What are the Wilderness Medical Society guidelines on prehospital treatment of frostbite?

Updated: Oct 13, 2020
  • Author: Bobak Zonnoor , MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

The following is a summary of field treatment (>2 hours from definitive care):

  • Treat hypothermia or serious trauma
  • Remove extraneous material (eg, jewelry) from affected body part
  • Rapidly rewarm affected body part in water (maintain 37-39°C [98.6-102.2°F]) until the area is soft (pliable) to the touch; passive rewarm if rapid rewarming not available
  • Administer ibuprofen at 12 mg/kg/day divided twice daily, if available
  • Administer pain medication (eg, opiates) as needed, if available
  • Institute air drying (ie, do not rub at any point)
  • Protect from refreezing and direct trauma
  • Apply aloe vera gel or cream, if available
  • Use dry, bulky dressings
  • Elevate affected body part, if possible
  • Ensure systemic hydration
  • Avoid ambulation on thawed lower extremity, except if only distal toes affected

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