Over the years, there have been many anecdotal approaches to treating frostbite. The following advice has been compiled from information provided by persons who are current experts in treating these injuries.What is frostbite?

Frostbite is an injury caused by the actual freezing of tissues. Once temperature of the hand or foot drops to 59^o F (15^o C),the blood vessels maximally constrict and minimal blood flow occurs.

• Factors that predispose a person to frostbite include poor circulation (caused by previous cold injuries, tobacco use, alcohol ingestion, diseases of the blood vessels, constricting garments, poorly fitted boots, old age) and extremes of cold exposure.
• Windchill contributes markedly to frostbite risk. For instance, at an air temperature of 20^o F (minus 6^o C), a 45 mph wind causes the same rate of heat loss as a 2 mph breeze at an air temperature of minus 22^o F (approximately minus 30^o C).

Immersion, or "trench" foot (affecting lower limbs) is caused by prolonged (hours to days) exposure to cold water or to conditions of persistent cold (32 to 50^o F [0 to 10^o C]) and high humidity, without actual freezing of tissues.

• Early symptoms include itching, tingling, and burning pain. The skin looks red immediately after exposure, then becomes mottled or pale with a gray-blue tint within a few hours to days. At the same time, skin numbness, swelling, and muscle cramps develop.
• After 2 to 7 days, the skin once again appears red, with accompanying tingling, swelling, blisters, oozing, and occasional gangrene.
• Furthermore, since a human in motion creates his own wind (e.g., riding a snowmobile), the risk for frostbite in such a person increases.

How do I treat frostbite?

1. Rapid rewarming is the standard therapy. However, do not thaw out a frostbitten body part if it cannot be kept thawed.
• Refreezing causes an injury that will far exceed the initial frostbite wound. It is much better to walk out on frostbitten toes until safety is reached than to thaw and allow refreezing.
• In other words, if you come upon a lost hiker 10 miles back in the woods who has frostbitten toes, do not use your stove to heat water to thaw out his feet, if he will then have to put his wet boots back on and hike out, in the process refreezing his toes.
2. Once the victim has reached a location where refreezing will not occur:
1. Remove all constrictive jewelry and wet clothing. Replace wet clothes with dry garments.
2. Immerse the frostbitten part in water heated to 102^o to 108^oF (39^o to 42.2^o C). Do not induce a burn injury by using hotter water.
• Never use a numb frostbitten finger or toe to test water temperature. Use your own hand or the victim's uninjured hand to test the temperature.
3. Circulate the water to allow thawing to proceed as rapidly as possible (usually requires 30-45 minutes). Thawing is complete when the skin is soft and pliable, and color (usually red; rarely, bluish) and sensation have returned.
3. Never rewarm the skin by vigorous rubbing or by using the heat of a campfire, camp stove, or car exhaust. You most certainly will damage the tissues.
4. After thawing the skin, protect it with fluffy sterile bandages (aloe vera lotion, gel, or cream should be applied if available). Pad gently between the digits with sterile cotton or wool pads, held in place by a loose rolled bandage.
• Blisters appear 6 to 24 hours after rapid rewarming. If blisters appear, leave them intact.
5. Transport the victim to a medical facility.
• Elevate the affected part.
• Apply a protective splint if necessary to surround the bulky cushion dressing.

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First Aid: Blisters (friction)

First Aid: Burns

First Aid: Cuts and Scrapes

First Aid: First Aid Kit

First Aid: Sunburn