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Cold injury
Last reviewed: 07.07.2025
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Exposure to cold can cause a decrease in body temperature (hypothermia) and local damage to soft tissues. Freezing of tissues results in frostbite. Non-freezing tissue damage includes cold cramps, trench foot, and frostbite. Treatment for cold injury involves warming.
Susceptibility to cold injury is increased by exhaustion, hunger, dehydration, hypoxia, cardiovascular disease, and contact with dampness or metal. Risk groups include the elderly, children, and people under the influence of alcohol or drugs. Elderly people have reduced temperature sensitivity, impaired mobility, and impaired sociability, which can lead to prolonged exposure to an excessively cool environment. These disorders, combined with thinning of the subcutaneous fat, contribute to hypothermia, sometimes even indoors, in cool rooms. Young children also have reduced mobility and sociability, and a higher body surface to mass ratio, which also increases heat loss. People under the influence of alcohol or who have lost consciousness in the cold are at high risk of hypothermia.
Prevention of cold injuries is extremely important. Layers of warm clothing and protection from dampness and wind are important even when the weather is unlikely to cause a cold injury. Wear clothing that does not give off heat, even when wet (e.g. wool or polypropylene). Gloves and socks should be kept dry if possible. In very cold weather, boots that do not restrict blood circulation are needed. Warm headgear is especially important because 30% of heat is lost from the surface of the head. Drinking enough fluids and food promotes metabolic heat production. A person’s attentive attitude to chilled or frozen areas of the body and their immediate warming can prevent cold injuries.
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