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081-831-1045 (SL1) - Perform First Aid for Cold Injuries

Standards: Identified the type of cold injury and gave the correct first aid.

Conditions: You see a casualty who has signs and symptoms of a cold
injury. 
Necessary equipment and materials:
canteen of potable water, blanket or similar
item to use for warmth, and dry clothing.

Standards:
Identified the type of cold injury and gave
the correct first aid.

Performance
Steps

Note.  When
performing first aid on a casualty,
seek medical aid as soon as possible. 
Do not stop the first aid; but,
if the situation allows, send another
person to find medical aid.

1.   Identify the type of cold injury.

a.
Chilblain/frostnip. 
If the signs and symptoms are
as follows, go to step 2a.

(1) 
Prolonged exposure of
bare skin at temperatures of 60
degrees Fahrenheit to 32 degrees
Fahrenheit.

(2) 
Redness or pallor of
affected areas.

(3) 
Absence of pain (numb).

(4) 
May have ulcerated
bleeding skin lesions.

Note.  Freezing of
superficial skin tissue may occur with
frostnip; however, there is no
freezing of the deeper tissues.

b.
Frostbite.  If the signs and symptoms are as follows, go to step 2b.

(1) 
Superficial.

(a)  
Loss of sensation or
numb feeling in any part of the
body.

(b)  
Sudden whitening of
the skin in the affected area
followed by a momentary tingling
feeling.

(c)  
Redness of skin in
light-skinned soldiers, grayish
coloring in dark-skinned
soldiers.

(2) 
Deep.

(a)  
Blisters.

(b)  
Swelling or tender
areas.

(c)  
Loss of previous
feeling of pain in the affected
area.

(d)  
Pale, yellowish,
waxy-looking skin.

(e)  
Frozen area feels
solid or wooden to the touch.

c.
Immersion foot/trench
foot. 
If the signs and symptoms are
as follows, go to step 2c.

(1) 
Long exposure of feet
to wet conditions at temperatures
from 50 degrees Fahrenheit to 32
degrees Fahrenheit.

(2) 
Early stage/first
phase.

(a)  
Affected area feels
cold.

(b)  
Numb and painless.

(3) 
Later stage/advanced
phase.

(a)  
Limbs feel hot and
burning.

(b)  
Shooting pains.

(c)  
Affected area is pale
with bluish cast.

(d)  
Pulse strength
decreased.

(e)  
Other signs that may
follow include 
blisters, swelling,
redness, heat, hemorrhages, or
gangrene.

d.
Snow blindness.  If the signs and symptoms are as follows, go to step 2d.

(1) 
Scratchy feeling in
eyes, as if from sand or dirt.

(2) 
Watery eyes.

(3) 
Redness.

(4) 
Headache.

(5) 
Increased pain with
exposure to light.

e.
Hypothermia.  If the signs and symptoms are as follows, go to step 2e.

(1) 
Mild hypothermia (body
temperature 90 to 95 degrees
Fahrenheit).

Note.  This condition should be suspected in any chronically ill
person who is found in an environment
of less than 50 degrees Fahrenheit

CAUTION:
With generalized hypothermia, the
entire body has cooled with the core
temperature below 95 degrees
Fahrenheit. 
(Temperature is provided as a
guide; the common soldier probably
would not have a thermometer to use.) 
This is a medical emergency

(a)  
Conscious, but
usually apathetic or lethargic.

(b)  
Shivering.

(c)  
Pale cold skin.

(d)  
Slurred speech.

(e)  
Poor muscle
coordination.

(f)   
Faint pulse.

(2) 
Severe hypothermia
(body temperature 90 degrees
Fahrenheit or lower).

(a)  
Breathing slow and
shallow.

(b)  
Irregular heart
action.

(c)  
Pulse weaker or
absent.

(d)  
Stupor or
unconsciousness.

(e)  
Ice cold skin.

(f)   
Rigid muscles.

(g)  
Glassy eyed.

CAUTION:
Hypothermia is a medical emergency. 
Prompt medical treatment is
necessary. 
Casualty should be evacuated to
medical treatment facility immediately

f. 
Dehydration (cold
weather). 
If the signs and symptoms are
as follows, go to step 2f.

(1) 
Mouth, tongue, and
throat are parched and dry.

(2) 
Swallowing is
difficult.

(3) 
Nausea and dizziness.

(4) 
Fainting.

(5) 
Tired and weak.

(6) 
Muscle cramps
especially in the legs.

(7) 
Focusing eyes may be
difficult.

2.   Perform first aid for the cold injury.

a.
Chilblain/frostnip.

(1) 
Apply rewarming (body
heat).

(a)  
Apply warmth with
casualty’s bare hands.

(b)  
Blow warm air on the
affected area.

(c)  
For hands and
fingertips, place hands in
armpits.

(2) 
Protect lesions (if
present) with dry sterile
dressing.

(3) 
Seek medical aid.

CAUTION:
Do not rub or massage area.

Note.  If the condition does not respond to simple care, begin
first aid for frostbite.

b.
Frostbite.

CAUTION: 
DO NOT–
Rub snow on the frostbitten part.
Massage or rub the frostbitten part.
Use dry or radiant heat to rewarm.
Rupture blisters.
Use ointments or other medications on
the part.
Handle a frostbitten extremity
roughly.
Allow a thawed extremity to refreeze.
Allow the casualty to use alcohol or
tobacco products

(1) 
Warm the area using
firm, steady pressure of hands,
underarm, or abdomen.

(2) 
Face, ears,
nose-cover with hands
(casualty’s or a buddy’s).

(3) 
Hands-open casualty’s
field jacket and place against the
body (under armpits if possible),
then close the jacket.

(4) 
Feet-remove boots,
socks, and place feet under
clothing and against the body of
another soldier.

CAUTION:
Do not remove clothing in a chemical
environment.

WARNING:
Do not attempt to thaw the casualty’s
feet, or other seriously frozen areas,
if the soldier will be required to
walk or travel to a medical center to
receive medical treatment. 
The possibility of injury from
walking is less when the feet are
frozen than after they have been
thawed (if possible, avoid walking). 
Thawing in the field increases
the possibility of infection,
gangrene, or injury.

(5) 
Loosen or remove
constricting clothing and remove
any jewelry.

(6) 
Increase insulation
(cover with blanket or something
similar and dry).

(7) 
Have the casualty
exercise as much as possible,
avoiding trauma to injured part(s).

(8) 
Seek medical aid. 
(Evacuate the casualty.)

WARNING:
Monitor the casualty for
life-threatening conditions and apply
appropriate first aid as necessary.

c.
Immersion foot/trench
foot.

(1) 
Gradually rewarm by
exposing to warm air.

(2) 
Protect affected parts
from trauma.

(3) 
Dry feet thoroughly and
avoid walking.

(4) 
Elevate the affected
part.

(5) 
Seek medical treatment. 
(Evacuate the casualty.)

d.
Snow blindness.

(1) 
Cover the eyes with a
dark cloth.

(2) 
Seek medical treatment.
 (Evacuate
the casualty.)

e.
Hypothermia.

CAUTION:
This is a medical emergency! 
Prompt medical treatment is
necessary.

(1) 
Mild.

(a)  
Rewarm body evenly. 
(Must provide heat
source–campfire or other
soldier’s body.)

Note.  Merely
placing the casualty in a sleeping bag
or covering with a blanket is not
enough since the casualty is unable to
generate his own body heat.

(b)  
Keep dry and protect
from the elements.

(c)  
Give warm liquids
gradually if the casualty is
conscious.

(d)  
Seek medical
treatment immediately.

(2) 
Severe.

(a)  
Stabilize the
temperature.

(b)  
Attempt to avoid
further heat loss.

(c)  
Evacuate to the
nearest medical treatment
facility as soon as possible.

Note.  Rewarming a severely hypothermic casualty in the field is
extremely dangerous. 
There is a great possibility of
complications such as rewarming shock
and disturbance in the rhythm of the
heartbeat.

WARNING:
Monitor the casualty for
life-threatening conditions.

f. 
Dehydration.

(1) 
Keep warm.

(2) 
Loosen clothes to
improve circulation.

(3) 
Give fluids for fluid
replacement.

Note.  Medical
personnel will determine the need for
salt replacement.

(4) 
Rest.

(5) 
Seek medical
assistance.

Evaluation Preparation: 

Setup:  Have a soldier
play the part of the cold injury casualty. 
Select one type of cold injury on
which to evaluate the soldier. 
Coach the simulated casualty on how
to answer questions about symptoms. 
Physical signs and symptoms that the
casualty cannot readily simulate (for
example blisters) must be described to the
soldier.

Brief
Soldier: 
Tell the soldier to determine what
cold injury the casualty has. 
After the cold injury has been
identified, ask the soldier to describe the
proper treatment.

Performance
Measures

GO

NO
GO

1.   Identified the type of cold injury.

2.   Provided the proper first aid for the cold injury.

Evaluation
Guidance: 
Score the soldier GO if all the
performance measures are passed. 
Score the soldier NO GO if any
performance measure is failed. 
If the soldier scores NO GO, show
what was done wrong and how to do it
correctly.

References

 

Required

Related

 

 

FM
4-25.11