Frostbite Symptoms and Treatment
From e-medicine health.com
Medical Author:
Melissa Conrad Stöppler, MD, Chief Medical Editor
Medical Editor:
Mary Nettleman, MD, MS, MACP
A variety of frostbite classification systems have been proposed. The easiest to understand, and perhaps the one that gives the best clues to outcome, divides frostbite into two main divisions: superficial and deep.
In superficial frostbite, you may experience burning, numbness, tingling, itching, or cold sensations in the affected areas. The regions appear white and frozen, but if you press on them, they retain some resistance.
In deep frostbite, there is an initial decrease in sensation that is eventually completely lost. Swelling and blood-filled blisters are noted over white or yellowish skin that looks waxy and turns a purplish blue as it rewarms. The area is hard, has no resistance when pressed on, and may even appear blackened and dead.
The affected person will experience significant pain as the areas are rewarmed and blood flow reestablished. A dull continuous ache transforms into a throbbing sensation in 2 to 3 days. This may last weeks to months until final tissue separation is complete.
At first the areas may appear deceptively healthy. Most people do not arrive at the doctor with frozen, dead tissue. Only time can reveal the final amount of tissue damage.
First, call for help.
Keep the affected body part elevated in order to reduce swelling
Move to a warm area to prevent further heat loss. Avoid walking on frostbitten feet as this can lead to further damage.
Note that many people with frostbite may be experiencing hypothermia. Saving their lives is more important than preserving a finger or foot.
Remove all wet clothing and constrictive jewelry because they may further block blood flow.
Give the person warm, nonalcoholic, noncaffeinated fluids to drink.
Apply a dry, sterile bandage, place cotton between any involved fingers or toes (to prevent rubbing), and take the person to a medical facility as soon as possible.
Never rewarm an affected area if there is any chance it may freeze again. This thaw-refreeze cycle is very harmful and leads to disastrous results.
Also, avoid a gradual thaw either in the field or in the transport vehicle. The most effective method is to rewarm the area quickly. Therefore, keep the injured part away from sources of heat until you arrive at a treatment facility where proper rewarming can take place.
Do not rub the frozen area with snow (or anything else). The friction created by this technique will only cause further tissue damage.
Above all, keep in mind that the final amount of tissue destruction is proportional to the time it remains frozen, not to the absolute temperature to which it was exposed. Therefore, rapid transport to a hospital is very important.