Winter is upon us, and it’s important to keep your family safe in dropping temperatures. Whether you’re hitting the slopes or just working outside around the house, be sure know these five facts about frostbite:

1. Frostbite is caused by freezing injury usually to the nose, ears, cheeks, chin, fingers and toes, parts of the body frequently exposed to the cold and whose circulation is easily impaired due to the cold. Prevention includes keeping these body parts covered with insulation, not going out in extreme cold, and keeping the whole body warm with adequate insulation, food and hydration and avoiding smoking and alcohol.
2. The early signs of frostbite are loss of feeling and color in these exposed areas. The skin becomes white or grayish-yellow in color and it feels firm or waxy. Do not ignore these early signs, otherwise frostbite can lead to blistering and permanent loss of tissue including amputation of fingers, toes, ears and nose. Be vigilant with your fellow adventurers outside to look for signs of frostbite on each other.
3. At the first signs of frostbite immediately stop what you are doing and take measures to warm up affected area. This may be as simple as putting on extra clothing or warming up fingers by blowing on them or putting them in your armpits. If this does not help then get into a warm environment, change out of wet clothing and put on new dry clothing.
4. Further measures include putting frostbitten extremities in warm water (heated to 100-105⁰F, have companion test warmth with their hands). Always try to warm up affected areas before attempting evacuation. Do not use fires, heating pads or stoves to directly warm up skin, this can lead to further injury.
5. Do not walk on frostbitten feet unless absolutely necessary to evacuate to safety. Once affected areas are re-warmed do not let them get frozen again. This will lead to even more injury. If you are an outdoor adventurer, take a wilderness first aid course to help prevent and treat all kinds of outdoor emergencies.

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Dr. Craig Warden is a Professor of Emergency Medicine and Pediatrics at OHSU. He currently serves as the Medical Director of the Global Mission Readiness in Clackamas, the Oregon State Urban Search & Rescue Task Force 1, Clackamas County Emergency Medical Dispatch and Clackamas County Emergency Medical Services Advisory Council.