Environmental Emergencies – Part 1 “Cold Exposure”​

This portion of the First Aid program offers a detailed explanation of how to handle environmental emergencies including exposure to both “Heat” and “Cold“. To explain how we can help, we must first refer back to a previous post about “Burns”, as we are talking about a “Thermal Dynamic Energy” your body can take damage from to much exposure to both heat and cold, it depends on the amount you are exposed to that will detail the severity of the injury. To quote a slogan from our post about Burns, if “Hot is Fast, then Cold must be Slow“. Once again this will help us distinguish the difference in the injuries and potential treatments we can use to help the patient.

Just remember that Thermal energy in either direction Hot or Cold will result in levels of severity and symptoms that are very similar but on opposite ends of the spectrum “Fire / Ice“, Lets focus on Cold exposure for this article.

As your flesh cools down to levels where it can sustain damage, your tissue will naturally react as many other substances do when encountering a “Cold energy Source“. Your flesh will freeze and the “cold” energy your flesh is being exposed to will naturally react, as you are roughly 60%-65% water, your tissue will naturally expand and crystallize as it freezes. we have heard the saying “Hot is Fast & Cold is Slow.” as it takes “Time” for your tissue to freeze, it will also take “Time for it to thaw. once you know this you can see that “to much heat” can actually cause damage rather than helping. The best way to describe this is to picture an “Ice Cube” that you just made in an ice cube tray, now in your mind take that ice cube from the tray and drop it in a hot cup of soup because the soup is too hot. What does the ice cube do? It cracks, snaps, pops and breaks apart, now…. picture someone’s frozen fingers, if you were to run their frozen fingers under hot water to warm it up what would happen? “Hot is Fast so Cold MUST be slow” once you can see the difference the treatments will be clear.

“Frost Nip”

  • Damage to the first and second layers of your tissue comes with redness around the injury, blanching at site of injury, pain, possible swelling. Most commonly comes with itching, stinging and finally numbness of the flesh.

“Frost Bite”

  • Damage to all layers of tissue and flesh. Frost Bite may present with a burning sensation, pain mild to severe “Darker, hard, solid Waxy skin that is colder than the area around it“, swelling, blisters, pain and tenderness may remain after thawing. Always consult medical professionals for Frost Bite or full thickness Cold injuries as infection rates are dramatically increased.


  • Exposure to cold temperatures.


Thermal Burns From a Cold Source

  • If you are in, on, or around a cold environment, prepare properly, wear layer of clothing and warm yourself if you feel cold.
  • Wear a tuque and layers of clothing made of tightly woven fibers, such as wool or synthetics like fleece. “AVOID COTTON!
  • Cover Up vulnerable areas such as your fingers, toes, cheeks, ears, and nose “But don’t cover them too tightly”
  • Drink plenty of warm fluids to help your body stay warm, if warm drinks are not available, drink plenty of plain water or electrolyte drinks “Not energy drinks“.
  • Avoid caffeine & alcohol because they can cause dehydration, which stops your body from controlling its temperature properly.
  • Take frequent breaks from the cold to let your body warm up. This will help you cope better with short periods of extreme cold.

How to Treat a Burn: “Thermal – From a Cold Source”

  1. Check the area, once the area is safe, Check the person and ensure the persons ABC’s are present “Airway / Breathing / Circulation REMEMBERWear gloves if available to avoid bodily fluids.
  2. Call 911 and get an AED if the cold injury covers more than 10% of the body, the person is in a great deal of pain, there is blackening on the wound, full thickness “Frost Bite” or the injury was caused by a chemical “Dry Ice / Nitrogen” or you suspect “Hypothermia
  3. Care for the Cold Injury by:

Always follow recommendations by your Emergency Response professionals and 911 Dispatch personnel. ” Never endanger yourself and maintain a safe distance from the source of the injury”

a) Warm the affected area with warm water, body heat or hot packs by “Placing a heat source at the Joint nearest the coldest Point” your joints are full of veins and arteries, by placing a heat source at the joints you can warm the blood before it enters the frozen tissue to “Gradually” thaw out the injured body part to reduce potential damage to the flesh. “Patience NEVER place an active heat source against frozen tissue, this may cause extreme pain and damage to the tissue.

b) Don’t break any blisters! Protect them with loose, dry dressings. Place gauze between the fingers or toes if they are affected.

c) Always Seek Medical Attention for “Frost Bite“.


  • Don’t rub the frozen area or put snow on it. Warm the area only if you are sure it will not freeze again.
  • Avoid “Direct” heat as this may damage the tissue further, use heat sources closer to the core above the injury. “Put the Hot Pack at the Point, Nearest the coldest Joint

As you can see, the treatment on Cold Exposure in this tutorial are the same regardless of the name “Frost Nip / Frost Bite“. Once you master the First Aid technique on how to aid a Thermal injury caused from a Cold source you can aid anyone who has been exposed to too much Cold energy. Just remember that it does not matter what the name of the cold exposure injury is, the treatments are often the same “Hot is Fast & Cold is Slow“. Put a heat source at the joint nearest the coldest point and gradually warm the cold exposure related injury.

In any emergency just remember to Protect Yourself!!! Call 911!!! Don’t Waste Time!!!

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