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First Aid - Frostbite
First Aid - Hypothermia
Frostbite of the Ear
- Frostbite is a cold injury to the skin.
- Symptoms of mild frostbite (frostnip) are cold, tingling and painful skin.
- True frostbite causes white, hard, completely numb skin; can be serious, and always requires medical attention after re-warming.
- Common sites are toes, fingers, tip of the nose, outer ear or cheeks.
- Frostbite and hypothermia are two distinct and independent medical problems.
- Frostbite results from a cold injury to the skin. The body's core temperature can be normal. In frostbite, the nerves, blood vessels and skin cells of a part of the body are temporarily frozen. The ears, nose, penis, fingers, and toes are most commonly affected.
- In contrast, hypothermia signifies a marked decrease in the body's core temperature, and frostbite may not be present. Hypothermia is defined as a body temperature < 95° F (35° C) rectally, and can be fatal without intervention.
Frostbite Severity - Frostbite can be classified like burns:
- Frostnip (mild frostbite): Cold, tingling and painful skin
- 1st Degree: White and waxy (hard) while frozen; mild erythema and swelling after re-warming
- 2nd Degree: Same as 1st degree plus blisters after 24 hours
- 3rd Degree: Hemorrhagic blisters progressing to skin necrosis
Factors Contributing to Frostbite
- Alcohol, mental illness: Impairs judgement and reduces normal self-protective actions.
- Medical conditions: A number of medical conditions predispose to frostbite. Patients with diabetes, congestive heart failure, peripheral vascular condition, Raynaud's disease, and previous frostbite are all at greater risk.
- Type of contact: The frostbite is much worse if the skin and clothing are also wet at the time of cold exposure. Touching bare hands to cold metal and volatile products (like gasoline) stored outside during freezing weather can cause immediate frostbite.
- Duration of contact: The longer the cold exposure the greater both the heat loss and the likelihood of frostbite. The wind velocity on a cold day (windchill index) also determines how quickly frostbite occurs.
Frostbite Prevention - General
- Change wet gloves or socks immediately
- Set limits on the time spent outdoors when the wind-chill temperature falls below zero.
- Know the earliest warnings of frostbite. Pain, tingling, numbness are signals from your body that you are not dressed adequately for the weather and that you need to go indoors.
Frostbite Prevention - Clothing
- Clothing: Dress in layers for cold weather. The first layer should be long underwear preferably made of polypropylene or polyester (wicks moisture away from skin). The middle layer(s) should be fleece or wool. The outer layer serves as a windbreaker and also needs to be waterproof. The layers should be loose, not tight.
- Hand Protection: Mittens are warmer than gloves. You may wish to wear a thin glove under the mitten.
- Footwear: Avoid tight shoes that might interfere with circulation. Wear 1-2 pairs of socks made from wool or a wool blend. You may also wish to wear a thin liner sock made from polyester or polypropylene (wick away moisture) under the wool socks.
- Headwear: Wear a hat, because over 50% of heat loss occurs from the head.
FIRST AID Advice for Frostbite:
Rewarm the frostbitten area rapidly with wet heat.
- Move into a warm room.
- For frostbite of an extremity (e.g., fingers, toes): Place the frostbitten part in very warm water. A bathtub or sink is often the quickest approach. The water should be very warm (104 to 108 F, or 40 to 42 C), but not hot enough to burn. Immersion in this warm water should continue until a pink flush signals the return of circulation to the frostbitten part (usually 30 minutes).
- For frostbite of the face (e.g., ears, nose): Apply warm wet washcloths to frostbitten area of the face. Continue doing this until a pink flush signals the return of circulation to the frostbitten area (usually 30 minutes).
Note: Do not rewarm a frostbitten area if there is a chance of refreezing.
FIRST AID Advice for Frostbite During Transport to a Medical Facility:
- Wrap frostbitten area in warm blanket or clean dressing.
- Protect frostbitten area from injury.
- Avoid walking on frozen feet if possible (Reason: may cause further tissue injury).
FIRST AID Advice for Hypothermia:
- Remove wet clothing.
- Wrap in warm blankets (or clothing, sleeping bag, even newspaper).
- Move into a warm space (e.g., home, building, car, tent).