Frostbite & Hypothermia

Posted on Nov 15, 2014 in Safety Tips


Outdoor activities can be fun, but they can also be risky. The South Dakota Safety Council offers the following tips to prevent and treat a couple of the most common problems: hypothermia and frostbite.


How to dress for winter success:

  • Think function, not fashion. The most important preventive measure when fighting the cold is how you dress. Staying dry is as important as staying warm. Dress in light layers. Long underwear made of polypropylene wicks moisture away from the body. Inner layers of wool or waffle weave synthetics provide insulation. The outer layer should be made of wind- and moisture-resistant fabrics.
  • Wearing a hat cuts body heat loss. Cover as much skin as possible. Take extra care with fingers and toes. Wear an extra pair of socks and wear boots. Wearing mittens will keep your fingers warmer than wearing gloves.


Other preventive measures include:

  • Eat well, at least one hot meal a day. Drink hot liquids such as broth, cider or soup. Avoid drinks containing caffeine, such as coffee or tea, and alcoholic beverages, as these can make you more susceptible to the cold.
  • Find out if any medications you are taking will make you more vulnerable to cold. Take extra precautions if they do.
  • Use a “buddy system” to monitor physical reaction to cold when engaging in outdoor activities.
  • Keep your home adequately heated or wear layers indoors. The elderly are more susceptible to cold-related stress. Check on those living alone.




Hypothermia conjures up pictures of extreme cold. Actually, hypothermia can occur in all types of weather and can result from inadequate heating indoors. Hypothermia is a condition that occurs when the body’s core temperature drops below the norm of 98.6 degrees Fahrenheit.

Hypothermia can range from mild to severe, and infants and the elderly are more vulnerable. Watch for these stages.

Hypothermia is considered mild when the body temperature is between 98 and 90 degrees Fahrenheit. Symptoms include a chilly feeling with shivering ranging from slight to violent. The skin begins to numb and the victim loses coordination. As the core temperature decreases, mental sluggishness and slowed speech occur along with some amnesia.

Between 90 and 86 degrees Fahrenheit, moderate hypothermia symptoms include severe lack of coordination along with stiffness and immobility. The victim has stopped shivering and is often incoherent, confused and irrational.

When the victim’s temperature drops between 86 and 78 degrees Fahrenheit, his/her condition is considered severe. Symptoms include severe rigidity, extreme lethargy with the need for sleep, slowed respiration and slowed heartbeat. The skin feels ice cold. At the lower temperatures the victim lapses into unconsciousness that is followed by death due to heart and respiratory failure.

Recognition is the key in treating a victim of hypothermia. The victim should be treated gently because rough treatment may cause cardiac arrest. For mild cases, the victim should be encouraged to stay active to increase body heat. If the victim’s clothes are wet, they should be removed immediately and replaced with dry layers. The victim’s head should be covered and they should be given warm (not hot) sweet fluids.

For moderate cases the treatment is much the same as for mild cases, although the extremities should be thoroughly covered. If possible, place warm objects such as hot water bottles next to the victim’s groin, head, neck and chest. The victim should be taken to a medical facility as soon as possible.

Treatment for severe hypothermia should preferably be done at a medical facility. Victims are often mistaken for dead because heartbeat, pulse and respiration are not apparent. The victim should be handled with extreme care and CPR should be started immediately. There are numerous documented cases of victims recovering from this condition despite losing all signs of life.



Frostbite occurs when exposed flesh becomes frozen. Ice crystals form in the soft tissues due to over-exposure to cold. These ice crystals cause the skin to rupture, killing the cells. The most common areas affected by frostbite are the nose, cheeks, ears, toes and fingers. Like hypothermia, frostbite goes through several stages of severity. Symptoms of the first stage, called frostnip, are numbness and changes in the color of the skin, which turns first red, then white. Frostnip causes no permanent damage because only the surface of the skin is involved; however, the affected area may develop long term sensitivity to cold.

Superficial frostbite occurs if exposure continues. The skin becomes white and has a waxy appearance. The surface is frozen and hard while the underlying tissues remain soft and normal. Blisters often occur approximately 1-2 days after freezing and may become blackened and hard. Injuries heal in about 3-4 weeks but the affected area remains sensitive to heat and cold. The victim should be seen by a health care professional if blistering occurs.

As freezing continues, deep frostbite occurs. The affected area becomes hard and firm to the touch as underlying tissues become involved. All sensation is lost and the skin appears “dead” white, yellowish-white or a mottled blue-white.

Because frostbite has a numbing effect, the victim may not be aware of its occurrence. Regardless of the degree of severity, the victim should be moved indoors before attempting to thaw the affected area. Do not rewarm the victim if there is a possibility of re-freezing. Treatment for the early stages of frostbite is as simple as warming the affected areas. NEVER RUB THE AFFECTED AREA! This will only aggravate the injury. It should be handled gently–the injured tissue is extremely fragile. Also avoid warming the area over a fire or next to a heater because of the high risk of burns and the tendency to dry out the affected tissue, which may cause more damage. The victim will feel pain as the frozen area thaws. This pain can be severe depending upon the degree of frostbite suffered.

A victim of superficial frostbite should be transported to a medical facility. Apply a steady source of external heat and cover the affected area with a dry, sterile dressing. If the area is a hand or foot, carefully place padding between toes and fingers. Put a splint on the affected area if it involves an extremity.

The victim of deep frostbite should be transported immediately to a medical facility where rewarming may be done under supervised conditions. Severe pain is associated with the rewarming of deep frostbite injury. Prior to transport, the affected areas should be dressed, padded and splinted. On-site rewarming should occur only if there is absolutely no chance of re-freezing or transport is delayed. In those instances the affected area should be warmed in a water bath of between 100 and 105 degrees Fahrenheit. Rewarming is complete only when the affected area is warm and red or blue in color and remains so after being removed from the bath. Blistering of the affected area will occur, and in extreme cases amputation (of fingers and toes, for example) may be required. Because of the nature of the injury it may take several months to determine the severity of the loss.

Retrieved from South Dakota Safety Council