If refreezing risk is absent, which warming method is appropriate for frostbite in the field?

• A. Rewarm rapidly in water hotter than 60°C
• B. Rewarm only after full transport time
• C. Rewarm gradually in 37–39°C water when safe
• D. Massage aggressively while warming

Answer: (C)

Controlled rewarming in a warm water bath around 37–39°C is the appropriate field method when there’s no risk of the tissue refreezing. This gradual, active warming helps ice crystals soften and tissue viability recover with less additional injury than harsher methods. Heating tissue with very hot water (60°C or hotter) can burn the skin and underlying tissues, causing more damage. Waiting to rewarm until transport is complete allows frostbite to worsen and increases the chance of tissue loss. Massaging or rubbing frostbitten tissue is harmful because it can disrupt fragile tissue and crystals, worsening injury. After thawing, protect the area with sterile dressings, keep it warm and dry, avoid further cold exposure, and seek definitive care.