Exposure to cold and health: How do I prevent hypothermia or frostbite and how do I provide first aid in an emergency?



Human adaptability to different environmental conditions is the focus of numerous scientific studies. Among the extreme environmental conditions, the cold occupies a special place. Exposure to low temperatures can lead to serious health consequences such as frostbite, which can occur with inadequate preparation or extreme cold. Worldwide, the total mortality from cold-related deaths is 5,083,173 people per year. This figure is around 20 times higher than the number of heat-related deaths per year. Cold affects us all, especially in the winter months. So how do you recognize hypothermia and what can I do for others or myself in an emergency?


Unterkühlung (Zay Nyi Nyi/iStock)

Hypothermia - Hypothermia


Hypothermia is when the body's core temperature falls below 35°C and the body loses more heat than it can produce over a longer period of time. This can happen when we are outside for a long time in winter. A cold home, rain or perspiration can also be the cause of hypothermia. Children, due to their larger ratio of body surface area to body mass, older people and exhausted people are particularly affected. However, impaired people (alcohol, drugs, etc.) also have a higher risk of suffering hypothermia.

Classification of hypothermia

Hypothermia can be divided into three different classes:


Depending on the degree and severity of hypothermia, various symptoms may occur, such as shivering, shivering or an increase in blood pressure. In moderate to severe hypothermia, symptoms can range from a slowed heartbeat and reduced breathing to respiratory failure and thus respiratory-circulatory arrest.

Rescue teams at the scene usually classify their patients according to the Swiss classification system, which is divided into the following five stages:

Stage IFreezing, responsive, clear consciousness35-32°C
Stage IIDifficult to respond, clouding of consciousness32-28°C
Stage IIIunresponsive, unconscious28-24°C
Stage IVApparent death, no/minimal signs of life<24°C
Stage Vdeath<15°C

Heat regulation of the body and symptoms of hypothermia

The body controls heat processes via temperature sensors. These sensors measure the actual value, which is then compared with a target value. If the actual value is lower than the target value, the body tries to increase the actual value through activity, e.g. shivering. If the actual value is higher than the target value, the body tries to cool itself down, e.g. by sweating. Heat is transported through the blood to all areas of the body. If our body can no longer compensate for the deviations from the setpoint, either hypothermia or fever occurs.

In the case of hypothermia, our body tries to protect the most important organs for as long as possible. This increases blood flow in the trunk of the body and reduces blood flow to the extremities. This phenomenon is also known as circulatory centralization and explains why we usually get cold in our fingers and toes first.

Freezing girl

Mädchen friert (Mitrey/pixabay)

Depending on the stage, there are other symptoms that indicate hypothermia:

Stage I

Muscle tremors, deep breathing, increased pulse, clear consciousness

Stage II

Impairment of brain functions, stiff muscles, drowsiness, barely responsive

Stage III-VAbsolute danger to life, unconscious, pulse barely palpable

From a core body temperature of <24°C, respiratory-circulatory arrest occurs. People with hypothermia are usually unaware of their situation, as their consciousness is altered due to impaired brain function. Confusion, tiredness, drowsiness and unconsciousness occur.

General first aid measures

If there are signs of hypothermia, you should proceed as follows:

Euro emergency call 112 Euronotruf 112

Allgemeine Erste Hilfe Maßnahmen

If you notice signs of hypothermia, you should proceed as follows:

  1. Call the emergency services: in Austria and Switzerland call 144 or in Germany and throughout Europe call 112
  2. Check consciousness
    Talk to the person concerned and shake them gently. It is important that you speak loudly and clearly.
  3. Check breathing
    1. If the person is breathing normally, place them in the recovery position and wait for the emergency services to arrive. It is important that you keep checking the person's breathing so that you can detect a respiratory arrest as early as possible and start resuscitation measures.
    2. If the person is NOT breathing, start resuscitation measures immediately. 30 chest compressions and 2 ventilations. Continue this until the emergency services arrive or the person shows signs of life again. Try to draw attention to yourself so that you can get help and take turns with the resuscitation measures. This is very important, as various studies have shown that the quality of chest compressions deteriorates after just a few minutes.

Further first aid measures depend on the stage of hypothermia.

In stage I (see above for symptoms), the following first aid measures should be taken:

  • Affected person should be taken to a warm place and warmed up SLOWLY
  • Remove cold and/or wet clothing and wrap the affected person in dry (rescue) blankets
  • Avoid further exposure to cold
  • Do NOT actively warm the affected person (with hot water bottles, cherry stone cushions, rubbing, etc.)
  • if the person is conscious: give warm, sweetened drinks (e.g. teas)
  • Do not give alcoholic drinks
  • Calm the affected person and wait until the emergency services arrive
  • NEVER leave the affected person alone

In stage II or higher (see above for symptoms), the following first aid measures should also be taken:

  • DO NOT attempt to warm up
  • DO NOT ACTIVELY warm the affected person (hot water bottles, cherry stone cushions, etc.)
  • If unconscious, place the victim in a stable lateral position and cover them up

If the victim is lying on the cold floor, it is advisable to place a blanket underneath.

Mountain rescue Bergrettung (Roman Apaza/pexels)

Rescue death is a very special phenomenon. The person concerned dies immediately after being rescued. The reason for this is the redistribution of blood in the body in the cold. Due to the centralization of the circulation, the warm blood is concentrated in the center of the body (trunk). In severe hypothermia, the temperature difference between the body core (trunk) and the body periphery (extremities) is very large. Movement causes the cold blood to flow to the center of the body and lowers the core body temperature within minutes, which can lead to fatal cardiac arrhythmias. Rapid movements during repositioning should therefore be avoided at all costs.


Definition of frostbite

Frostbite is skin and tissue damage caused by cold temperatures or touching cold objects. Parts of the body that protrude are more frequently affected than others. These include fingers, ears, nose, cheeks or toes. Children are also more at risk of frostbite than other people. The cold leads to circulatory problems in the affected areas of the body, resulting in a lack of oxygen and, in the worst case, cell death (necrosis).

Winter clothing

Winterkleidung (pasja1000/pixabay)


Frostbite is roughly divided into superficial and deep frostbite. Superficial frostbite affects the uppermost layers of the skin and is not normally an emergency. The symptoms usually subside a few minutes after the affected area has been protected and warmed up again. However, medical help should be sought in the event of prolonged numbness.

In the case of deep frostbite, all layers of skin up to and including the muscle can be affected. In very severe cases, bone damage may even occur and the affected body part may have to be amputated. Deep frostbite is a medical emergency and therefore requires immediate medical treatment.


Those affected have numbness or numbness in the affected areas. The areas of the body may turn bluish-red, white-yellow or white-grey. People with frostbite also often report the feeling that their shoes are too small. The affected areas are cold, soft and painful at first and then hard and numb. There may also be bruising and blistering.

The problem with frostbite is that it is hardly noticed at first, but only when it warms up again, when severe pain occurs. At this point, the damage is usually already very severe. The onset of numbness in cold weather should therefore always be taken very seriously.

Euro emergency call 112 Euronotruf 112

Erste Hilfe Maßnahmen

  • Call anemergency number: in Austria and Switzerland 144 or in Germany and throughout Europe 112.
  • DO NOT move frostbitten areas of the body
  • Open tight clothing or shoes
  • Try to warm up, with the exception of parts of the body that are already hard and frozen
  • Affected persons should try to move the affected body parts themselves (active movement)
  • Under no circumstances should movement be carried out by a third party (passive movement)
  • DO NOT apply active heat (hot water bottles, cherry stone cushions, etc.)
  • Avoid further exposure to cold
  • Give warm sugared drinks
  • Do not administer alcoholic drinks
  • Blisters should be covered aseptically
  • Look after the victim until the emergency services arrive;
  • NEVER leave the affected person alone

If hypothermia is present at the same time, first aid measures to combat hypothermia have priority.

Rescue helicopter

Rettungshubschrauber (Stuhli55/pixabay)

What can I do to avoid hypothermia/frostbite?

To avoid hypothermia or frostbite, you should avoid extreme cold as a first measure. It makes sense to find out about the weather before you leave your home. In very extreme weather conditions, it makes sense to stock up on heating material and food so that you can wait out the weather at home. If this is not possible, you should make sure you choose the right clothing. It should be breathable and windproof at the same time. Spare clothing and provisions can be a lifesaver for longer stays outdoors. It is important to eat and drink enough, not only in the heat but also in the cold. However, alcoholic drinks are contraindicated because alcohol dilates the blood vessels and the body loses heat even faster. The saying "alcohol warms you up" is a myth. It only changes the sensation of warmth, which gives you a warming feeling. Alcohol therefore not only ensures that the body cools down more quickly, but also gives you a warming feeling. This combination makes alcohol very dangerous in extremely cold weather. You should also carry a cell phone with you on longer car journeys or snow hikes so that you can call for help quickly.

Warm sugared drink

Warmes gezuckertes Getränk (JillWellington/pixabay)

Caritas cold telephone

A special project to combat cold deaths, which is run by Caritas, is the cold telephone. You can call it if you discover homeless people sleeping rough during the winter months. The cold phone is manned around the clock from November to the end of April. Click here for the telephone numbers.

So if you discover a sleeping place of a homeless person, you can call them and should provide the following information:

  • Date
  • time
  • exact location
  • Description of the person(s)

Due to the large number of reports received, it is not always possible to guarantee immediate intervention. In acutely life-threatening situations, call the emergency number: in Austria and Switzerland 144 or in Germany and throughout Europe 112.

Editorial principles

All information used for the content comes from verified sources (recognised institutions, experts, studies by renowned universities). We attach great importance to the qualification of the authors and the scientific background of the information. Thus, we ensure that our research is based on scientific findings.
Thomas Hofko

Thomas Hofko

Thomas Hofko is in the last third of his bachelor's degree in pharmacy and is a writer on pharmaceutical topics. He is particularly interested in the fields of clinical pharmacy and phytopharmacy.

The content of this page is an automated and high-quality translation from DeepL. You can find the original content in German here.

Last Update





Your personal medicine assistent

afgis-Qualitätslogo mit Ablauf Jahr/Monat: Mit einem Klick auf das Logo öffnet sich ein neues Bildschirmfenster mit Informationen über medikamio GmbH & Co KG und sein/ihr Internet-Angebot: medikamio.com/ This website is certified by Health On the Net Foundation. Click to verify.

Search our database for drugs, sorted from A-Z with their effects and ingredients.


All substances with their common uses, chemical components and medical products which contain them.


Causes, symptoms and treatment for the most common diseases and injuries.

The contents shown do not replace the original package insert of the medicinal product, especially with regard to dosage and effect of the individual products. We cannot assume any liability for the correctness of the data, as the data was partly converted automatically. A doctor should always be consulted for diagnoses and other health questions. Further information on this topic can be found here.