Hypothermia and Frostbite:
Recognising and Responding to Cold-Related Emergencies

Hypothermia and frostbite are serious conditions that occur when the body is exposed to extreme cold. They can develop quickly and lead to life-threatening complications if not treated immediately. Knowing how to recognise the signs and provide first aid for cold-related emergencies can prevent permanent damage or death.

What is Hypothermia?

Hypothermia occurs when the body loses heat faster than it can produce it, causing the core body temperature to drop below 35°C (95°F). Prolonged exposure to cold weather, immersion in cold water, or wearing inadequate clothing in cold conditions can lead to hypothermia. It is a medical emergency that affects the brain and vital organs, slowing the body’s functions.

What is Frostbite?

Frostbite is the freezing of skin and underlying tissues caused by exposure to extreme cold. It most commonly affects the extremities, such as fingers, toes, ears, and nose. Frostbite can cause permanent damage to the affected areas and, in severe cases, may lead to amputation if untreated.

Signs and Symptoms of Hypothermia

Hypothermia develops gradually, and the symptoms can vary in severity depending on how long the person has been exposed to the cold. Key signs and symptoms include:

• Shivering: The body’s natural response to generate heat. Shivering may stop in severe hypothermia, which is a dangerous sign.
• Cold, Pale Skin: The skin may feel cold to the touch and appear pale or blue.
• Slurred Speech: The person may have trouble speaking clearly due to the cold affecting their muscles.
• Drowsiness or Confusion: Hypothermia affects brain function, leading to disorientation, confusion, or impaired judgment. The person may not realise they are cold.
• Weak Pulse: The heart rate slows down as the body temperature drops.
• Shallow Breathing: Breathing may become slow and shallow as the body’s systems begin to shut down.
• Loss of Coordination: The person may stumble or have difficulty walking due to numbness in their extremities.
• Loss of Consciousness: In severe hypothermia, the person may become unresponsive or fall unconscious.

Signs and Symptoms of Frostbite

Frostbite primarily affects the skin and underlying tissues in areas exposed to the cold. The severity of frostbite can vary from superficial to deep, with the following symptoms:

• Cold, Hard Skin: The skin may feel hard and cold to the touch in the affected areas.
• Numbness: The person may lose sensation in the frostbitten areas, making it difficult to feel pain or touch.
• Discoloured Skin: The skin may appear pale, white, or blue in mild frostbite. In severe cases, the skin may turn black due to tissue death (gangrene).
• Blisters: In some cases, blisters may form on the affected skin after it has thawed.
• Stiff Joints and Muscles: Frostbitten areas may become stiff and difficult to move.

First Aid for Hypothermia

1. Call 999 Immediately:

• Hypothermia is a medical emergency. Call 999 for emergency help as soon as you recognise the signs of hypothermia.

2. Move the Person to a Warm, Dry Place:

• Get the person out of the cold and into a warm, sheltered area as quickly as possible. If indoors, wrap them in blankets and close windows or doors to keep out drafts.
• If moving them indoors is not possible, provide insulation from the cold ground by placing blankets, sleeping bags, or clothing underneath the person.

3. Remove Wet Clothing:

• Wet clothing accelerates heat loss. Gently remove any damp or wet clothing and replace it with dry, warm layers. Be careful when handling the person, as rough movements can cause cold blood to rush to the heart, potentially causing a heart attack.

4. Warm the Person Gradually:

• Wrap the person in blankets, coats, or any available warm material to help raise their body temperature slowly. Use warm (not hot) water bottles, heating pads, or body heat to warm their core. Focus on the chest, neck, and groin.
• Avoid using direct heat, such as a hot water bottle directly on the skin or a heating pad set to high, as this can cause burns or shock to the person’s system.

5. Offer Warm Drinks (if Conscious):

• If the person is alert and able to swallow, offer them warm, sweet, non-alcoholic beverages, such as tea or hot chocolate. Avoid giving them alcohol or caffeine, as these can worsen dehydration and affect circulation.

6. Monitor Breathing and Consciousness:

• Keep a close watch on the person’s breathing and level of consciousness. If they become unresponsive or stop breathing, begin CPR immediately and continue until emergency help arrives.

First Aid for Frostbite

1. Move the Person to a Warm Place:

• Like with hypothermia, get the person out of the cold and into a warm area. This will prevent further heat loss and stop frostbite from progressing.

2. Gradually Warm the Affected Area:

• Warm the frostbitten area gradually by immersing it in warm water (37–39°C or 98–102°F) for 15–30 minutes. Do not use hot water, as it can burn the skin. Warm towels or blankets can also be used if warm water is not available.
• Never rub or massage the frostbitten area, as this can cause further damage to the frozen tissues.

3. Protect the Frostbitten Area:

• After warming, gently dry the affected area and wrap it in clean, soft cloths or bandages. Keep the frostbitten area elevated if possible, as this can reduce swelling.
• Do not expose the frostbitten area to cold again. Refreezing can cause further damage to the tissues.

4. Do Not Walk on Frostbitten Feet or Toes:

• If frostbite affects the feet or toes, avoid walking on them if possible, as this can worsen the damage. Carry the person if necessary.

5. Seek Medical Help:

• Frostbite can cause permanent tissue damage, so it’s important to seek medical attention even if the symptoms seem mild. Severe frostbite may require hospital treatment, including rewarming techniques, medication, or surgery.

Prevention of Hypothermia and Frostbite

• Dress Appropriately for Cold Weather: Wear layers of clothing, with moisture-wicking materials closest to the skin and insulating layers on top. Don’t forget hats, gloves, and scarves to protect extremities.
• Stay Dry: Wet clothing accelerates heat loss, so it’s important to stay dry in cold weather. Change out of wet clothing as soon as possible.
• Limit Exposure to Cold: Take breaks indoors or in warm shelters if you’re spending time outside in cold weather. Avoid staying out in the cold for extended periods.
• Keep Moving: Physical activity helps generate body heat, but avoid excessive sweating, as this can lead to wet clothing.
• Stay Hydrated and Nourished: Drink fluids and eat regularly to help your body maintain its energy and heat.

When to Seek Medical Help

• For Hypothermia: Call 999 if you suspect someone is suffering from hypothermia. Immediate medical attention is required to prevent life-threatening complications.
• For Frostbite: Seek medical help if the frostbite is severe, affects a large area, or if blisters or blackened skin are present. Mild frostbite should still be assessed by a healthcare professional to prevent long-term damage.

Key Points to Remember

• Hypothermia is a medical emergency – call 999, move the person to warmth, and rewarm them gradually.
• Frostbite requires slow rewarming and protection of the affected areas. Never rub frostbitten skin or use direct heat.
• Always seek medical attention for frostbite and hypothermia, as both can lead to serious complications if untreated.