Health Services

Frostbite

EphNotes

What is it?

Frostbite is the freezing of bodily tissues due to excessive exposure to cold conditions. Such conditions include not only severe temperatures, but also milder temperatures aggravated by factors such as wind, rain, dampness, dehydration, lack of energy (i.e., food), and illness.

It occurs in varying severity, from frostnip (the commonly seen white patches on noses, ears, cheeks, fingertips and toes; the skin is still pliable at this point, as no tissue has actually frozen yet), to mild and severe frostbite.

Frostbite (as distinct from frostnip) is when the tissues actually begin to freeze. Mild frostbite involves only the outermost layer of tissues (characterized by a hard, white appearance), while severe frostbite freezes right through to the bone, making tissues black or even gangrenous.

Most frostbitten tissues will blister, except for the most severely damaged ones. If left untreated, the hard, white tissue of mildly frostbitten tissues will become red, then mottled purple; within 24-36 hours, blisters will fill with fluid. Blackening of the affected tissues may take up to 10 days to appear.

Treatment

The sooner frostbitten tissues are attended to, the better their chance of surviving intact. If left too long without treatment (or if allowed to refreeze after thawing), frostbitten tissues will be permanently lost.

Frostnip is easily treated by placing a warm body part — either your hand or someone else’s — directly onto the affected area until skin warms up again.

Frostbite requires more specialized attention. Frostbitten tissues should be immediately warmed, except when there is danger of refreezing. A frostbitten tissue, if thawed and then subsequently frostbitten (in the near future), will turn gangrenous and be lost 100% of the time. When there is no such danger, however, the affected areas should be placed in a water bath of a temperature no greater than 105°F (be sure to use a thermometer), since frostbitten tissues can burn more easily than other tissues. Do not rub the affected areas. The water temperature should be maintained by refilling with warm/hot water as the old water cools, always checking the temperature before placing the frostbitten tissues into the bath.

The process of rewarming is extremely painful; the tissues will not hurt at all until they are rewarmed, but once they begin to thaw, the pain is intense. Therefore, pain medication may be required to help alleviate pain until the process is complete. Thawing is complete when all the pallor of an affected area is gone.

A frostbite patient should also be given warm fluids and fast-energy foods to help restore heat and body energy. A blanked around the body core is helpful, even when the extremities are the affected areas. All wet clothing should be removed and replaced with warm, dry clothing.

In severe cases, get the patient to the nearest hospital or emergency health care unit as soon as possible.

Prevention

Frostbite can be easily prevented. Here are some tips to protect yourself from it:

  • Dress for the weather, using many layers and non-cotton/polypropylene in cold areas where you will be active. Wear wool in damp climates, and be sure to have dry clothes available.
  • Stay hydrated and make sure you’ve eaten enough.
  • When your feet are cold, put on your hat.” 70% of body heat is lost through the head.
  • Tissues that have been frostbitten before are more susceptible to it in the future.
  • Stay smart, travel in groups in the cold, and keep an eye on each other.

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