Frostbite

Frostbite develops after prolonged exposure to subfreezing temperatures or to forceful winds with low temperatures. Blood vessels near the surface of the skin constrict to preserve internal body heat. This reduces the blood supply to the skin. As a result, skin tissue freezes and is damaged. Health problems that reduce circulation or weaken the body increase the risk of frostbite.

Frostnip (first degree): The skin turns white and numb, and then swells and becomes painful. Burning, itching or peeling may occur. The nose, ears, hands, or feet are usually affected. The only treatment needed is to get out of the cold and gradually warm the affected area.

Frostbite: If frostnip is not treated, the affected area will become red, swollen, and painful. In severe cases of frostbite, the skin turns blue or black, and the pain disappears.

Never massage or rub frostbitten areas and do not apply any ointments. Treatment varies with the type of frostbite. Care should be taken to avoid bruising the skin or tissue and to prevent infection. Do not apply heat to arms and legs or have the person take a hot bath. Emergency medical care should be obtained as soon as possible. Rewarming or thawing of a frostbite injury should never be attempted if medical care is immediately available.

The following first aid may be carried out while waiting for transportation to a medical facility:

• move the person out of the cold
• remove wet clothing
• cover with dry blankets, warm ones if possible
• remove rings or other constricting jewelry or clothing
• offer warm, non-alcoholic beverages and
• avoid walking on frozen feet or toes

To prevent frostbite:

• wear adequate clothing to protect the skin (Wear several layers of warm loose-fitting clothing that will block wind, keep moisture away from the skin, and maintain body heat.)
• cover hands, feet, nose, ears, and head (Wear mittens [not gloves], wool socks, a neck muffler to cover the nose, and a hat with ear protection.)
• allow the body time to adjust from a warm climate to a cold one
• remain indoors during unusually cold or windy days or keep outside trips short
• do not drink alcohol or smoke cigarettes before going into the cold or while in it and
• keep the skin dry (Wet skin freezes faster than dry skin.)

If medical care is not immediately available, rewarming should be started immediately. Once started rewarming must continue until the frostbitten part is completely thawed. Once thawed, the frostbitten part must be protected against refreezing. The following are the steps for rewarming:

• warm the area with warm water between 100 to 104 degrees Fahrenheit (37.8 to 40 degrees Centigrade)
• keep the water moving and
• continue until completely rewarmed, and the part is pink or red

As the part warms up, it may be very painful. Over-the-counter pain medication, such as acetaminophen, aspirin, or ibuprofen may be taken for the pain. Carefully follow the label instructions for any pain medication that is taken.

Aspirin or medicines that have aspirin in them should not be given to anyone younger than 18 years of age. Taking aspirin is a risk for a serious illness called Reye's syndrome. Non-steroidal anti- inflammatory drugs (NSAIDs) should be taken with food or milk to prevent stomach upset. NSAIDs should be avoided by anyone who has been diagnosed with asthma, ulcer disease, or a bleeding disorder. Taking NSAIDs increases the risk of bleeding with trauma, dental work, surgery, or if taking blood thinners (anticoagulants). Acetaminophen should not be taken by anyone with known liver or kidney disease. Do not drink alcohol when taking more than 1 dose of acetaminophen.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File GHEA3517.rf2 VRS# 4582 Data Version 7.0 Copyright 1998, 2000, 2002-2003 McKesson Health Solutions LLC. All rights reserved.