Cold Risks: Hypothermia and Frostbite Basics

A Swedish winter is safe for anyone dressed for it, but cold still kills about 30 to 45 people a year here. This page gives the first aid Sweden’s own health service, the Red Cross and the ice-safety bodies publish: how to spot cold injury, what to do and when to call.

When you need this

You’re heading out for winter walks, skiing, skating, a snowmobile trip or a long night waiting for the northern lights. You’re traveling with a baby or small child who can’t tell you they’re cold. Or something is already happening: someone in your group has gone quiet and clumsy, a white patch has appeared on a cheek, or someone has gone through the ice. This is first aid as the Swedish bodies publish it, not medical advice.

Two different cold injuries

Hypothermia (nedkylning, or hypotermi) means the core body temperature has fallen below 35 °C. 1177, the regions’ joint health service, says it happens after long exposure to low temperatures or cold, damp surroundings, for example in snow or water. It isn’t only a deep-winter problem: the Swedish Red Cross notes it can also happen in milder weather in wind, lying on a cold floor, or in water.

Frostbite (köldskada, or förfrysning) is local. A body part gets so cold that blood stops circulating through it, most often hands, feet, ears, nose and cheeks. It creeps up on you: feeling disappears as the skin freezes, so you can be injured without noticing.

Both get worse with wind and wet. And 1177 says frostbite risk is greater for the young and the old, who have thinner skin and less muscle.

Wind chill: why the thermometer lies

SMHI, the Swedish weather agency, calculates a wind-chill temperature (vindkyletemperatur), how cold it actually feels on bare skin once the wind is included. Its own example: −10 °C with a light 2 m/s breeze feels like −14 °C in still air.

When it gets serious, SMHI issues a warning:

Check SMHI’s warnings before a long day outdoors, especially in the mountains, where our mountain safety guide explains the rest of the system.

Hypothermia: what to do

The early signs are easy to miss because they look like a bad mood. Issäkerhetsrådet, the ice-safety council, lists hunger, nausea, tiredness, going quiet, irritability, slurred speech, clumsiness and confusion. The person affected is usually the last to notice, so watch each other.

Mild hypothermia — shivering, pale and cold, clumsy hands:

1. Get them indoors, or at least out of the wind.
2. Remove wet clothes and change to dry ones.
3. Warm them gently with blankets, a sleeping bag or dry clothes. The Red Cross says to use towels, sheets or even cardboard if that’s all you have.
4. If they can drink by themselves, give something warm and sweet. Avoid alcohol and caffeine.
5. Call 1177 for advice, or 112 if they get worse.

Severe hypothermia — shivering has stopped, or they’re drowsy, stiff, very tired or unconscious:

1. Call 112, or have someone else call.
2. Move them very gently and keep them lying flat. Don’t make them walk or exercise; activity only helps in mild cases.
3. If they’re unconscious but breathing, put them in the recovery position on something insulating and cover them.
4. If they look lifeless, check breathing for up to one minute. If they don’t breathe normally, start CPR and keep going until help arrives.

Never give up on a cold, lifeless person. 1177 notes that body temperature can fall so low that a person seems dead, and the Red Cross says nobody really knows how low a temperature a human can survive. Handle them gently: as cooling deepens, the heart slows and its rhythm can become irregular.

Frostbite: what to do

Check each other’s faces for white patches on cheeks, nose and ears, and wiggle fingers and toes to make sure you still have feeling. Then:

1. Get indoors or into shelter from the wind.
2. Take off rings if the hands are affected, before swelling traps them.
3. Warm it skin to skin: a warm hand on a frozen cheek, fingers in your armpits, a companion’s stomach or armpit for frozen toes.
4. Keep going until normal color and feeling return, even if it hurts.

What not to do matters as much:

• Don’t rub or massage the area, and don’t rub it with snow.
• Don’t use hot water or heated objects to speed things up; they damage the skin. The Red Cross allows body-warm water, about 37 °C, for about 30 minutes.
• Don’t walk on frostbitten feet.
• Don’t thaw it if it may freeze again before you reach care. 1177 says deep frostbite is better left cold than thawed and refrozen.

Cold water and ice

Water pulls heat from the body about 25 times faster than air, so falling through ice or out of a boat is the quickest way to hypothermia. But the first danger isn’t the cold. Sjöräddningssällskapet, the volunteer sea-rescue society, warns that the gasp reflex can drown you within seconds.

If you go through the ice yourself, the advice from Issäkerhetsrådet and Sjöräddningssällskapet:

1. Get through the first moments: face above water, breathing under control, stay calm. After that you have many minutes before cold weakens you.
2. Turn back the way you came. The ice held there.
3. Pull out your ice claws (isdubbar) with gloves on, work steadily back to firm ice and lever yourself up with elbows close to your body.
4. Crawl well onto firm ice before standing.
5. If help is coming, lie still to save strength and heat. Your hands fail first, so use them early. Don’t swim for a distant shore; cold makes swimming weak and ineffective.

If someone else goes in, call 112 first. Approach from the direction they came, and always keep something between you and them: a line, a pole, a branch, a jacket. A rescuer in a second hole makes things worse. If you can’t get them out, keep their airway above water. Once they’re out, remove wet clothes and insulate them. Anyone who nearly drowned needs hospital assessment, even if they seem fine.

This isn’t only a winter risk. Cold shock depends on how cold the water is and how you enter it, not on the month, and Krisinformation reminds boaters that it’s often cold on the water. It also notes that almost half of those who drowned after falling from a boat would have survived in a life jacket.

Ice itself — how thick, where it’s weak, skating tours — is in our ice safety guide; swimming and life jackets are in water safety in Sweden.

Children, alcohol and layers

Small children cool faster. 1177 says they can’t shiver or move enough to keep warm, and their hands and feet get cold quicker than an adult’s. Feel the back of the neck and the forehead: cold there means too cold. Keep a newborn indoors on windy, very cold days, and bring older children in to warm up regularly. Don’t wash or cream their faces just before going out; it strips the skin’s natural protection. Children on ice need at least one adult with them.

Alcohol speeds up cooling. It widens blood vessels, reduces shivering and blunts judgment. 1177 adds that alcohol, smoking and snus weaken the body’s defense against cold and slow healing. A drink “to warm up” does the opposite.

Layering (lager-på-lager) is 1177’s core advice:

• Several loose, thin layers rather than one thick one
• A windproof outer layer, and a hat
• Something that keeps the skin dry next to the body — 1177 names wool — and no cotton, which gets damp and cools you
• Spare socks and mittens in case you get wet
• Watch out for metal glasses, watches and jewelry, which can cause cold injury on bare skin

112 or 1177?

Practical information

FAQ

What are the first signs of hypothermia?

Shivering, pale and cold skin, and clumsy hands come first. As cooling continues, people become hungry, nauseous, tired, quiet and bad-tempered, then slur their words and get confused. When shivering stops and the person becomes drowsy or unconscious, hypothermia is severe and you call 112. The affected person rarely notices their own decline, so watch each other.

How do I warm up someone with hypothermia?

Get them indoors or out of the wind, remove wet clothes and wrap them in blankets, a sleeping bag or dry clothes. If they can drink on their own, give something warm and sweet, not alcohol or coffee. Warm gently: if they are drowsy, stiff or no longer shivering, keep them lying still, handle them carefully and call 112.

What does frostbite look like?

At first the skin turns white and cold and loses feeling; as it thaws it stings or burns, can hurt, swell, redden and blister. Hard, white-yellow skin, dark blood-filled blisters, trouble moving the part, or color and feeling that do not return after an hour of warming are signs of deep frostbite needing care the same day.

How do I treat frostbite?

Get into shelter, take off rings, and warm the area skin to skin — a hand on a cheek, fingers in an armpit. Continue until color and feeling return, even if it hurts. Do not rub, massage or use hot water, and do not walk on frozen feet. If the part may freeze again before you reach care, leave it cold.

What is wind chill, and when does SMHI warn about it?

Wind chill is how cold it feels on bare skin once the wind is included. SMHI’s example: −10 °C with a 2 m/s wind feels like −14 °C. SMHI issues a yellow strong wind-chill warning when the mean wind is at least 10 m/s and the effective temperature is −28 °C or lower. The risk of frostbite is then high.

What should I do if I fall through the ice?

The first moments are about the gasp reflex: get your face up and your breathing under control. After that you have many minutes before cold weakens you. Turn back the way you came, where the ice held. Pull out your ice claws with gloves on, work to firm ice, lever up on your elbows, and crawl well away before standing. Then get dry and warm.

When should I call 112 and when 1177?

Call 112 when life is at risk: someone severely hypothermic, drowsy or unconscious, not breathing normally, or pulled from cold water. Call 1177 for advice on a cold injury you are unsure about, or where to get care; from a foreign phone dial +46 771 1177 00. Blistered or deep frostbite needs a clinic or emergency department the same day.

Are children more at risk from the cold?

Yes. 1177 says small children cool more easily because they cannot shiver or move enough to stay warm, and their hands and feet get cold faster than an adult’s. Feel the neck and forehead: cold there means the child is too cold. Look for white patches, change damp mittens and socks, and bring children indoors regularly to warm up.

Related guides

• Ice safety on frozen lakes — how thick, where it’s weak, and what to carry
• Mountain safety in the Swedish fjäll — weather, help phones and rescue far from roads
• Winter driving in Sweden — the kit that keeps you warm if the car stops
• Sweden’s emergency numbers — 112, 1177 and when to use which
• Cold baths and winter bathing — the Swedish dip, done safely

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Facts verified 2026-09-24. Sources: 1177, the Swedish Red Cross, SMHI, Issäkerhetsrådet (Svenska Livräddningssällskapet and partners), Sjöräddningssällskapet, Krisinformation and SOS Alarm — full register in this topic’s source file. This is first aid as those bodies publish it, not medical advice; no current weather warnings are shown here. Found something outdated? Tell us and we’ll fix it.