Treatment of Frostbite

Frostbite is most likely to occur in the unprepared individual, so the best initial treatment would be to prevent frostbite from occurring in the first place. If frostbite should occur in the individual, field treatment would be necessary.
In order to be prepared for the environment and to prevent frostbite we have to look at contributing factors:

• Frostbite usually occurs when the ambient air temperatures are below 32 degrees Fahrenheit.
• Low relative humidity is a major contributing factor.
• Windchill will accelerate the process of frostbite.

Any part of the body may be affected by frostbite but the most vulnerable areas are the nose, cheeks, chin, forehead, wrists, hands and feet. Keep these areas covered to prevent the occurrence of frostbite. Layering of clothing is important, especially when engaged in strenuous outdoor activities. When you are doing strenuous outdoor tasks, shed a layer or two of clothing to prevent a buildup of perspiration. Remember to replace these layers when you are idle.

Symptoms of frostbite include:
• A sensation that there are pins and needles in the affected area.
• Numbness.
• Discoloration at the site. This would be a redness in light skinned people and a grayness in people of darker skin.

As frostbite progresses watch for these symptoms:
• Loss of sensation in affected area.
• Hard, waxy skin
• Swelling of the affected area. This is an indication of deep tissue injury.

If frostbite is left untreated, the blood vessels may actually freeze causing permanent damage. Gangrene then may set in.

Treatment of frostbite includes:

• Getting the individual out of the elements into a warm, dry area.
• Treat the patient as if they are hypothermic [low body temperature]. Remove any wet clothing and passively rewarm the individual using blankets.
• Remove any constricting clothing or jewelry.
• If immediate medical care is available, wrap the affected area with dry, sterile dressings, making sure to separate the fingers and toes, and transport to the nearest medical facility.

If immediate medical care is not available:
• Attempt to rewarm affected area.
• For mild cases, rewarming affected area is the best course of action.
• Skin to skin contact also works. Remember, even in mild cases never rub the affected area. You may cause damage to the underlying tissue.

For more severe cases:
• Immerse affected area in warm, never hot, water. This water should be at a temperature of 104 degrees F. Leave affected area in this water bath for 20-30 minutes.
• Warm, wet towels may also be used.
• Pain and discoloration may occur in affected area.
• If patient is able to tolerate, give warm fluids since frostbite can lead to dehydration. Remember, no alcohol. Alcohol will only worsen any condition of dehydration.
• Do not thaw out any area that you cannot protect from refreezing. Refreezing will only cause more tissue damage.
• Do not use direct heat such as a campfire or a hairdryer. This can burn the affected area.
• Do not pop any blisters at the affected site.
• Do not rub the affected area. This can cause tissue and blood vessel damage due to the formation of ice crystals in the affected area

When ready to transport any individual suffering from frostbite to a medical care facility remember to wrap any affected area with dry, sterile dressings taking care to separate the fingers and toes. Cover the affected areas with warm blankets and watch the patient for any signs or symptoms of shock.