FROSTBITE

General Information

DEFINITION--Temporary or permanent tissue damage from exposure to subfreezing temperature.

BODY PARTS INVOLVED--Arms and legs (especially fingers and toes); face (especially nose and ears).

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

During exposure:

• Gradual numbness, hardness and paleness in the affected area.
• Whiteness or yellowness of the skin.

Upon rewarming:

• Pain and tingling or burning (sometimes severe) in the affected area, with color change from white to red, then purple.
• Blisters (severe cases).
• Shivering.
• Slurred speech.
• Memory loss.

CAUSES--Blood flow to the outer area of the body decreases when exposed to cold (the body tries to protect vital, internal organs). As a result, skin tissue freezes and dies because of the lack of a warm blood supply.

RISK INCREASES WITH

• Diabetes mellitus.
• Blood-vessel disease such as Raynaud's phenomena.
• Peripheral neuropathy.
• Smoking.
• Excess alcohol consumption.
• Windy weather, which increases the chill factor.
• Elderly.

HOW TO PREVENT

• Anticipate sudden temperature changes and carry a jacket, gloves, socks, hat and scarf.
• Don't drink or smoke prior to anticipated exposure.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• X-rays of damaged areas.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization (sometimes).
• Cautious rewarming; continuous temperature monitoring.
• Surgery to remove permanently damaged (gangrenous) tissue (sometimes).

POSSIBLE COMPLICATIONS

• Gangrene.
• 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.

PROBABLE OUTCOME--For mild cases, full recovery is possible with treatment. You may be sensitive to cold and experience burning and tingling. Healing process may take 6 to 12 months. Severe cases often require amputation of the affected part.

How To Treat

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

• Upon reaching shelter, remove clothing from the frostbitten parts.
• Never massage damaged tissue.
• Immerse the affected parts in warm water (about 100F or 37.8C). Use a thermometer, if available. Higher temperatures may cause further injury. Pat the skin dry.
• Drink warm fluids with a high sugar content.
• Don't smoke.
• After rewarming, cover the affected areas with soft cloth bandages.
• Don't use affected limbs until you have medical care (if feet are involved, don't walk).
• Maintain skin-to-skin contact with any companion.

MEDICATION--

• Your doctor may prescribe: Warm intravenous fluids and heated oxygen. Analgesics, including narcotics, to relieve severe pain. Antibiotics to fight infection. Antitetanus toxoid.
• You may use non-prescription drugs, such as acetaminophen, for minor pain.

ACTIVITY--Physical therapy may be required after healing progresses sufficiently.

DIET--Whatever is tolerated. Warm fluids to start with.

Call Your Doctor If

• You have symptoms of frostbite or observe them in someone else.
• The following occurs during treatment: Increased pain, swelling, redness or drainage at the site of injury. Fever, muscle aches, dizziness or a general ill feeling.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.