frostbite


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frostbite

 [frost´bīt]
injury to tissues due to exposure to cold. Usually the first areas of the body to freeze are the nose, ears, fingers, and toes. The flesh feels cold to the touch, and frozen parts become pale and feel numb. There may also be some prickly or itchy sensation. A person suffering from frostbite may feel no warning pain. In mild cases, proper treatment can rather quickly restore normal circulation of blood. In more serious cases the area may become painfully inflamed, and blistering may follow. Especially severe frostbite can cause death of the injured tissues and gangrene.

Mild frostbite usually appears as a shallow, blanched wheal on the nose, ears, fingers, or toes. After rewarming, the area is slightly reddened for several hours and then resumes a normal appearance. If the frostbite is more severe, deeper tissues are affected and the area appears waxy and feels doughlike to the touch. With rewarming, the area becomes edematous and the patient feels itching, burning, and deep pain. Later on, mild edema may remain and the skin becomes mottled, cyanotic, or red without blistering. Over the following weeks the pain and edema should subside, but the skin may peel and the patient may experience increased sensitivity to cold in that area until healing is complete.

Blistering occurs in deeper frostbite. The vesicles may contain pink or clear fluid that has leaked from damaged cells and tissues. Eventually the vesicles contract and dry out, leaving an eschar that sloughs off and exposes new skin underneath if there has been adequate circulation to the part.

Severe frostbite damages all layers of soft tissue down to connective tissue and bone. The frostbitten area is hard and wooden and appears lifeless. There is no sensation of pain and the patient cannot voluntarily move the frozen part. With rewarming there are aching pain, burning, and blistering. If there is no pain or other sensation after rewarming, the tissue may be dead and amputation may be indicated.
Treatment. Rewarming is best done in an emergency care facility where assessment of the extent of frostbite can be done and appropriate measures taken to rewarm the frostbitten part without further damaging tissue. In the field, it is best to keep the part as warm as possible to prevent further freezing. Blankets and warm clothing are appropriate and, if possible, the frozen area can be placed in contact with any other part of the body that is warm. Rubbing and massaging the area is not recommended because it can only serve to further damage frozen tissue. The victim should not smoke and should avoid caffeine and alcohol because any of these can further restrict blood circulation.

Emergency medical care, if the patient cannot be brought to the hospital and rewarming must be done in the field, includes rapid rewarming in water baths not exceeding 40.6°C (105°F). Hot water can cause further tissue destruction. Tetanus prophylaxis is administered as necessary. If severely frostbitten tissue swells to the point of totally restricting circulation, a fasciotomy may be required to allow adequate blood supply. Vesicles are left intact but frostbitten fingers and toes should be separated with cotton balls and a loose dressing applied. If the patient will be taken outside for transport to a medical facility, rewarming should be started at the hospital.

frost·bite

(frost'bīt),
Local tissue destruction resulting from exposure to extreme cold; in mild cases, it results in superficial, reversible freezing followed by erythema and slight pain (frostnip); in severe cases, it can be painless or paresthetic and result in blistering, persistent edema, and gangrene. Frostbite is currently treated by rapid rewarming.

frostbite

(frôst′bīt′, frŏst′-)
n.
Injury or destruction of skin and underlying tissue, most often that of the nose, ears, fingers, or toes, resulting from prolonged exposure to freezing or subfreezing temperatures.
tr.v. frost·bit (-bĭt′), frost·bitten (-bĭt′n), frost·biting, frost·bites
To injure or damage by freezing.

frostbite

Tissue damage or destruction induced by temperatures below 0ºC, which is divided into superficial–frostnip and deep forms; in deep frostbite, subcutaneous tissue, muscle, and bone are involved Clinical Numbness, prickling, itching, if severe paresthesia, stiffness, bullae formation, necrosis, gangrene Treatment-immediate Rewarm in water 40-42ºC/104ºF-107.6ºF, never warmer Treatment-post emergent Debride blister, topical aloe vera gel, tetanus prophylaxis, analgesia, NSAIDs, penicillin, hydrotherapy, physical therapy

frost·bite

(frawst'bīt)
Local tissue destruction resulting from exposure to extreme or prolonged cold. In mild cases, it results in superficial, reversible freezing followed by erythema and slight pain; in severe cases, it can be painless or paresthetic and result in blistering, persistent edema, and gangrene.

frostbite

Freezing of bodily tissues, especially the tips of the extremities. Expanding ice crystals damage the tissues and the local blood supply is cut off. The result is local tissue death (GANGRENE).

Patient discussion about frostbite

Q. What are the visual distinctions between thermal burns and frostbite? Is it possible to definitively distinguish the two from each other in all cases, or do they present identically in many cases? In other words, are frostbite injuries-for all intents and purposes, actual burns and if they are not, in what ways do they differ?

A. Early frostbite and minor burns may resemble one another visually (by whitened, blanched looking skin, and blister formation). However, last stage frostbite and thermal (heat) burns are very different.
In late stage frostbite, the ice crystals in the cells melt and the ruptured cells pour out their contents, then blisters may form. Since the affected area has basically lost circulation, gangrene sets in rather quickly and the tissue turns black and dry.
Deep (full thickness) heat related burns are surrounded by areas of erythema (reddened skin) and skin with less degrees of burning. Also, eschar is obviously charred skin tissue forming a scab like structure, and looks nothing like gangrene. The wound bed in a burn leaks plasma constantly. Blistering is pretty immediate with heat related burns of a sufficient degree.

More discussions about frostbite
References in periodicals archive ?
For any of us who might have had a mild case of frostbite to the ears and fingers--at any time in our lives--the burning and itching sensations have a tendency to recur when these same areas are again subjected to the cold (or even heat).
Being outside at 15 degrees Fahrenheit in a wind of 15 miles per hour was listed as "frostbite possible."
Include frostbite risk as a consideration in the development of future aerosols for consumer use.
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If you develop frostbite, try to warm the affected body part for 20 minutes by applying warm towels, cotton or warm water (approximately body temperature) to conduct heat to the frostbitten area, according to Kimmelman.
The Moddb website claims that Frostbite 3 features upgraded tessellation technology which gives better 3D effects and graphics.
A spokesman said: "We regret to announce Sir Ranulph Fiennes has developed a case of frostbite."
"Let's hope his frostbite doesn't reach the worst-case scenario."
These are the warnings signs of frostbite: deep layers of skin and tissue begin to freeze and the skin becomes hard and numb; its color is pale or waxy white.
The 29 pelicans are now being treated for frostbite at a Delaware bird rescue facility, where they will spend the winter getting massages, warm-water foot baths, and a choice selection of fish.
"Most body heat is lost through the head, so always wear a hat, and wear gloves to help prevent frostbite."
When bare skin comes in contact with these super-cooled liquids, frostbite can occur instantly.