How should frostbite be managed in the field?

• A. Rewarm affected areas gradually with warm water; avoid rubbing; protect with sterile dressings; do not rewarm if re-freeze risk exists
• B. Rub vigorously to restore circulation
• C. Use hot water from the tap immediately
• D. Expose to heat lamp to speed warming

Answer: (B)

Frostbite in the field is managed with controlled rewarming and careful protection, not massage or direct heat. When it’s safe to rewarm, immerse the affected area in circulating warm water at about 37–39°C (98–102°F) for 15–30 minutes until the skin softens and color returns. Rubbing or massaging the tissue should be avoided because mechanical friction can cause further tissue injury. Do not use hot water, dry heat, or heat lamps, as these can burn damaged tissue after freezing. If there’s a real risk of the area refreezing, postpone rewarming and instead protect and insulate the frostbitten part until safe rewarming can be performed. After rewarming, cover with a sterile dressing, avoid breaking blisters, keep the patient warm, and arrange for medical evaluation.