Coronavirus
Frostbite

​Overview:

  • Frostbite is an injury caused by exposure of parts of the body to extremely low temperature (freezing).
  • Frostbite is most common on the head, face, ears, fingers and toes.
  • Frostbite can develop permanent damage to the tissue, or even amputation of limbs.
  • In some advanced cases, a surgical intervention may be necessary.
  • Avoiding going out in the cold weather, and avoiding physical inactivity are among the most effective prevention strategies. 

Introduction:
Frostbite is an injury caused by the exposure of parts of the body to extremely low temperature (freezing). It causes damage to the skin and underlying tissue, as well as numbness and discoloration of affected area. Frostbite can affect any part of the body, including the nose, ears, cheeks and lips, but is most common on the fingers and toes.

Names:
Frostbite, frostnip, freezing

Frostbite stages:
  • Stage 1 frostbite (frostnip): affects the epidermis (the outer layer of the skin) only.
  • Stage 2 frostbite (superficial frostbite): affects the epidermis and a part of the dermis (the second layer of the skin).
  • Stage 3 frostbite: affects the epidermis, the dermis and the fact tissue below the dermis.
  • Stage 4 frostbite (deep or severe frostbite): affects the skin and the tissue underlying it, as well as muscles, tendons and bones.

Cause:
Blood carries oxygen throughout the body. However, when the body is exposed for a long time to low temperature (e.g.  cold weather, or touching ice, frozen metals or extremely cold liquids), the blood vessels redirect the oxygenated blood to the vital body organs, as a precautionary response, leading to deficiency of the blood supply to the limbs. 

Risk factors:
  • Medical conditions (e.g. arterial stenosis, diabetes)
  • Impaired blood circulation
  • Taking medications that cause the blood vessels to narrow
  • Inadequate clothing
  • Smoking

Who is at high risk?
  • Soldiers
  • Outdoor workers
  • The homeless
  • Children
  • The elderly
  • The individuals practicing outdoor sports (e.g. skaters and mountaineers)

Symptoms:
Due to the numbness associated with frostbite, the affected person may not take notice of the injury till another person draws their attention to it. It is most common on the fingers, toes, nose, ears, cheeks and chin. The symptoms include:
  • Redness, a prickling feeling and numbness;
  • Cold skin;
  • Hard or waxy-looking skin;
  • Palpitation and pain in the affected area;
  • Pale, white skin;
  • A bite, a burn and swelling;
  • Loss of sensation and pain in the affected area, and blistering after rewarming in severe cases.

When to see a doctor?
Medical attention should be sought upon the onset of some signs and symptoms, including:
  • Pale, white skin;
  • Numbness and severe pain;
  • Low body temperature.

Complications:
  • Infections (e.g. tetanus)
  • Low body temperature
  • Nerve damage
  • Amputation

Diagnosis:
The diagnosis of frostbite is usually based on the visible signs and symptoms associated with it (e.g. the appearance of the skin), and a review of recent activities. Other tests include:
  • Medical history
  • Clinical examination
  • Other tests, including: X-ray imaging, bone examination, and MRI.

Treatment:
Frostbite treatment varies depending on the injury severity. It may require a medical attention, that might take any of the following forms:
  • Rewarming the body with warm (and not hot) water, under the doctor’s supervision;
  • Medications (e.g. clot-busting drugs, pain killers, infection-fighting drugs);
  • A bandage or a cast if the bones or muscles are affected; 
  • Removal of damaged tissue (debridement);
  • Surgical intervention (in severe cases).

Prevention:
  • Limit time you're outdoors in cold-weather conditions; 
  • Avoid staying outdoors in cold weather for a long time;
  • Wear adequate warm clothing;
  • Wear mittens and a headwear that covers the ears and the neck;
  • Wear socks and sock liners that fit well;
  •  Change the wet cloths as soon as possible;
  • Stay hydrated;
  • Eat well-balanced meals and stay hydrated;
  • Exercise and keep moving to stay warm.

Guidelines to follow when suffering a frostbite:
  • Avoid cold-weather, and stay in a warm place;
  • Don’t rewarm the frozen skin with direct heat (e.g. stove, heater or heat lamp);
  • Don’t walk with your feet or toes frozen;
  • Don’t immerse the affected area in hot water;
  • Don’t scratch the affected area, or prop the blisters that may develop;
  • Avoid rubbing the affected area to rewarm it.

FAQ :
  • Does a frostbite increase the chances of having another frostbite in the future?
    • Frostbites can reoccur if the individual is exposed to severe coldness; if he/she fails to follow the recommended precautions; or he/she suffers weak blood circulation.

Myths & Truths:
  • Rubbing the affected area helps rewarm it.
    • Truth: Rubbing may lead to damaging the tissue.


Clinical Education General Department
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