(4) Remove excess clothing when in a warm enclosure or in front of a fire to
avoid sweating.
4-7.
TREATMENT
Treatment of cold injury depends upon the time elapsed after the injury, the
severity of the injury, the presence of complications, and the area affected. In military
operations, treatment will be influenced by the tactical situation, as well as by the
facilities available for the evacuation of causalities. Most cold injuries appear en masse,
during periods of intense combat, and at the time that large numbers of casualties
occur. The examination and treatment of life-endangering wounds must take
precedence over cold injuries. Highly individualized treatment is difficult during military
operations, because of the large numbers of patients who require treatment almost
simultaneously. The treatment of cold injury is divided into first aid, initial or emergency
medical treatment in forward areas, and definitive treatment after the patient has
reached a hospital. Since the latter two stages of treatment are conducted only by
qualified medical personnel, we shall discuss only first aid at this point. Prevent further
exposure to cold or at least shelter the patient from wind and cover the affected area.
Rewarming is accomplished promptly by body heat such as by putting cold-injured
hands into armpits under the clothing. If location of the injury prohibits use of patient's
own body, use body of another cold-injury victim or someone else. If cold injury occurs,
the patient should be restricted from his usual duties or activities until the severity of
injury can be evaluated. All constricting items of clothing such as boots, socks, or
gloves should be removed from the site of injury. The injured area must then be
protected from further cold injury by blankets or any available clothing that is not
constricting. Smoking, drinking of alcohol, and the application of medications, salves, or
ointments are prohibited. Blisters must not be opened. Drinking hot liquids is
encouraged, if available. If the lower extremity is involved, treat the victim as a litter
patient with the part level or slightly elevated. In unusual circumstances, where travel
on foot is the only means of evacuation for frostbite of the feet, thawing of the injured
area is not indicated until the patient reaches an aid station and medical help. DO NOT
allow an injury that has thawed to refreeze, as the resultant injury can be quite severe.
4-8.
THE WIND CHILL CHART
The human body is continually producing and losing heat. Wind increases the
loss of heat by removing the thin layer of warm air next to the skin. This loss increases
as the wind speed increases. When the temperature of the air is below freezing and the
wind removes the heat faster than the body can replace it, frostbite may occur. Thus,
decreasing the ambient (air) temperature or increasing the wind speed acts to increase
the danger of frostbite to exposed skin. The combined effect of wind and temperature is
expressed in the wind chill chart (Table 4-1) as an equivalent temperature.
MD0008
4-9