Treating Frostbite in Survival Situations


Frostbite and First Aid



© copyright 2003, by Gary Benton

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Combining knowledge with common sense can help you avoid this dangerous condition, and treat it in emergencies.


Winters in the United States can be harsh, but when compared to the far north are less severe. Occasionally a cold spell will hit and it may last for weeks. We have all seen it happen. One day it is fairly warm, a front moves in, and the temperature drops quickly. With in a few hours there will be snow and temperatures will drop to the below zero range. Nonetheless, most people do not stop their day-today activities; we just slow down a little. Some folks, however, never hesitate when the weather turns sour. This is especially true of skiers, hunters, or ice fishermen.


When severe weather strikes, one of our primary concerns should be frostbite. While usually easy to prevent, it can hamper or permanently injure a victim. Most of us have experienced the beginning of frostbite, the red, painful skin, and perhaps some numbness. If we have suffered the onset of frostbite (also called frost nip), we will vividly remember the pain associated with the warming up. This was deep, aching pain we felt as the affected limb was exposed to warmth. Does this bring back uncomfortable memories? What exactly is frostbite? How do we prevent it? How do we treat it?


Frostbite is the freezing of body tissue during exposure to the cold. Frostbite may accompany hypothermia; so exercise extreme caution if you suspect the onset of either injury. What are the symptoms of Frostbite? There may be a white or waxy appearance to the damaged skin tissue. In the beginning stages of frostbite the skin may still be pliable. In advanced stages the damaged tissue may appear hard, solid to the touch, and there may even be ice crystals under the skin, joints may appear to stiffen, and there can be numbness or loss of sensation to the injured area. Usually, but not always, frostbite affects an extremity or limb, i.e., a finger, toe, nose or ears. I have seen cases on the legs (thigh and calf) from skiing trips. Stay alert for these symptoms on any area of your body.


While frostbite can be a crippling injury, it can usually be prevented with proper dress and common sense. First, let's discuss how to dress for the severe cold. When I lived in Alaska, the first thing I learned was to dress in layers. I would don long underwear, wool pants, and then nylon trousers. This protected me in layers, allowing air to be trapped, which acted as insulation. I then put on nylon socks, wool socks, and finally my boots (made with Thinsolite or Gore-Tex). My coat was a three-layered coat, consisting of a fleece under garment, then cotton garment over that, and finally a nylon outer shell.


But, I didn't stop there. I wore glove liners and then a heavy pair of mittens (once again, Thinsolite ® or Gore-Tex ®). My headgear consisted of a "mad bomber" hat with earflaps. This hat was constructed of leather, usually cow or deer hide, and lined with fur. Also, the most common type of fur used for the lining, and least expensive, is rabbit. The hat should fit loosely and has large flaps that can be secured on top of the hat or lowered to cover the ears. A strap holds the flaps in place once snapped under the chin. With the flaps down, the hat covers most of the head with the exception of the face. This hat really keeps the body heat in.


If the weather turned really severe, I would wrap the lower half of my face, including my nose, in a scarf. All exposed parts of the skin should be protected. Since most body heat escapes through the head, this is an important fact to remember. This layering was how the old timers survived and it still works most of the time. When layering does not work (high winds), or you are improperly dressed due to an emergency, how do you prevent injury from frostbite, and once you suspect you are injured, what steps do you take?


Earlier, I mentioned common sense. Of all the tools you have with you during an emergency, common sense is one of the most important. If you suspect a symptom we discussed, stop. First aid must be given quickly to avoid additional injury to the damaged tissue. Prolonged exposure will only compound the damage and may lead to amputation of the damaged limb or extremity.


Seek medical treatment immediately if possible. If not, then the following steps may be used in emergencies.


Seek shelter immediately. Get out of the wind and into either a natural or manmade shelter. An example of a natural shelter might be a group of large rocks that block the wind, a ditch, a cave, or even up under the bottom limbs of a large evergreen tree. I usually have a poncho with me (survival kit item), so if a natural shelter is not handy, I can quickly make a "poncho tent." This quick shelter is made by tying a line (550 parachute cord is the best) between two trees, approximately two feet off the ground, and then draping the poncho over the line. The bottom edge of my shelter can be held in place by large rocks or wooden stakes. You can also make shelters and windbreaks out of a variety of natural items you may find around you, including snow. Your skill at making such expedient shelters will depend on your study and knowledge of this sort of thing, and any prior training and experience you may have.


Get warm. This means more than just having a fire. You should drink plenty of hot fluids, if you can, and if possible generate body heat by eating candy or other foods. In all situations avoid drinking alcohol; you do not need your judgment clouded. Also, remember, two or three small fires will warm you faster than one large one. Make a small fire on each side of you and you will warm evenly. Do not rub snow on frostbite. This act, though portrayed frequently in movies, only causes additional damage to the already frozen tissue. The rubbing may increase tissue damage, while the snow may lower the tissue temperature.


Carefully remove boots or gloves. Do not force frozen clothing off of the affected area. If needed, the frozen area (hands or feet) may have to be soaked in warm water to loosen the clothing. Place the injured part in luke warm water, if possible, using your elbow to test it. The water should feel comfortable, and not hot. It should be around 42 degrees C, or 100 degrees F. Warm the tissue until flushed with a red color from returning blood. Do not rub the warmed tissue. This may cause additional damage as well.


If a fire is not available, or a container for water, you can place the frozen part at the crotch of your arms/legs using body heat to thaw it. Keep in mind, this will lower the body temperature of the person giving first aid, and is done only as a last resort. The process of treating frostbite is very painful. Doctors treating frostbite often use narcotics to lessen the pain during treatment. In the field you will not have that luxury.


Ensure the treated tissue does not become frozen again. If there is a possibility of the area becoming refrozen, do not thaw it. Once frozen, then thawed, the tissue will refreeze much quicker and cause additional tissue damage. Protect the damage skin by applying a loose dry dressing and do not break any blisters. Avoid bumping or additional injury to the injury.


As soon as possible, seek medical attention. Frostbite is a crippling injury that can lead to the loss of a finger, toe, all or part of a nose, ears, or even a limb. It can happen to skiers, hunters, fishermen, children, or those who have car problems on lonely roads. It is not something to be taken lightly.


But, by knowing the best prevention techniques, symptoms, and emergency treatment, it can be battled. By combining knowledge with common sense, you too, can have an enjoyable winter. Be safe!


Authors note: Various procedures in this article may be disagreed with by some readers, especially armchair “Survival Experts.” I quickly admit to not being a medical doctor, but the above information was gained from years of field experience, USAF Survival Arctic Survival School Training, USAF Mountain Survival School Training, USAF Basic Survival School Training, The American Red Cross and Canadian Red Cross First Aid Booklets, The SAS Survival Manual, and other resources too numerous to list. Besides, I know from experience the steps I recommended work, I have experienced it first hand. Watch for frostbite.



Treating Frostbite


Gary Benton has over 45 years of outdoor experience in camping, hiking, fishing, and other activities. He's no armchair survival man, he's walked the walk from the arctic to the desert and all the area in between. Gary has an associates degree in Search and Rescue, Survival Operations, a B.S. in Industrial Occupational safety, and all but his thesis completed for a M.S. in Counseling Psychology.
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