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Frostbite with refreezing risk — DipIMC MCQ

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HardEnvironmental MedicineFrostbite with refreezing riskDipIMC

A 65-year-old man with frostbite of several toes is found after a night outdoors. The feet are numb, pale and waxy; there is a chance he may refreeze during a long evacuation. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Protect the feet from trauma and avoid rewarming until refreezing risk is controlled

Frostbite should be protected from trauma, and rewarming should be avoided if refreezing may occur because freeze-thaw-freeze cycles worsen tissue loss. Rubbing with snow and walking on frostbitten tissue cause mechanical injury. Blister management is not a pre-hospital priority in this context. The pearl is that controlled rewarming is beneficial, uncontrolled refreezing is harmful.

Reference: JRCALC Guidelines 2025; Wilderness Medical Society frostbite principles