FROSTBITE (Cold injury) |
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General Information
DEFINITION--Temporary or permanent tissue damage from exposure to subfreezing temperature. Ice crystals form in the skin and blood vessels, leading to tissue injury or tissue death, depending on the temperature and length of exposure.
SIGNS & SYMPTOMS DURING EXPOSURE:
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Gradual numbness, hardness and paleness in the affected area. AFTER REWARMING THE SKIN:
Pain and tingling or burning (sometimes severe) in the affected area, with color change from white to red, then purple.
Blisters (severe cases).
Shivering.
CAUSES & RISK FACTORSThe following factors make frostbite more likely:
Constriction of blood vessels in the extremities by too-tight clothing.
Wet skin.
Blood-vessel disease such as Raynaud's phenomenon (a circulatory-system disorder affecting fingers and toes).
Smoking.
Excess alcohol consumption.
Windy weather, which increases chilling.
Any chronic disease.
HOW TO PREVENT
Anticipate sudden temperature changes. Carry a jacket, gloves, socks, hat, knit face mask and scarf.
Don't drink alcohol or smoke prior to anticipated exposure.
WHAT TO EXPECT
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of damaged areas.
SURGERYSometimes necessary to remove permanently damaged (gangrenous) tissue.
NORMAL COURSE OF ILLNESSFor mild cases, full recovery is possible with treatment. Severe cases usually require amputation of the affected part.
POSSIBLE COMPLICATIONS
Temporarily slurred speech and memory loss after rewarming the skin.
Death or severe infection, requiring amputation of affected tissue. This is most likely in fingers, toes, nose or ears following severe exposure.
Cardiac arrest, if frostbite is accompanied by total body hypothermia.
HOW T0 TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
MEDICAL TREATMENT
Doctor's care for all but the mildest cases.
Hospitalization (sometimes).
FIRST AIDThe 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 l00F or 37.8C). Use a thermometer, if available. Higher temperature may cause further injury.
Drink warm fluids with a high sugar content, if available.
Don't smoke.
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.
HOME TREATMENTAppropriate for mildest cases only.
MEDICATION
Your doctor may prescribe:
Analgesics, including narcotics, to relieve severe pain. Don't use strong pain killers longer than 4 to 7 days.
Antibiotics to fight infection.
You may use non-prescription drugs, such as acetaminophen, for minor pain.
ACTIVITYResume normal activities after treatment.
DIETNo special diet.
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. Drugs used in treatment may produce side effects.
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