Frostbite

General Illness Information


Medical Term:

FROSTBITE

Common Name: Frostnip

Description: Frostbite is a cold injury in which freezing of tissues occurs to one or more parts of the body causing permanent damage. Skin and muscle are more prone to freezing damage than tendons and bones, and that a person with severe frostbite can still sometimes move his fingers and toes.

Exposed hands, feet, earlobes and the nose are most vulnerable to frostbite.

Causes: Frostbite is caused by prolonged exposure to cold. The damage from frostbite is caused by a combination of a decreased blood flow to the tissues and ice crystals forming between cells and drawing water from the cells, causing cellular dehydration. This, with constriction of blood vessels, causes tissue injury.

Prevention: Dress  in layers with appropriate cold weather gear i.e. jacket, gloves, socks, hat and scarf. Cover exposed areas  and extremities appropriately.

Proper preparation for trips to cold climates. Don’t drink prior to anticipated exposure. Continue to move arms and legs when exposed to cold weather.

Signs & Symptoms

  • Frostnip is a temporary paleness and numbness of exposed parts. Often appears on fingertips, ears, nose, chin and cheek. There is no permanent damage to the tissues;
  • Frostbite results in numb, painless and white or waxy tissue. Progresses to blotchy-red, swollen and painful regions after rewarming;
  • Superficial frostbite involves skin and subcutaneous tissue;
  • Deep frostbite involves freezing of deeper tissues (muscles, tendon, etc.) and the affected part is numb, painless, hard or wooden to touch;
  • Blistering;
  • Blue discoloration.

Risk Factors

  • Blood-vessel disease such as Raynaud’s phenomenon;
  • Diabetes mellitus;
  • Peripheral neuropathy;
  • Smoking;
  • Excess alcohol consumption or drug abuse;
  • Elderly;
  • Underlying psychiatric disturbance.

Diagnosis & Treatment

  • Diagnosis is generally based on history and physical examination;
  • Professional treatment is important. Do not attempt to thaw frostbitten extremities in areas where professional competent help and adequate facilities are not available.

General Measures:

The following instructions apply to emergency care until medical care is available:

  • Never massage frostbitten tissue;
  • Carefully remove clothing from the affected part;
  • Immerse affected part in a warm water bath at 40-42.2 (C (104-108(F) for 20-30 minutes. Use a thermometer and do not use warmer temperatures. Give warm fluids with high sugar content;
  • After rewarming, cover the affected areas with soft cloth bandages;
  • Don’t use affected limbs until you have medical attention (if feet are involved, don’t walk);
  • Maintain skin-to-skin contact with any companion.

Medical measures:

  • Hospitalization (sometimes);
  • Cautious rewarming; continuous temperature monitoring;
  • Surgery to remove permanently damaged (gangrenous) tissue (sometimes). Amputation is not to be  considered until it is definite that the tissues are dead which may take 3 weeks.

Medications:

  • In hospital, warm intravenous fluids and heated oxygen;
  • Analgesics, including narcotics. To relieve severe pain. Don’t use strong pain killers longer than 4-7 days;
  • Antibiotics to fight infection;
  • You may use non-prescription drugs, such as acetaminophen, for minor pain;
  • Antitetanus toxoid;
  • Reserpine given by mouth or injection is sometimes given to dilate the blood vessels and improve the blood supply to frostbitten areas.

Activity:

Physical therapy may be required after healing progresses sufficiently.

Diet:

As tolerated, but start with warm fluids.

Possible Complications:

  • Amputation of dead or infected tissue, especially fingers, toes, nose or ears, following severe exposure;
  • Cardiac arrest, if frostbite is accompanied by total body hypothermia.

Prognosis

For mild cases, full recovery is possible with treatment. Severe cases usually require amputation of the affected part.

Other

Nothing Specified.