults and people with chronic health conditions such as diabetes and high blood pressure are among those at highest risk when it’s cold.

He said community awareness matters because many people may not realize they need help until someone checks on them. “Check on your neighbors,” Mehrotra said. “You don’t know how people are doing.”