Treatment For Frostbite
People with superficial or deep frostbite should be taken to the hospital immediately. If transport to a hospital is delayed, the following measures can be taken to prevent further injury:
- Keep the person warm. Try to get the person indoors to a heated environment and cover with blankets, if available.
- Don't let the person smoke or drink alcohol. Both nicotine and alcohol can further constrict blood vessels and decrease blood circulation.
- Don't rub the affected area.
Most experts advise people not to rewarm or thaw frostbitten areas themselves. If thawing is not done properly, serious consequences such as loss of the affected area can result. For instance, thawing a frostbitten area by holding the affected area close to a campfire or in front of an open oven door can burn already-damaged tissues. Rubbing a frostbitten area with snow or ice is also not recommended. Rubbing with snow or ice will only cause more ice crystals to form in frozen tissue.
Rewarming should only be performed by trained hospital personnel. The rewarming should be gradual. The affected part of the body (or sometimes the entire person if the affected area is extensive) is submerged in a tub of warm water. The water is usually between 100–106°F (37.7–41.1°C). Pain is a sign that thawing is taking place. During the rewarming procedure, it is extremely important that the person remain as still as possible. Motion can cause still-frozen tissue to break into pieces which may injure delicate, newly-thawed tissues.
After rewarming, the affected area is sometimes loosely wrapped in sterile cloth. The person is carefully monitored for infection and for signs of restored circulation. If the area does not show renewed circulation or if the area becomes infected, amputation is sometimes performed. Amputation is necessary to prevent infection from spreading into other areas of the body.
In the United States, hospitals in Alaska have established guidelines for the assessment and treatment of frostbite. Many physicians and other health care personnel have also made helpful observations about the incidence of frostbite that may prevent some cases. One physician has noted a sharp increase in the incidence of frostbite affecting the ears in young male patients in the late 1970s and 1980s compared to the 1960s and early 1970s. This physician surmised that in the 1960s and 1970s, men wore their hair longer, thus protecting their ears from frostbite, but the shorter hair styles of the 1980s exposed ears to the elements. Another physician notes a correlation between snorting cocaine and frostbite affecting the tip of the nose. Like the cold, cocaine also leads to constriction of the mucous membranes and the arteries in the nose. A person using cocaine may develop frostbite faster than a person who isn't using cocaine. Yet another observation is a correlation between frostbite affecting the feet and the wearing of tennis and running shoes. In cold climates especially, proper footwear is essential in preventing frostbite.
In addition to these guidelines, other measures can be taken to prevent frostbite. When working or playing outdoors, a person should refrain from drinking alcohol or smoking. They should always wear proper clothing and take special care of the areas most vulnerable to cold exposure: the ears, tip of the nose, fingers, and toes. When any part of the body starts to feel numb, a person should immediately go indoors to warm that part. These common sense tactics should ensure safety when the mercury drops.
Grant, Henry, et. al. Brady Emergency Care. 6th ed. Englewood Cliffs: Prentice Hall, 1990, pp. 566-568.
Mills, William J. "Summary of Treatment of the Cold Injured Patient: Frostbite." Alaska Medicine 35. (1): 61-66.