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Medical Evaluation for Exposure Extremes: Cold

Fudge, Jessie R. MD*; Bennett, Brad L. PhD; Simanis, Juris P. MD, MPH, MSPH; Roberts, William O. MD, MS§

Clinical Journal of Sport Medicine: September 2015 - Volume 25 - Issue 5 - p 432–436
doi: 10.1097/JSM.0000000000000224
Care of the Wilderness Athlete

Abstract: Risk of injury in cold environments is related to a combination of athlete preparedness, preexisting medical conditions, and the body's physiologic response to environmental factors, including ambient temperature, windchill, and wetness. The goal of this section is to decrease the risk of hypothermia, frostbite, and nonfreezing cold injuries as well as to prevent worsening of preexisting conditions in cold environments using a preparticipation screening history, examination, and counseling. Cold weather exercise can be done safely with education, proper preparation, and appropriate response to changing weather conditions.

*Activity, Sports and Exercise Medicine Department, Group Health Cooperative, Everett, Washington;

Military and Emergency Medicine Department, F. Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland;

Sports and Occupational Medicine Department, Citizens Memorial Hospital, Bolivar, Missouri; and

§Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota.

Corresponding Author: Jessie R. Fudge, MD, Activity, Sports and Exercise Medicine Department, Group Health Cooperative, 2930 Maple St, Everett, WA 98201 (

The authors report no conflicts of interest.

This article appears in a “Care of the Wilderness and Adventure Athlete” special issue, jointly published by Clinical Journal of Sport Medicine and Wilderness & Environmental Medicine.

Received February 23, 2015

Accepted May 16, 2015

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.