Parts of the Dakotas and Minnesota dove to -27 degrees F or lower this week, according to the National Weather Service. That's not just uncomfortable — that kind of cold can be dangerous and even deadly, especially if you don't take precautions in how long you're out and how you dress.

"I've seen patients develop frostbite within approximately 10 to 15 minutes after being exposed to these extreme temperatures," Dr. Jeff Schaider tells NPRs Ari Shapiro on All Things Considered. Schaider is chief of emergency medicine at the John H. Stroger Jr. Hospital in Chicago and the head of emergency medicine at Cook County Health.

Just taking a brief walk outside without a hat can give somebody frostbite on the back of their unprotected ears, he says.

Frostbite's damage to skin and underlying tissue is the most common injury resulting from exposure to severe cold and it usually occurs on the body's extremities — fingers, toes, nose, ears, cheeks and chin.

The damaged skin typically appears white, waxy or grayish-yellow at first, Schaider says, and is cold and numb. Call your health care provider if you notice these symptoms. If the condition is caught early, it's possible to prevent permanent damage. If not, frostbite can progress, and lead to the need for amputation.

An even more dangerous reaction begins when the internal body temperature significantly drops, in a condition called hypothermia. Initially when you're exposed to the cold, Schaider says, you'll shiver and that can be beneficial in trying to keep you warm. But, as hypothermia progresses, your body's response to the cold actually diminishes.

"You'll stop shivering, and then your body temperature will start dropping at a more rapid rate," he explains. The body gets colder and moves slower. Your mind thinks slower. Your heart moves slower. And, as time goes on, he says, you become confused. You can go into a coma or even die.

So — how do you protect yourself in the worst-hit areas? First, anticipate likely problems. Check local news sources for updated weather warnings, and stay inside unless you absolutely have to go out. If you must go out, wear layers of protection appropriate to your activity level. (The cold-weather authorities at the Appalachian Mountain Club have some specific tips.)

And if you're headed out in a car, Schaider says, be sure to pack along additional clothes, a blanket, an extra hat and extra gloves (mittens are best) — just in case something happens to your car.

Also, recognize that drinking alcohol may affect your judgment and your physiology, he says.

"People who go out and drink might walk outside because they don't feel the effects of the cold that much when they're intoxicated."

They might be exposed to the cold for a longer period of time than is safe in frigid climes, he says, and their body temperature would begin to drop.

Copyright 2019 NPR. To see more, visit https://www.npr.org.

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