Treatment for hypothermia is enumerated as
Carefully observe respiratory effort and
heart beat; CPR may be required while the
warming process is underway.
Rewarm the victim as soon as possible. It
may be necessary to treat other injuries
before the victim can be moved to a
warmer place. Severe bleeding must be con-
trolled and fractures splinted over clothing
before the victim is moved.
Replace wet or frozen clothing and remove
anything that constricts the victims arms,
legs, or fingers, interfering with circulation.
If the victim is inside a warm place and is
conscious, the most effective method of
warming is immersion in a tub of warm
(100° to 105°F or 38° to 41°C) water. The
water should be warm to the elbownever
hot. Observe closely for signs of respiratory
failure and cardiac arrest (rewarming
shock). Rewarming shock can be mini-
mized by warming the body trunk before
the limbs to prevent vasodilation in the ex-
tremities with subsequent shock due to
blood volume shifts.
If a tub is not available, apply external heat
to both sides of the victim. Natural body
heat (skin to skin) from two rescuers is the
best method. This is called buddy warm-
ing. If this is not practical, use hot water
bottles or an electric rewarming blanket,
but do not place them next to bare skin,
and be careful to monitor the temperature
of the artificial heat source, since the vic-
tim is very susceptible to burn injury.
Because the victim is unable to generate
adequate body heat, placement under a
blanket or in a sleeping bag is not suffi-
If the victim is conscious, give warm liquids
to drink. Never give alcoholic beverages or
allow the victim to smoke.
Dry the victim thoroughly if water is used
As soon as possible, transfer the victim to
a definitive care facility. Be alert for the
signs of respiratory and cardiac arrest dur-
ing transfer, and keep the victim warm.
Local cooling injuries, affecting parts of the
body, fall into two categories: freezing and
nonfreezing injuries. In the order of increasing
seriousness, they include chilblain, immersion
foot, superficial frostbite, and deep frostbite. The
areas most commonly affected are the face and
CHILBLAIN. Chilblain is a mild cold injury
caused by prolonged and repeated exposure for
several hours to air temperatures from above
freezing (32°F/0°C) to as high as 60°F (16°C).
Chilblain is characterized by redness, swelling,
tingling, and pain to the affected skin area. In-
juries of this nature require no specific treatment
except warming of the affected part (if possible
use a water bath of 90° to 105°F), keeping it dry,
and preventing further exposure.
IMMERSION FOOT. Immersion foot,
which also may occur in the hands, results from
prolonged exposure to wet cold at temperatures
ranging from just above freezing to 50°F (10°C)
and usually in connection with limited motion of
the extremities and water-soaked protective
Signs and symptoms of immersion foot are
tingling and numbness of the affected areas; swell-
ing of the legs, feet, or hands; bluish discolora-
tion of the skin; and painful blisters. Gangrene
may occur. General treatment for immersion foot
is as follows:
Get the victim off his or her feet as soon
Remove wet shoes, socks, and gloves to im-
Expose the affected area to warm dry air.
Keep the victim warm.
Do not rupture blisters or apply salves and
If the skin is not broken or loose, the in-
jured part may be left exposed; however,
if it is necessary to transport the victim,
cover the injured area with loosely wrapped
fluff bandages of sterile gauze.
If the skin is broken, place a sterile sheet
under the extremity and gently wrap it to
protect the sensitive tissue from pressure
and additional injury.
Transport the victim as soon as possible to
a medical treatment facility as a litter
FROSTBITE. Frostbite occurs when ice
crystals form in the skin or deeper tissues after
exposure to a temperature of 32°F (0°C) or lower.