Cold Injury First Aid

Prolonged exposure to cold can damage body tissues. Frostbite is a freezing injury. Frostnip is a mild form of frostbite in which the skin is not yet frozen. The most common places affected by cold injury are the fingers, toes, cheeks, chin, ears, and nose. Ice put directly on the skin and left too long can also cause it. Frostbite symptoms include:

  • White, gray, or blue-white skin

  • Cold, hard skin

  • Loss of feeling in body part

  • Peeling skin

  • Clear or blood-filled blisters

  • Black skin (severe)

Frostnip symptoms are milder and include pain, numbness, and pale skin color.

What to do for cold injury

If any of the symptoms of frostbite are present:

  • Get to a hospital as soon as possible!

  • Protect the affected area from further injury by wrapping it in dry clothing, blankets, towels, or newspaper.

If it' s not possible to get to a hospital soon or symptoms are very mild, begin to rewarm the affected area. This can be done in two ways:

  • Warm water. Place the affected part it in warm water at 98-102°F (37-39°C). Use water that feels warm but comfortable on unaffected skin. 

  • Body heat. Hold the affected part under an armpit or in a warm hand.

To prevent worsening the injury:

  • Don't rewarm the affected part if there is a chance of it refreezing before getting to a hospital. Refreezing leads to greater damage.

  • Don't rub the affected part with hands, snow, or anything else. Friction increases damage to the tissues.

  • Don't use a stove, radiator, open fire, or heating pad. The skin can easily burn.

  • Don't smoke or drink alcohol. These affect blood vessels and circulation to the damaged area.

  • Move the person to a warm environment. Splint or pad the affected area to minimize injury during the move.

  • Don't walk on frostbitten feet. This can increase the damage.

As soon as possible, go to a hospital for evaluation. Frostbite often causes dead areas of skin and tissue that may need surgery for removal and to prevent infection.

Preventing cold injury

To prevent tissue damage from the cold, do the following:

  • Wear enough layers to keep you warm. Cover exposed body parts to protect them from cold weather.

  • Eat enough food when you are out in the cold.

  • Don't drink alcohol. Don't smoke. Either of these can make the skin more sensitive to cold.

  • Don't get wet.

  • Carry emergency supplies when you are out in the elements.

  • If you use an ice pack, wrap it in a thin towel, and only use it for up to 15 minutes every 1 to 2 hours.

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