Treatment for Frostbite
The development of frostbite depends on a number of factorstemperature, wind, moisture, and clothing are very important. Persons who are immobile or in poor health are at greater risk. Smoking, alcohol consumption, and diseases of the circulation may increase frostbite injury. Frostbite, as well as hypothermia, are more likely to occur at higher altitudes, since extremely low temperatures and high winds are often encountered there.
Frostnip is the most superficial stage of frostbite. It is usually seen on the face and ears when the temperature drops below freezing with a significant wind-chill factor.
Frostbite is due to freezing of the tissues. The skin normally freezes at 0 to 0.53 C (3l F). Deeper tissues freeze at tissue temperatures between -2 C and -10 ° C (14 to 29 F). Frostbite most commonly involves the feet, hands, ears and nose in that order?6 The likelihood of frostbite depends both on temperature and wind velocity, but the duration of exposure to cold is probably equally important. As the skin temperature drops, the skin pales and a sensation of cold and sometimes tingling is felt. If the skin temperature continues to fall, a relative excess of oxygen develops, because the metabolism of the tissues has been lowered so much by the cold that much less oxygen is needed. This excess oxygen causes the skin to redden, and decreased sensation with a feeling of warmth occurs at this point. Further reduction in the temperature produces more reddening with numbness and a loss of the sensations of pain and touch. In the final stages, the tissues are white, waxy, and entirely without feeling. The frozen part may feel like a piece of wood or stone. All frostbitten members, regardless of severity, look and feel this way.
Frostbite has been classified on the basis of severity of tissue damage seen on rewarming. This classification is as follows:
1 st degree - redness and swelling
2nd degree - blisters in addition to redness and swelling
3rd degree - necrosis (dead tissue), loss of a full thickness of skin and perhaps some subcutaneous tissue
4th degree - loss of a body part (amputation), including skin, muscle and bone
This classification is helpful in gaining an understanding of frostbite, but it has been criticized because it is of minimal use in diagnosis and treatment. A more practical classification is simply superficial and deep frostbite.
Rewarming of the tissue results in redness, followed by swelling in all but the mildest cases. In tissue that is thawing, the victim experiences throbbing, itching, burning pain, and a "pins and needles" sensation. The failure of any sensation to return is, of course, a bad sign. In 3rd degree frostbite, complete healing takes two or three months.
The worst outcome of frostbite is gangrene and loss of the part. I t is usually a month or more after the injury before it can be determined how much of the part will be lost. More often, disturbances such as increased sweating, changes in sensation, pain, arthritis, and increased sensitivity to cold are seen.
Frostnip is the most superficial stage of frostbite. It is usually seen on the face and ears when the temperature drops below freezing with a significant wind-chill factor.
Frostbite is due to freezing of the tissues. The skin normally freezes at 0 to 0.53 C (3l F). Deeper tissues freeze at tissue temperatures between -2 C and -10 ° C (14 to 29 F). Frostbite most commonly involves the feet, hands, ears and nose in that order?6 The likelihood of frostbite depends both on temperature and wind velocity, but the duration of exposure to cold is probably equally important. As the skin temperature drops, the skin pales and a sensation of cold and sometimes tingling is felt. If the skin temperature continues to fall, a relative excess of oxygen develops, because the metabolism of the tissues has been lowered so much by the cold that much less oxygen is needed. This excess oxygen causes the skin to redden, and decreased sensation with a feeling of warmth occurs at this point. Further reduction in the temperature produces more reddening with numbness and a loss of the sensations of pain and touch. In the final stages, the tissues are white, waxy, and entirely without feeling. The frozen part may feel like a piece of wood or stone. All frostbitten members, regardless of severity, look and feel this way.
Frostbite has been classified on the basis of severity of tissue damage seen on rewarming. This classification is as follows:
1 st degree - redness and swelling
2nd degree - blisters in addition to redness and swelling
3rd degree - necrosis (dead tissue), loss of a full thickness of skin and perhaps some subcutaneous tissue
4th degree - loss of a body part (amputation), including skin, muscle and bone
This classification is helpful in gaining an understanding of frostbite, but it has been criticized because it is of minimal use in diagnosis and treatment. A more practical classification is simply superficial and deep frostbite.
Rewarming of the tissue results in redness, followed by swelling in all but the mildest cases. In tissue that is thawing, the victim experiences throbbing, itching, burning pain, and a "pins and needles" sensation. The failure of any sensation to return is, of course, a bad sign. In 3rd degree frostbite, complete healing takes two or three months.
The worst outcome of frostbite is gangrene and loss of the part. I t is usually a month or more after the injury before it can be determined how much of the part will be lost. More often, disturbances such as increased sweating, changes in sensation, pain, arthritis, and increased sensitivity to cold are seen.
Treatment Guide for Frostbite:
Frostnip is easily remedied by simple rewarming and requires no further care. Rapid rewarming is all that is necessary, as the, damage is minor. If possible, DON'T shave, wash, or apply cologne or aftershave lotion before heading out into the cold. These rituals dry the skin and make it more susceptible to frostnip.
For superficial or deep frostbite, rapid rewarming is preferred. This should be accomplished by immersing the limb in a water bath at a temperature of 40 to 42 C (98 to 104 F). Water that is not uncomfortably hot for a normal forearm is about right, but excess heat must be avoided. Warming by a fire is dangerous, since the frozen tissues feel no pain and may be burned. Treatment with ice, snow, rubbing, or dry heat is also harmful. If warm water is not available, the frostbitten extremities can be placed against warm skin, such as in the armpit or groin. Rewarming should not be attempted if the tissues may refreeze, because this will increase the damage considerably.
Rewarming will take at least ½ hour and perhaps as long as 1 ½ hours. The limb may be removed from the bath when the fingers or toes become pink. In severe injuries this may not occur, and rewarming should be stopped when no further improvement is observed. Pain may be so severe as to require narcotics. Constricting garments should be removed. The general status of the victim must be observed, since he may be hypothermic.
Afterwards, the affected parts are protected with loose, dry dressing; blisters are left intact. The area should be observed carefully for signs of infection.
Posts
