Extreme Cold Safety: Preventing Hypothermia and Frostbite

Author: Northwestern Medicine
Published: 7 Jan 2015 - Updated: 22 Oct 2026
Publication Type: Instructive / Helpful

Table of Contents:
Synopsis - Definition - Overview - FAQs - Insights, Updates - Related Content

Synopsis

This information from Northwestern Medicine sets out practical, physician-backed guidance for getting through extreme cold and severe winter weather without injury or illness. It explains how the body loses heat faster than it can produce it in cold conditions, defines hypothermia as a core body temperature below 95 degrees F (35 degrees C), and describes how frostbite progresses from red, cold skin to numb, hard and pale tissue that needs prompt medical care. Advice from Dr. Jack Franaszek, medical director of Northwestern Medicine's immediate care centers, covers the warning signs of hypothermia such as shivering, drowsiness, slurred speech and confusion, along with dressing in layers, avoiding slips on ice and pacing yourself when clearing snow. The guidance matters most for older adults, babies, people with heart or back conditions and people with disabilities, who can be more vulnerable to the cold and more likely to be cut off at home during a storm, which is why it also urges readers to check that elderly neighbors and relatives have heat, food and supplies.*

At a Glance

• 1 - Ice patches often form on bridges, overpasses and ramps even when the rest of the road is only wet.
• 2 - When shoveling, aim to clear four to six inches per load and lift with your legs and buttocks rather than your back.
• 3 - Frostnip, a mild form of frostbite, can be rewarmed by breathing into cupped hands or tucking a hand under the armpit.
• 4 - Home fires are more common in winter, so have the furnace checked, the chimney inspected and smoke and carbon monoxide detectors installed.

Topic Definition

Cold Weather Safety

Cold weather safety is the set of practices used to prevent injury and illness when temperatures drop, snow falls or ice forms. It centers on keeping the body's core temperature in its normal range and protecting exposed skin, mainly by dressing in dry, insulated layers, limiting time outdoors and recognizing early signs of hypothermia and frostbite. It also covers the secondary hazards of winter, including falls on ice, heart strain from shoveling snow, home heating fires, carbon monoxide poisoning and hazardous driving conditions, along with preparing homes and vehicles so that older adults, young children and people with disabilities stay warm and supplied during severe weather.

Overview

Tips On Staying Safe During Extreme Cold Temperatures

When exposed to cold temperatures, your body begins to lose heat faster than it can be produced. It is very important to remember to take caution during extremely cold temperatures and severe winter weather to prevent injuries and illness, such as hypothermia and frostbite. Hypothermia occurs most commonly at very cold environmental temperatures, but can occur even at cool temperatures (above 40 degrees F) if a person becomes chilled from rain, sweat, or submersion in cold water.

Frostbite:

Very serious condition that may occur when skin is exposed to a temperature lower than 14 degrees F (-10 degrees C). Skin first becomes very cold and red, then numb, hard, pale and swollen when underlying tissues are affected. Frostbite requires immediate medical attention because of possible extensive injury, which can be complicated by infection and nerve damage.

Frostnip:

Frostnip is a mild form of frostbite which irritates the skin, causing it to become mildly pale or red and feel cold, followed by numbness and a tingling feeling. The skin is not permanently damaged from frostnip. The affected part may be slowly warmed by breathing onto the injured site, such as breathing into cupped hands. A hand with frostnip can also be warmed under the armpit. Numbness gives way to a warm flush feeling that can be painful as rewarming progresses.

Hypothermia:

Hypothermia is a condition in which body core temperature drops below the required temperature for normal metabolism and body functions defined as 35.0 degrees C (95.0 degrees F). Body temperature is usually maintained near a constant level of 36.5 to 37.5 degrees C (97.7 to 99.5 degrees F). Hypothermia can quickly become life threatening and should be treated as a medical emergency. Hypothermia is the opposite of hyperthermia which is present in heat exhaustion and heat stroke.

"We usually see an increase in patients during cold spells," said Jack Franaszek, MD, medical director of Northwestern Medicine immediate care centers. "Minor injuries such as bumps, bruises and sprains from slips and falls on the ice are very common, as well as more serious conditions like frostbite and hypothermia."

To ensure a healthy and safe winter season, Franaszek recommends the following tips:

Be cautious of slippery conditions:

Icy sidewalks are the cause of many slips and falls. Wear boots that are well-insulated and have good traction on the bottom. Take shorter, slower steps to decrease your chance of falling and walk on shoveled sidewalks when possible.

Watch for falling ice:

Icicles build quickly and can be dangerous for unsuspecting pedestrians. Pay attention to signs for falling ice and be aware of your surroundings as you walk near tall buildings.

Dress in layers for warmth:

Avoid being outside for extended periods of time in extreme cold weather. If you are going outdoors, dress appropriately by layering clothing and wearing a scarf, hat and gloves, making sure to cover all areas of exposed skin.

Know the symptoms:

"Prolonged exposure to the cold can cause serious health problems including hypothermia," explained Franaszek. "If you experience symptoms such as shivering, drowsiness or exhaustion, slurred speech, memory loss or confusion, seek medical attention immediately."

Recognize the warning signs of Frostbite:

Frostbite affects areas of exposed skin including the nose, ears, cheeks, fingers and toes. Numbness, loss of feeling or a stinging sensation are early warning signs, and if you find your skin to feel firm or waxy or be white or grayish-yellow in color, get out of the cold and cover the area exposed. For suspected cases of frostbite, rewarm the affected area gently by immersing in warm, not hot, water, and make sure that the fingers or toes are not re-exposed to cold.

Clearing snow:

"Even though clearing snow is good exercise, it can also be dangerous," cautioned Franaszek. "Don't work to the point of exhaustion and pace yourself. If you have a history of heart or back problems, check with your doctor before clearing snow or have someone else shovel for you."

Prepare your house:

More home fires occur during the winter months than any other time of year. Take the proper precautions by having your furnace checked, your chimney inspected and proper smoke and carbon monoxide detectors installed. Make sure all electrical heaters are away from flammable materials, and that combustion heaters are well vented and working properly.

Eat and drink sensibly:

Caffeinated and alcoholic beverages can cause your body to lose heat more rapidly. Drink warm beverages or broth to maintain body temperature.

Check on neighbors and elderly relatives:

Colder weather can put the elderly at higher risk for health problems and restrict them to their homes due to severe weather. When subzero temperatures occur, be sure to check on elderly neighbors and relatives to make sure that their home is adequately heated and that they have the necessary food and other items they need.

Travel safely:

Before you pack up the car and hit the road this season, check the weather forecast. Slow down when driving. Be aware that ice patches can form on bridges, overpasses, and ramps when the rest of the streets are simply wet. It is also a good idea to pack a winter weather emergency kit in your car, complete with extra clothing and blankets, a shovel, sand or cat litter for traction and non-perishable snacks and water.

"Injuries and illnesses related to cold weather are preventable," Franaszek said. "Babies are especially vulnerable to the cold so make sure they are bundled up. An uncovered head loses heat quickly, so wearing suitable headgear is important. It's really all about taking simple precautions that will keep you safe this season."

Shovel Snow Safely

Dress appropriately:

Cold temperatures slow circulation to the body's extremities. Wear layered clothing, gloves and a hat to help maintain body temperature and circulation.

Don't procrastinate:

The longer the snow sits on the ground, the more compact it becomes. The more compact the snow is, the more exertion it takes to move it. Get out there at first snowfall and plan to make repeat trips.

Take it easy:

Start slowly, take breaks as necessary and try not to do the entire job at once.

Hydrate:

Your body needs hydration, even in frigid weather. Drink water regularly to prevent dehydration and don't drink alcohol before shoveling.

Avoid heavy meals:

Digestion strains the heart, so don't eat a meal before shoveling. Choose a protein-rich snack instead for a quick energy source.

Lift small amounts:

Use a small shovel and lift with your legs and buttocks instead of your back to avoid strain on the heart, back and neck. Aim to clear four to six inches per shovel load.

Listen to your body:

Your body knows best. If you are feeling winded or overexerted while shoveling, go inside and rest. Be on the lookout in particular for shortness of breath, chest, throat or arm discomfort or tightness, or lightheadedness. Seek medical attention if those symptoms persist.

Frequently Asked Questions

NOTE: Researched FAQs by Disabled World (DW)

Why are some people with disabilities at higher risk in extreme cold?

Conditions such as spinal cord injury, multiple sclerosis, diabetes with nerve damage and some circulatory disorders can reduce the ability to feel cold or regulate body temperature. Limited mobility can also make it harder to warm up, change wet clothing or leave a cold environment quickly.

Can medications increase the risk of hypothermia?

Yes. Some medications, including certain antipsychotics, sedatives, beta blockers and other drugs that affect circulation or alertness, can make it harder for the body to stay warm or to notice that it is getting cold. Anyone taking regular medication should ask a doctor or pharmacist whether it affects cold tolerance.

What is wind chill and why does it matter?

Wind chill describes how cold it feels on exposed skin when wind and low temperature combine. Wind strips heat from the body faster, so frostbite can develop on exposed skin in 30 minutes or less when wind chill values fall to around minus 18 degrees F.

Should you rub frostbitten skin to warm it up?

No. Rubbing or massaging frostbitten skin can damage the tissue further. Avoid heating pads, fireplaces and other direct heat as well, because numb skin can burn without the person feeling it.

How far should space heaters be kept from other items?

Fire safety groups recommend keeping at least three feet of clear space around a space heater. Plug it directly into a wall outlet rather than an extension cord and turn it off when leaving the room or going to sleep.

What are the signs of carbon monoxide poisoning?

Common signs include headache, dizziness, weakness, nausea, vomiting, chest pain and confusion. If several people in a home feel unwell at the same time, get everyone outside to fresh air and call emergency services.

What should people who rely on powered medical equipment do before a winter storm?

Keep backup batteries charged, ask the equipment supplier about backup power options and register with the local electric utility if it offers a medical priority program. It also helps to have a plan for where to go if the power stays off for a long time.

Is it safe to use a generator or grill indoors during a power outage?

No. Generators, charcoal grills and camp stoves produce carbon monoxide and should never be used inside a home, garage, basement or near open windows. Generators should be placed at least 20 feet from the house with the exhaust pointed away from doors and windows.

Insights, Analysis, and Developments

Editorial Note: Cold weather injuries are largely preventable, yet they still fill emergency departments every winter, and most of them come down to a handful of everyday risks - an icy sidewalk, a driveway shoveled too fast, a furnace that was never inspected or a car trip taken without a basic emergency kit. For people with disabilities, chronic illness or limited mobility, those risks are sharper: reduced sensation can hide the early signs of frostbite, some conditions and medications weaken the body's ability to regulate temperature, and a power outage or blocked road can quickly turn into isolation. Planning ahead, keeping warm layers and supplies on hand and having someone who checks in during a cold snap are simple steps that make a real difference to staying safe until the weather breaks.*

Attribution/Source(s): This quality-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally issued as a press release by Northwestern Medicine and published on 7 Jan 2015. Last updated on 22 Oct 2026. This content may have been edited for style, clarity, or brevity.

* Editorial additions by Ian C. Langtree.