With frostbite the tissues of the extremities – usually the toes and the fingers – freeze due to low temperatures. In severe cases, it can lead to a permanent loss of sensation and, eventually, tissue death (gangrene) as the blood vessels become irreversibly damaged.

Frostbite usually occurs in freezing or windy and cold conditions. People who cannot move around are particularly susceptible. In many cases frostbite is accompanied by hypothermia and this should be treated accordingly.

Recognition features

There may be:

• ‘Pins and needles’ to begin with.
• Pallor followed by numbness.
• Hardening and stiffening of the skin.
• A colour change to the skin of the affected area: first white, then mottled and blue. On recovery, the skin may be red, hot, painful and blistered. Where gangrene occurs, the tissue may become black due to the loss of blood supply.

Treatment

If possible move the casualty into the warmth before you thaw the affected part.

Gently remove rings, gloves and any other constrictions such as boots. Warm the affected part with your hands on your lap, or under the casualty’s armpits. Rubbing the affected areas must be avoided as this can damage the skin and other tissues.

Place the affected part in warm water at around 40°C (104°F). Dry carefully, and apply a light dressing of fluffed-up, dry gauze bandage.

Support and raise the affected limb to reduce swelling. An adult casualty may take two paracetamol tablets for intense pain. Take or send the casualty to hospital.

Warning

Do not:

• put the affected part near direct heat
• attempt to thaw the affected part if there is a danger of it refreezing
• allow the casualty to smoke.