NORTH KOREA COUNTRY HANDBOOK

many other factors. The normal reaction of the body to severe cold is
very similar to its reaction to shock. Therefore, shock usually develops
more rapidly and progresses more deeply in extreme cold than in
warmer temperatures. Symptoms include apprehension, sweating, pallor,
rapid/faint pulse, cold/clammy skin, and thirst.
Treatment
■ Reassure the casualty. Pain can be reduced with proper positioning,
good bandaging, and splinting.
■ Position the stretcher so that the casualty’s head and chest is lower
than his lower body and legs. About a 1-foot difference is right. Do
not do this if it will cause discomfort to the casualty.
■ Keep the casualty warm. Normal temperature is best.
■ Do not move the casualty any more than necessary. This does not
mean movement over distance, but moving a casualty from one
stretcher to another, unnecessary lifting or turning over when bandaging
or splinting, or moving a casualty from a sleeping bag into a
casualty bag, etc.
■ Loosen the clothing at the neck, chest, and waist, weather permitting.
■ If the casualty is conscious, give sips of warm soup, tea, cocoa, coffee,
or another available liquid, but not alcohol.
■ The casualty should receive medical attention as soon as possible.
Freezing Injury (Frostbite)
Frostbite is the injury of tissue caused by exposure to freezing temperatures.
Frostbite can cause the loss of limbs or other serious, permanent
injury. It is the most common injury and is almost always preventable.
It seldom occurs in individuals who maintain adequate heat production.
Frostbite is most commonly associated with an overall body heat deficit
resulting from inadequate equipment, lack of food, lack of water,
exhaustion, injury, or a combination of such factors. The feet are most
vulnerable to serious frostbite and must receive constant attention.
Superficial Frostbite. This injury involves only the skin or the tissue
immediately beneath it. There is a certain amount of whiteness or a
waxy appearance around the affected area. Frost nip, a superficial frost-
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