Safety Feature:
Trench Foot... surely that was a First World War thing, not a problem for the modern British Army!
What is Trench Foot?
Trench Foot, or more properly – Non-Freezing Cold Injury (NFCI) is the most common form of injury suffered on exercise in the UK (despite the advances in clothing and boot technology). It occurs in cold, wet weather – although the flesh itself does not freeze. If unchecked, it can result in severe pain for long periods of time and at worst, a medical discharge. Otherwise, the individual might be restricted to light duties, be unable to play sport, or be restricted to inside employment only. Not a good situation for a soldier!
It is a significant injury and is neither an illness nor a weakness. It can affect the operational effectiveness of your unit – and yet it is entirely preventable.
The Details
NFCI usually affects the feet but can also affect the hands. It is a ‘local neurological disturbance’ that we know as numbness. That is, when the cold extremity, feet and/or hands, become numb and stay numb. The simple fact is that numbness isn’t normal – and something must be done about it.
Who Gets it and Where?
Everyone is at risk. However, soldiers of Afro/Caribbean descent are more susceptible to NFCI. Smokers are also at an increased risk. Most cases will occur in UK or North West Europe. Unlike other injuries, it is often quite hard to recognise the problem in the early stages. A sufferer may misguidedly try to work through it for a number of reasons:
- Failure to recognise the symptoms.
- Fear of being removed from training.
- Fear of being medically downgraded.
- Being unaware that damage is being caused.
Instructors at all levels must be particularly aware of this climatic injury. This is not just a job for medics and PT staff!
NFCI Symptoms
Stage 1
- Tissue is white, numb and cold – but probably not swollen.
- Feels like "wearing someone else’s feet".
- There may be a history of waterlogged boots and socks.
Stage 2
- With gentle early re-warming there will be slight swelling and mottling.
- Pain – often like "pins and needles" lasting for a maximum of 24 hrs.
Stage 3
- Limb(s) swollen, red and very painful (especially at night).
- Pain will not respond to normal painkillers and may last for some weeks.
First Aid
- Keep casualty warm and sheltered until evacuation can be arranged.
- Dry the feet if wet – then keep them insulated.
- DO NOT rapidly re-warm using hot water or stoves.
- If the limb has been gently re-warmed, it should not be used, i.e. if the foot has been affected – do not walk or ski.
- Evacuate.
– Legal requirement.
– Spot trends early.
– Report form (Annex D, Ch 3, JSP 539).
– Army Accident and Incident Notification Cell (AINC).