Emergency War Surgery NATO Handbook: Part I: Types of Wounds and Injuries: Chapter IV: Cold Injury

Prophylaxis

United States Department of Defense

The successful prevention and control of cold injuries depend, first of all, upon vigorous command interest, the provision of adequate clothing, and a number of individual and group measures. These measures include:

1. A thorough appreciation and comprehension by command, staff, technical personnel, and all combat components regarding the potential losses that may occur from cold injury, both in winter combat and in other circumstances in which cold injury has been known to occur.

2. There should be full command support, by echelon, of a comprehensive and practical cold injury prevention and control program. It should be emphasized again that this is a command, not a medical, responsibility.

3. Indoctrination of all personnel in the prevention of cold injuries individually and by units.

4. The provision of adequate supplies of clothing and footgear and their correct utilization to avoid exposure to cold. The program of supply must provide adequate dry clothing for the daily needs of the soldier who is farthest forward in combat; it must also provide for the correct fitting of clothing and boots. All articles of clothing must be sized and fitted to avoid constriction of the extremities and tightness over the back, buttocks, and thighs.

   Clothing for cold weather, based on the layering principle, is now designed as an assembly for protection of the head, torso, and extremities. The clothing is worn in loose layers, with air spaces between the layers, under an outer wind-resistant and water-resistant garment. Body heat is thus conserved. The garment is flexible, and inner layers can be removed for comfort and efficiency in higher ambient temperatures or during strenuous physical exertion. Prevention of loss of body heat by the proper protection of the body is as important as the efficient use of appropriate dry footgear and warm dry gloves. Finally, the most efficient clothing is of no value unless a high level of individual and unit clothing discipline are maintained through training.

5. Special protection for certain groups who may be especially susceptible to cold injury, together with the regular rotation of all troops. It should be remembered that casualties with exposed wounds and injuries are particularly liable to cold injury because blood and transudate from their wounds will freeze from the clothing inward.

6. Effective policies of sorting in forward areas, with provision for early evacuation and treatment of casualties actually suffering from cold trauma.

7. The identification of factors responsible for cold injury in special situations, which is a command responsibility. Significant numbers of cases occur as a result of barehanded contact with cold metal or gasoline; as a result of rapid deployment of troops seated in unheated vehicles, without interruptions for short rewarming marches every few hours; as a result of airdrops of troops into cold areas without adequate-protective equipment and training; or as a result of several hours' confinement of artic-equipped airborne troops in heated aircraft, followed by a drop into a subzero environment after their insulating clothing has been saturated with perspiration. Only by the evaluation of these factors can the specific measures necessary in particular units or groups be put into effect.

Approved for public release; Distribution is unlimited.

The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. 

Operational Medicine 2001

Health Care in Military Settings

This web version is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

Contact Us  ·  ·  Other Brookside Products