Hypothermia, frostbite, and cold exposure

Recognize dangerous cooling early, stop additional heat loss, and know when evacuation is urgent.

General field reference, not medical advice. Use it to support immediate decisions, then follow 911, rescue coordinators, medical professionals, current warnings, and local agency guidance.

Act now

1. Shelter the person from wind, rain, snow, and cold ground.

2. Replace wet clothing with dry insulation when it can be done safely.

3. Warm the center of the body gradually and handle the person gently.

4. Call 911 or activate SOS for altered mental status, severe shivering that stops, loss of coordination, or inability to self-rescue.

5. Protect frozen tissue and do not thaw it when refreezing is possible.

Recognize cooling before collapse

Early cold stress may look like discomfort, shivering, numb hands, poor decisions, or unusual quietness. Worsening hypothermia can cause clumsiness, slurred speech, confusion, stumbling, drowsiness, and impaired judgment. Severe cases may have very slow breathing, unconsciousness, or little visible shivering.

Do not rely on the affected person to judge their own condition. Cold impairs insight and fine motor control.

Stop additional heat loss

Get the person onto insulation and into shelter. Remove or isolate wet clothing without exposing them longer than necessary. Add dry layers, cover the head and neck, and use vapor or waterproof barriers to protect insulation from wet ground and precipitation.

Warm the chest, neck, armpits, and groin with warm packs that cannot burn the skin. Avoid aggressive rubbing, very hot water, or direct high heat. Give warm sweet drinks only when the person is fully alert, can swallow normally, and is not likely to need immediate surgery. Do not give alcohol.

Minimize unnecessary walking by a person with moderate or severe signs. Rough handling and exertion can be dangerous in severe hypothermia.

Frostbite

Frostbite may cause numb, pale, waxy, firm, or blistered skin. Protect the area from pressure and further cold. Remove constricting jewelry when swelling is possible. Do not rub, massage, or apply snow.

Do not intentionally thaw frozen tissue if there is a meaningful chance it will refreeze. Refreezing after thawing can cause greater damage. Seek medical care promptly and follow emergency guidance.

Prevent the next cold injury

Cold injuries often result from combined wind, moisture, fatigue, hunger, and delay rather than temperature alone. Change layers before sweating heavily, protect spare insulation in waterproof storage, eat and drink regularly, and turn back while everyone can still operate zippers, buckles, navigation tools, and communication devices.