Hypothermia and Frostbite: Warning Signs and First Aid That Could Save a Life

You don’t need snow to get hypothermia. Wet clothes, wind and a cold house can drop your body temperature to dangerous levels, even when the thermometer reads well above freezing. Older people and babies are most at risk, and they often can’t tell you something is wrong.

Imagine visiting your elderly neighbour on a cold morning. The heating is off to save money. She is sitting in her chair, a little confused, speaking slowly, her hands cold and pale. She says she’s “just tired.” Those small changes, the slow speech, the confusion, the cold skin, are exactly how hypothermia often shows up in older people.

What is hypothermia?

Hypothermia is when your core body temperature falls below 35°C (95°F). Normal is around 37°C (98.6°F). It is a medical emergency.

Warning signs

• Adults: shivering, cold and pale skin, slurred speech, slow breathing, tiredness, confusion and clumsiness
• Severe hypothermia: shivering may stop, the person may become drowsy, unresponsive or have a very slow pulse
• Babies: cold to the touch, bright red or pale skin, floppy, unusually quiet and not wanting to feed

First aid for hypothermia

1. Call your local emergency number.
2. Move the person somewhere warm, or out of the wind and rain. Handle them gently.
3. Remove wet clothing and replace it with dry layers.
4. Warm the centre of the body first: chest, neck, head and groin. Use blankets, towels or skin-to-skin contact.
5. Give warm (not hot) sweet drinks only if the person is fully alert and can swallow. No alcohol.
6. Stay with them until help arrives. Start CPR if they stop breathing normally and you are trained.

Don’t rub their arms and legs, put them in a hot bath, or use a hot water bottle or heater directly on the skin. Rapid warming of the limbs can push cold blood back to the heart and cause dangerous heart rhythm problems.

What is frostbite?

Frostbite is damage to skin and the tissue underneath caused by freezing. It usually affects the fingers, toes, nose, ears, cheeks and chin.

• Early (frostnip): cold, pins and needles, red or pale skin. It recovers fully with warming.
• Superficial: skin turns white, grey or yellowish, feels hard or waxy, and may blister after warming
• Deep: skin and tissue below freeze, numbness, and later the area can turn black

First aid for frostbite

• Get out of the cold and check for hypothermia first. It is the bigger danger.
• Remove rings, watches and tight clothing near the area.
• Rewarm the area in warm (not hot) water, roughly body temperature, for 15 to 30 minutes, or use body heat such as an armpit.
• Don’t rub the area or burst blisters, and don’t use direct heat like a fire or heating pad. Numb skin burns easily.
• Don’t rewarm if there is a chance it will freeze again before you reach safety. Refreezing causes more damage.
• Get medical help for anything beyond frostnip.

But who is really at risk?

Anyone can be, but the highest risk is in older people living alone or in cold homes, babies, people who are homeless, people who have been drinking alcohol, people with dementia, diabetes or thyroid problems, and anyone hiking, climbing or working outdoors in winter. A warm home (at least 18°C in living rooms is a common public health guide), layered clothing, hot meals and checking on vulnerable neighbours all make a real difference.

Sources: NHS (Hypothermia, Frostbite), US Centers for Disease Control and Prevention (Winter weather), Mayo Clinic, Red Cross first aid guidance, World Health Organization housing and health guidelines. This guide is for general information and does not replace advice from your own nurse, doctor or pharmacist.