FROSTBITE

 Basic information

description

• Frostbite is the destruction of body tissue from exposure to temperatures or wind chill below freezing. Arms, legs, fingers, toes, face, nose, and ears are areas of the body that are usually affected. It can occur at any age, but is more common in males ages 30 to 49.
• Nonfreezing cold injuries include: frostnip, chilblains, and immersion foot (cold and wet exposure).

FREQUENT SIGNS & SYMPTOMS

• In milder cases, there may be burning, numbness, tingling, itching, or coldness in the affected area. Skin may be white and frozen in appearance, and may have some resistance when pressed.
• In more severe cases of frostbite, there may be no sensations in the affected area. Swelling and blood-filled blisters may appear. Skin may be white or yellow, look waxy, and turn purple as it is rewarmed. The area is hard when it is pressed. The affected area can look blackened and dead.
• Hypothermia (low body temperature) can cause uncontrolled shivering, weakness, and confusion.

causes

Frostbite occurs when ice crystals form in skin and blood vessels, which leads to destruction of the cells. Further damage can occur upon rewarming when blood flow resumes into the damaged blood vessels.

risk increases with

• Car accidents or car breakdowns in bad weather (especially in remote areas).
• Drinking too much alcohol or abusing drugs.
• Elderly persons.
• Diabetes, blood-vessel diseases, or smoking.
• Persons with mental disorders.
• Homeless persons.
• High-altitude travel or activities.
• Poor conditioning, inadequate clothing, clothing that is wet and tight, dehydration, malnutrition, and fatigue.

PREVENTIVE MEASURES

• Dress for the cold weather. Dress in layers. Carry extra gear (e.g., jacket, gloves, socks, hat, and blankets).
• Avoid smoking and alcohol.
• Travel with someone, in case help is needed.

expected outcomes

For milder cold injuries, complete recovery is expected. More severe frostbite may have complications. Full recovery can take months.

possible complications

• Minor complications, such as pain, changes in sensitivity of the affected area, and skin color changes.
• Major complications, such as amputation.

 diagnosis & treatment

general measures

• Emergency care for frostbite:
  • Call for help. Arrange for transport to a hospital.
  • Move patient to a warm area. Keep the affected area elevated. Keep the person warm to prevent hypothermia. Remove tight clothing or jewelry (they may block blood flow).
  • Don't rewarm the affected area if there is a chance it may freeze again. Don't rewarm it using an open fire or dry heat. Put the affected area in warm (not hot) water.
  • Give warm fluids to drink (no alcohol or caffeine).
  • Never massage (rub) the affected areas.
  • Cover the area with soft, cloth bandages. Place cloth or cotton between toes/fingers to prevent rubbing.
• Medical care:
  • An exam by a health care provider is done to check for life-threatening problems and to diagnose frostbite or other types of cold injury, such as frostnip.
  • Rewarming for frostbite is usually done in a warm bath until the thaw is complete. It can be a painful process. Fluids are often given through a vein (IV). Supplemental oxygen may be needed.
  • Hospital care may be required to treat skin damage, assess the extent of injury, and to prevent infection. Whirlpool bath therapy may be done to remove dead tissue. The affected area may be elevated and splinted.
  • It may take months to see if the affected tissue will be healthy or permanently damaged. Surgery may be done to remove damaged tissue, including amputation.

medications

You may be prescribed drugs for pain relief, antibiotics to prevent infection, and a tetanus booster.

activity

Limits will depend on extent of damage. Physical therapy may be needed.

diet

Warm fluids to start with; as tolerated thereafter.

 notify our office if

You or a family member has symptoms of frostbite or cold injury, or you observe them in someone else.

Special Notes: