Friday marks the first day of winter, a good time to prepare for the coldest months of the year and avoid an unnecessary trip to the emergency room.  A little common sense and the right clothing and gear go a long way, according to Stephanie Lareau who is an emergency medicine physician at Carilion Clinic in Roanoke and assistant professor at the Virginia Tech Carilion School of Medicine.

“How cold is too cold? It’s probably better to ask what gear you have and how prepared you are to be in that situation,” said Lareau. “People can go on polar expeditions where they’re in sub-zero temperatures for a long period of time and fare pretty well.  It really depends on what you’re accustomed to and what sort of gear and training you have.” 

So when do you know you need to get out of the cold and go the emergency room? 

“Anytime somebody is out in the cold and they’ve gotten to the point that they’ve stopped shivering, or that they seem to have any kind of confusion or change in their mental status related to being out in the cold, that’s definitely time they need to activate 9-1-1 and make it to the hospital.”


  • “The most common cold weather problem outside starts with the feet. Once feet get wet or begin to sweat, then get cold, you can get trench foot. Blistering and a painful foot condition can lead to infection and other more serious problems.”
  • “Those who spend a lot of time outside can suffer hypothermia, especially if they don’t keep their calorie intake up. You burn a lot more calories out in the cold, so it’s important to make sure your nutrition is good. Symptoms include shivering and teeth chattering.”
  • “The first stage of frostbite is actually called frostnip. Fingers and toes can actually turn red, and they’ll be tingly or painful. After that they’ll become numb and can have a whitish appearance.  That’s when you need to become worried, get out of the cold and seek medical treatment.”

Stephanie Lareau background

In addition to her work in the Carilion Clinic emergency room and teaching at Virginia Tech, Lareau is director of the Wilderness Medicine Fellowship which helps medical professionals get additional training in environmental emergencies such as hypothermia, hyperthermia, and other weather related outdoor problems. 

To secure a live or recorded interview with Stephanie Lareau, contact Bill Foy by email, or by phone at 540-998-0288.

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