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TABLE 7 List of Recommended Prevention Measures to Decrease References
Frostbite Risk* 1. Paton BC. Cold, casualties and conquests: the effects of cold on
Frostbite warfare. In: Pandolf KB, Burr RE, eds. Medical Aspects of Harsh
Risk Level Prevention Measures Environments. Vol 1. Falls Church, VA: Office of the US Army
• Increase surveillance with self and buddy checks Surgeon General; 2002:313–349.
2. Schechter DC, Sarot IA. Historical accounts of injuries due to
• Wear appropriate layers and wind protection for cold. Surgery. 1968;63(3):527–535.
work intensity 3. Sokolov V, Biryukov A, Chmyrev I, Tarasenko M, Kabanov P.
Low
• Cover exposed flesh if possible Burns and frostbite in the Red Army during World War II. Milit
• Wear vapor barrier boots <0°F Med Res. 2017;4:5.
• Avoid sweating 4. Schissel DJ, Keller R, Barney DL. Cold weather injuries in an
arctic environment. Milit Med. 1998;163:568–571.
• Mandatory buddy checks every 20–30 min 5. Leon GR, Venables NC. Fearless temperment and overconfidence
• Wear ECWCS or equivalent and wind protection, in an unsuccessful Special Forces polar expedition. Aerosp Med
including head, hands, feet, face Human Perform. 2015;86(6):567–570.
High • Cover exposed flesh 6. Degroot DW, Castellani JW, Williams JO, Amoroso PJ. Epide-
miology of U.S. Army cold weather injuries, 1980–1999. Aviat
• Wear vapor barrier boots <0°F
Space Environ Med. 2003;74(5):564–570.
• Provide warming facility 7. Hall A, Evans K, Pribyl S. Cold injuries in the United States mil-
• Avoid sweating itary population: current trends and comparisons with past con-
• Mandatory buddy checks every 10 min flicts. J Surg Educ. 2010;67(2):61–65.
8. Pozos RS, Danzl DF. Human physiological responses to cold
• Wear ECWCS or equivalent and wind protection, stress and hypothermia. In: Pandolf KB, Burr RE, eds. Medical
including head, hands, feet, face Aspects of Harsh Environments. Vol 1. Falls Church, VA: Office
• Wear vapor barrier boots of the US Army Surgeon General; 2002:351–382.
Severe • Provide warming facility 9. Cutter L. Extreme weather conditions: military medicine responds
to a Korean War winter. Milit Med. 2015;180:1017–1018.
• Work in groups of at least two personnel 10. US Army Technical Manual TM 10-8415-236-10. Extended
• No exposed skin Cold Weather Clothing System Generation III (ECWCS GEN III).
• Stay active https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx
• Avoid sweating ?PUB_ID=84917. Accessed 10 August 2020.
11. US Army Technical Bulletin (TB) MED 508. Prevention and
• Be ready to modify activity because of extreme risk management of cold-weather injuries. https://armypubs.army.mil
• Wear ECWCS or equivalent and wind protection, /ProductMaps/PubForm/Details.aspx?PUB_ID=82441. Accessed
including head, hands, feet, face 9 August, 2020.
• Wear vapor barrier boots 12. National Aeronautics and Space Administration. Arctic Sea Ice
• Provide warming facility Minimum. https://climate.nasa.gov/vital-signs/arctic-sea-ice/. Ac-
Extreme cessed 11 August 2020.
• Keep task duration as short as possible 13. Brosig M, Frawley P, Hill A, et al. Implications of climate change
• Work in groups of at least two personnel for the U.S. Army. https://climateandsecurity.files.wordpress.com
• No exposed skin /2019/07/implications-of-climate-change-for-us-army_army
-war-college_2019.pdf. Accessed 11 August 2020.
• Stay active 14. US Department of Defense. Report to Congress. Department
• Avoid sweating of Defense Arctic Strategy. https://media.defense.gov/2019/Jun
*From US Army Technical Bulletin MED 50811 /06/2002141657/-1/-1/1/2019-DOD-ARCTIC-STRATEGY.PDF.
ECWCS + Extended Cold Weather Clothing System Accessed 10 August, 2020.
15. Handford C, Thomas O, Imray CHE. Frostbite. Emerg Med Clin
North Am. 2017;35:281–299.
16. Vogel JE, Dellon AL. Frostbite injuries of the hand. Clin Plast
Surg 1989;16(3):565–576.
Disclaimer 17. Mohr WJ, Ahrenholz DH. Cold injury. Hand Clinics. 2009;25:
The views expressed here are those of the authors and do not 481–496.
necessarily reflect the official policy of the Department of 18. Golant A, Nord RM, Paksima N, Posner MA. Cold exposure
Defense, Department of the Army, US Army Medical Depart- injuries to the extremities. J Am Acad Orthop Surg. 2008;16:
ment, or the US government. The use of trademark names does 704–715.
not imply endorsement by the US Army but is intended only to 19. Nyssen A, Benhadou F, Magnée M, André J, Koopmansch C,
Wautrecht J-C. Chilblains. Vasa. 2020;49(2):133–140.
assist in the identification of a specific product. 20. Prakash S, Weisman MH. Idiopathic chilblains. Am J Med. 2009;
122(12):1152–1154.
Additional Resources 21. Imray C, Geieve A, Dhillon S. Cold damage to the extremities:
Cold Injury Prevention, Cold Weather Causality and Injuries: frostbite and non-freezing injueies. Postgrad Med J. 2009;85.
https://phc.amedd.army.mil/topics/discond/cip/Pages/Cold 22. Murphy JV, Banwell PE, Roberts AHN, McGrouther DA. Frost-
-Weather-Casualties-and-Injuries.aspx bite: pathogenesis and treatment. J Trauma. 2000;48(1):171–178.
23. Mills WJ. Clinical aspects of freezing cold injury. In: Pandolf
KB, Burr RE, eds. Medical Aspects of Harsh Environments. Vol
TB MED 508, Prevention and Management of Cold-Weather 1. Falls Church, VA: Office of the US Army Surgeon General;
Injuries (technical bulletin): https://armypubs.army.mil/Product 2002:429–466.
Maps/PubForm/Details.aspx?PUB_ID=82441 24. Petrone P, Kuncir EJ, Asensio JA. Surgical management and strat-
egies in the treatment of hypothermia and cold injury. Emerg Med
TM 0-8415-236-10, Extended Cold Weather Clothing Sys- Clin North Am. 2003;21:1165–1178.
tem Generation III (ECWCS GEN III) (technical manual): 25. Defense Health Agency, Armed Forces Health Surveillance
https://armypubs.army.mil/ProductMaps/PubForm/Details. Branch. Defense Medical Epidemiological Database. https://www
.health.mil/Military-Health-Topics/Combat-Support/Armed
aspx?PUB_ID=84917 -Forces-Health-Surveillance-Branch/Data-Management

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