How is Frostbite Treated?

How is Frostbite Treated?

Frostbite is a cold-related condition in which tissue freezes when the body is exposed to temperatures below the freezing point of the skin. Hands, feet, the nose, and ears are most commonly affected by this condition. Frostbite can affect almost anybody, but some have a higher risk of getting it.  Those who spend a great deal of time outside, the elderly, and those who are mentally ill are most at risk. Frostbite is caused by the cell death that happens due exposure to very low temperatures and cell deterioration as the cells are deprived of oxygen due to the constriction of the blood vessels.

Some of the most common symptoms of frostbite include white or grayish-yellow skin which may burn or have a burning feeling. In some cases, frostbite may cause blistering and hardening of the skin. The affected area may become reddish and cause severe pain. The focus of any treatment option is rewarming the affected areas or the body.

Rewarming can be rapidly accomplished in a water bath heated to 40-42°C for about 15-30 minutes. This procedure is generally very painful and narcotic pain medications are given to relieve pain. In cases involving dehydration, fluids may be given intravenously.

Once thawing is complete, it is important to extend post-thaw care to prevent infection and to treat reduced supply of oxygen to the affected area. Dead tissues in the area are removed slowly while the bloody tissues are left as such so that the blood vessels are not disturbed. In some cases, amputation may be required if there is increased risk of damage to the affected part. Tissue plasminogen activator is given to reduce the chances of blood clots. Hospitalization may be needed for one or two days for treatment and to determine the extent of injury to the parts.

Ibuprofen is recommended to prevent inflammation and aloe vera cream is suitable for application in the frostbite affected area. Skin should be protected from further exposure to low temperatures.  Some tips for preventing and treating frostbite are:

• Use dry gloves on your hands and remember to protect your face, nose, and ears.
• Avoid rubbing snow on the affected skin.
• Remove wet clothes once you are back indoors and wrap other areas with a warm blanket.
• If toes and feet are affected, avoid walking for some time
• Warm the frostbitten area and ensure that it is not frozen again.
• If numbness or pain remains or if blisters develop on the affected area of the skin, it is important to get medical attention immediately.

The severity of the symptoms will determine the treatment for frostbite. If you think that you or someone else has frostbite then seek medical attention. If it is not available then to treat frostbite and hypothermia the following steps can be taken:

If possible move to a warmer place. Since walking on the frostbitten feet and toes can cause further damage hence it is better to avoid them but this may not always be possible especially in emergency situations.

Soft dry clothing should be replaced with wet clothing. This is to prevent further heat loss. Wrap the body in blankets and warm it so that the parts that are frost bitten can be protected.

Since rubbing or directly applying heat to the affected area can cause further injury it hence do avoid doing that

If you have frostbite do not smoke since the blood circulation can be affected by smoking.

Rewarm the frostbitten areas

It is necessary to rewarm the areas that are frostbitten. Until you are out of the cold re-warming should not be attempted. Irreversible damage can be caused if the warming process is started and then to the cold the frozen parts are re- exposed .ideally under medical supervision re-warming should be carried out. This process can be painful and medical assessment may be needed.  A whirlpool bath that contains a mild antiseptic can give best results.

By immersing the affected area slowly in the warm water and not hot water the affected area can be re-warmed. It is recommended to have a bath of water of temperature 40-41 degree Celsius. At least 30 minutes re-warming should be done and once the affected part is red-purple color and is easily movable then only re-warming should be stopped. Until there are clear signs that the affected part is starting to heal twice a day this process can be repeated.   When the affected parts starts to heal there will be growth of new skin and normal skin color will return. There may be a need of very strong painkillers such as morphine depending on the severity of pain. For frostbite, as ibuprofen has additional protective properties it should also be taken.

After re-warming

Wrap the frostbitten area gently in clean bandage after it has been thawed. When you wrap it keep the toes and fingers separate. In order to avoid infection keep the skin clean. Limit movement and if possible keep the limbs raised. The feet and the toes that have been re-warmed avoid walking on them as the tissues are very delicate. The skin will be discolored after re-warming and it will be blistered. Eventually the skin will scab over. Beneath the discolored skin and scabs new pink skin will form if the frostbite is superficial. Usually within six months the area will recover.

Severe frostbite

You will need to be admitted to a specialist unit if you have severe frostbite. In treating these types of injuries the experienced medical staff will help you. This unit is a specialist burn unit. Since the exposure to very high temperature and exposure to very cold temperatures can cause the same type of injury.

You may have thrombolytic therapy if there is a very high risk of major damage. You may be given injections or a drip through which medication will be provided. In the frostbitten blood vessels the small clots can be broken with the help of this medication. To the affected body part this will help improve the blood flow. Healing is stimulated and further damage is thus prevented. To prevent the affected part from becoming infected you may also be given antibiotics.

To treat very severe cases of frostbite sometimes iloprost is used. The blood vessels that supply blood to the affected body part are widened by this medication. When the loss of limb, finger or toe is threatened by severe frost bite then within 24 hours of the injury the person should be considered for treatment with tPA or iloprost.

Past experiences have shown that best outcome has been achieved when treatment was given within this time frame. And the affected part of the body could be saved. At an experienced unit this option is still considered to be given as treatment after 24 hours. Same of the tissue of the affected body part will need to be removed if it has died. This procedure in which the dead tissue is removed is known as debridement.

If the case is more serious then an entire body part may need to be removed such as toes or finger.

Usually this decision of whether to perform amputation or debridement for several weeks is often delayed since sometimes what looks like a dead tissue tends to over a period of time heal and recover.

Long term effects

Some people are left with permanent problems after having frostbite. These problems include numbness, stiffness and increased sensitivity to cold, pain in the affected area. However to treat sensitivity to cold nothing much can be done. Similarly to treat numbness, stiffness nothing much can be done. Sometimes to control the pain associated with the long term effects of frostbite, a medication called amitriptyline can be effective.

Preventing frostbite

It can be dangerous if your body is exposed it cold weather and you are nota adequately prepared for it. Warning signs are numbness, or feeling cold and shivering. It is a warning that the body is losing too much of heat. Since children have a smaller body mass they are more at risks. Hence to ensure that their clothes are dry, extra care must be taken and keep their clothes as much as possible layered.

Prolonged exposure to cold weather should be avoided. Heath can be held by the body more efficiently by several layers of clothing. The body can be kept dry by a weatherproof outer layer. Use insulated boots, gloves, scarf’s, socks. If your clothes become wet then right away change them. For any signs of frostbite check your skin frequently. Avoid cigarettes, caffeine and alcohol. By taking a thermometer with you Keep your eye on the exact temperature. Drink adequate amount of fluids and eat regularly.