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Frostbite

Definition

Frostbite is damage to skin and tissues from prolonged exposure to below-freezing temperatures. Frostbite severity is based on the depth of tissue injury. The most severe frostbite can lead to permanent damage and/or amputation.
The most common parts of the body to become frostbitten include your fingers, toes, ears, nose, chin, or cheeks.
Frostbitten Skin
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Causes

Exposure to below-freezing temperatures can cause the body tissue to freeze. Ice crystals form within the frozen body part. Blood cannot flow through the frozen tissue. This causes the frozen tissue to be deprived of blood and oxygen. The combination of freezing and oxygen deprivation causes tissue damage or tissue death. Rewarming may also ultimately lead to tissue death.

Risk Factors

Factors that may increase your chance of frostbite include:

Symptoms

Early stages of frostbite may cause:
Later stages of frostbite may cause:

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Diagnosis is usually based on symptoms and the findings of the physical exam.

Treatment

Rapid rewarming in a warm (100°F to 110°F [37.8°C to 43.4°C]) water bath is the treatment of choice. Slow rewarming may cause more tissue damage.
If you are stranded with frostbite and unable to get medical help:
If you're able to get medical assistance, treatment may include moving you to a warm place and wrapping you in blankets. The injured body part may be soaked in warm (not hot) water.

Medications

Medications used depend on the severity of frostbite. Examples include:
  • Antibiotics to treat any bacterial infections
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation
  • Prescription pain medication
  • Drugs to prevent blood clots in the first 24 hours
  • Vasodilators after 24 hours if needed due to lack of improvement

Other Treatments

Other frostbite treatments may include:
  • Opening and emptying blisters
  • Aloe vera gel or other ointments to relieve inflammation and promote healing
  • Elevation of the injured body part above your heart
  • A tetanus booster shot
  • Hyperbaric oxygen therapy—a special chamber that uses oxygen under greater pressure than normal to help with blood flow and tissue repair
  • Surgery—in severe cases, amputation of all or part of the affected body part may be necessary

Prevention

To help reduce the chance of frostbite:

RESOURCES

Family Doctor—American Academy of Family Physicians http://familydoctor.org

Ortho Info—American Academy of Orthopaedic Surgeons http://orthoinfo.org

CANADIAN RESOURCES

Environment Canada http://www.ec.gc.ca

Health Canada http://www.hc-sc.gc.ca

References

Frostbite. Centers for Disease Control and Prevention website. Available at: http://emergency.cdc.gov/disasters/winter/staysafe/frostbite.asp. Updated December 3, 2012. Accessed August 5, 2015.

Frostbite. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 15, 2011. Accessed August 5, 2015.

Frostbite. Nemours Kids Health website. Available at: http://kidshealth.org/parent/firstaid%5Fsafe/emergencies/frostbite.html. Updated January 2015. Accessed September August 5, 2015.

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