First Aid For Cold Exposure, Frostbite, Hypothermia

Our bodies are affected by extremes in temperature. Shivering protects the chilled body by producing heat but stops when we are very cold. Water in our skin and tissues can crystallize and freeze, causing abnormal function and sensation. Toes, nose, fingers, and ears are especially sensitive to cold. Frostbite and hypothermia are the two emergencies associated with cold exposure. Hypothermia can be life-threatening and must be treated immediately. It can take days for a rewarmed person to show signs of functioning.

Frostbite

Signs & Symptoms:
- Cold, numb, or painful skin
- Skin color progresses from white to yellow to gray
- Skin hard to the touch
- Skin does not move when you push on it

Tips:
- Do not rub or massage the affected area.
- Do not break blisters.
- Do not give victim stimulants, including alcohol and tobacco.
- Do not leave victim alone. Frostbite can lead to hypothermia, which can lead to death.
- Do not place the affected body area in hot water.
- do not use chemical warmers directly on frostbitten areas.
- Do not use stove, heating pad or fire to warm affected area.
- Do not thaw frozen part if a chance of refreezing exists or if near medical help.
- Move the victim to a warm area, cover with space blanket.
- Put affected body parts in warm water (100° -105° F /37° - 40.6° C) until skin becomes flushed.
- After warming, keep affected fingers and toes separated with dry gauze.
- Give warm fluids.
- If normal sensations haven't returned within 30 minutes, get medical attention.

Hypothermia

Signs & Symptoms:

Mild hypothermia
- Shivering
- Loss of coordination
- Confusion, irrational behavior
- Urge to urinate

Severe hypothermia
- No longer shivering, muscles stiff and rigid
- Stumbling
- Slow breathing
- Low blood pressure, weak pulse
- Slow, irregular heartbeat
- Do not leave victim alone.
- Do not use hot water to warm victim.
- Do not give hot liquids, alcohol, or anything by mouth.
- Do not move the victim unless necessary.
- Do not rub or massage the victim.
- Get victim out of the cold. Your goal is to prevent further heat loss and add warmth.
- Call for medical help. If victim is unresponsive and not breathing, an untrained rescuer should start Chest Compressions before rewarming.
- If you are far from medical care, start rewarming the victim. Rapid warming is required.
- Remove any wet clothes, pat victim dry.
- Cover victim's head, not face.
- If possible, submerge victim in warm water (100°-105° F/37°- 40° C) up to the chin.
- If unable to submerge victim, use a space blanket or your own body heat to warm victim.
- Apply warm - not hot - packs to neck, armpits and groin. Reapply as packs become cool.
- Stay with the victim, warming him or her while monitoring responsiveness and breathing until help arrives.
- If victim must be moved, do so gently, keeping the victim in the horizontal position.