Downloaded from https://www.everyspec.com superficial injury without blistering. Second degree frostbite is manifested by superficial injury with clear blisters with only epidermal tissue loss. Third degree and fourth degree frostbite are manifested by significant subepidermal tissue loss. (2) Soldiers with first degree frostbite after clinical healing will be given a permanent P–2 profile permitting the use of extra cold weather protective clothing, including nonregulation items, to be worn under authorized outer garments.
(3) Soldiers with frostbite more than first degree will be given a P–3 profile, renewed as appropriate, for the duration of the cold season restricting them from any exposure to temperatures below 0 degrees C (32 degrees F) and from any activities limited by the remainder of the season. After the cold season, Soldiers will be reevaluated and, if appropriate, given the P–2 profile described in (2) above. (4) Soldiers will be referred to an MEB for recurrent cold injury, recurrent or persistent cold sensitivity despite the P–2 profile, vascular or neuropathic symptoms, or disability due to tissue lost from cold injury. b. Trench foot (nonfreezing cold injury).
(1) The definition of trench foot is the consequence of prolonged cold immersion of an extremity. It is manifested by maceration of tissue and neurovascular injury. (2) Soldiers with residual symptoms or significant tissue loss after healing will be referred to an MEB. c. Accidental hypothermia. (1) The definition of accidental hypothermia is clinically significant depression of body temperature due to environ- mental cold exposure. (2) Soldiers with significant symptoms of cold intolerance or a recurrence of hypothermia after an episode of accidental hypothermia will be referred to an MEB.
Table 3–1 Methods of assessing cardiovascular disability 37 AR 40–501 • 14 December 2007 Class New York Heart Association Functional Classification Canadian Cardiovascular Soci- ety Functional Classification Specific activity scale (Goldstein et al: Circulation 64:1227, 1981) New York Heart Association Functional Classification (Re- vised) I. Patient with cardiac disease but without resulting limita- tions of physical activity. Or- dinary physical activity does not cause undue fatigue, palpitations, dyspnea, or an- ginal pain. Ordinary physical activity, such as walking and climb- ing, stairs, does not cause angina.
Angina with strenu- ous or rapid or prolonged exertion at work or recrea- tion. Patients can perform to completion any activity re- quiring 7 metabolic equiva- lents: for example, can carry 24 lbs up eight steps, carry objects that weigh 80 lbs, do outdoor work. (shovel snow, spade soil), do recreational activities (ski- ing, basketball, handball, jog, and walk 5 mph). Cardiac status uncom- promised. II. Patients with cardiac dis- ease resulting in slight limi- tation of physical activity. They are comfortable at rest. Ordinary physical ac- tivity results in fatigue, pal- pitation, dyspnea, or anginal pain Slight limitations of ordinary activity.
Walking or climbing stairs rapidly, walking uphill, walking or stair climbing af- ter meals, in cold, in wind, or when under emotional stress, or only during the few hours after awakening. Walking more than 2 blocks on the level and climbing more than one flight of ordi- nary stairs at a normal pace and in normal conditions. Patient can perform to com- pletion any activity requiring ≥5 metabolic equivalents, but cannot and does not perform to completion activi- ties requiring metabolic equivalents: for example, have sexual intercourse without stopping, garden, rake, weed, roller skate, dance fox trot, walk at 4 mph on level ground. Slightly compromised. III.
Patients with cardiac dis- ease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fa- tigue, palpitation, dyspnea, or anginal pain. Marked limitation of ordinary physical activity. Walking one to two blocks on the level and climbing more than one flight in normal conditions. Patient can perform to com- pletion any activity requiring ≥2 metabolic equivalents but cannot and does not perform to completion activi- ties requiring ≥5 metabolic equivalents: for example, shower without stopping, strip and make bed, clean windows, walk 2.5 mph, bowl, play golf, dress with- out stopping. Moderately compromised.