Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Frostbite: 2019 Update

Wilderness Environ Med. 2019 Dec;30(4S):S19-S32. doi: 10.1016/j.wem.2019.05.002. Epub 2019 Jul 17.


The Wilderness Medical Society convened an expert panel to develop a set of evidence-based guidelines for prevention and treatment of frostbite. We present a review of pertinent pathophysiology. We then discuss primary and secondary prevention measures and therapeutic management. Recommendations are made regarding each treatment and its role in management. These recommendations are graded on the basis of the quality of supporting evidence and balance between the benefits and risks or burdens for each modality according to methodology stipulated by the American College of Chest Physicians. This is an updated version of the guidelines published in 2014.

Keywords: aloe vera; hypothermia; iloprost; rewarming; tPA; thrombolysis.

Publication types

  • Practice Guideline

MeSH terms

  • Frostbite / prevention & control*
  • Frostbite / therapy
  • Humans
  • Practice Patterns, Physicians'*
  • Societies, Medical
  • Wilderness Medicine / standards*