The areas most commonly affected are the face and
The symptoms of frostbite are progressive.
Victims generally incur this injury without being
acutely aware of it. Initially, the affected skin reddens
and there is an uncomfortable coldness. With
continued heat loss, there is a numbness of the affected
area due to reduced circulation. As ice crystals form,
the frozen extremity appears white, yellow-white, or
mottled blue-white, and is cold, hard, and insensitive
to touch or pressure. Frostbite is classified as
superficial or deep, depending on the extent of tissue
Superficial Frostbite.In superficial frostbite
the surface of the skin will feel hard, but the underlying
tissue will be soft, allowing it to move over bony
ridges. This is evidence that only the skin and the
region just below it are involved. General treatment for
superficial frostbite is as follows:
1. Take the victim indoors.
2. Rewarm hands by placing them under the
armpits, against the abdomen, or between the
3. Rewarm feet by placing them in the armpit or
against the abdomen of the buddy.
4. Gradually rewarm the affected area by warm
water immersion, skin-to-skin contact, or hot
5. Never rub a frostbite area.
Deep Frostbite.In deep frostbite, the freezing
reaches into the deep tissue layers. There are ice
crystals in the entire thickness of the extremity. The
skin will not move over bony ridges and will feel hard
The objectives of treatment are to protect the
frozen areas from further injury, to rapidly thaw the
affected area, and to be prepared to respond to
circulatory or respiratory difficulties.
1. Carefully assess and treat any other injuries
first. Constantly monitor the victims pulse and
breathing since respiratory and heart problems
can develop rapidly. Be prepared to administer
CPR if necessary.
2. Do not attempt to thaw the frostbitten area if
there is a possibility of refreezing. It is better to
leave the part frozen until the victim arrives at a
medical treatment facility equipped for
long-term care. Refreezing of a thawed
extremity causes severe and disabling damage.
3. Treat all victims with injuries to the feet or legs
as litter patients. When this is not possible, the
victim may walk on the frozen limb, since it has
been proven that walking will not lessen the
chances of successful treatment as long as the
limb has not thawed out.
4. When adequate protection from further cold
exposure is available, prepare the victim for
rewarming by removing all constricting
clothing such as gloves, boots, and socks. Boots
and clothing frozen on the body should be
thawed by warm-water immersion before
5. Rapidly rewarm frozen areas by immersion in
water at 100F to 105F (38C to 41C). Keep
the water warm by adding fresh hot water, but do
not pour the water directly on the injured area.
Ensure that the frozen area is completely
surrounded by water; do not let it rest on the side
or bottom of the tub.
6. After rewarming has been completed, pat the
area dry with a soft towel. Later it will swell,
sting, and burn. Blisters may develop. These
should be protected from breaking. Avoid
pressure, rubbing, or constriction of the injured
area. Keep the skin dry with sterile dressings
and place cotton between the toes and fingers to
prevent their sticking together.
7. Protect the tissue from additional injury and
keep it as clean as possible (use sterile dressings
8. Try to improve the general morale and comfort
of the victim by giving hot, stimulating fluids
such as tea or coffee. Do not allow the victim to
smoke or use alcoholic beverages while being
9. Transfer to a medical treatment facility as soon
During transportation, slightly
elevate the frostbitten area and keep the victim
and the injured area warm. Do not allow the
injured area to be exposed to the cold.