What should be included in patient education about frostbite?

Updated: Jul 29, 2019
  • Author: Bobak Zonnoor , MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

The primary defense against frostbite is to get out of the cold. If this is not possible, preplanning and use of appropriate clothing are mandatory. Follow weather forecasts, with special attention to both predicted temperature as well as wind-chill temperature index. Patients should be advised to do the following:

  • Keep hands and feet dry.

  • Use mittens instead of gloves.

  • Apply clothing in multiple layers.

  • Avoid perspiration by using adequately ventilated clothing.

  • Avoid tight clothing.

  • Increase fluid and calorie intake in cold weather.

  • Avoid alcohol and tobacco

  • Maintain current tetanus immunization.

  • Do not wash hands, face, or feet frequently under extreme cold conditions; weather-beaten skin is more resistant to frostbite

  • Keep toenails and fingernails trimmed

  • Do not rub affected areas; this causes further damage because of the presence of ice crystals in the skin

  • Do not use dry heat to thaw frostbitten areas; moist heat is better because it allows a more complete thaw

  • Do not allow the injury to thaw then refreeze; therefore, hospital rewarming is favored over field rewarming.

  • In remote areas, use a buddy system to help prevent cold injury; have a system for rapid evacuation, if needed

  • At high altitudes, moderate activity to minimize the work of breathing and associated heat loss through the respiratory tree; use of supplemental oxygen has been found to reduce the incidence of frostbite among mountain climbers

Patients should be informed that the frostbitten area may be more sensitive to cold, with associated burning and tingling. Individuals who have sustained a cold-related injury are at a 2- to 4-fold greater risk of developing a subsequent cold-related injury. Therefore, patients with frostbite should be counseled about their increased susceptibility to frostbite injury and about appropriate strategies to avoid it. They should also be given general advice on preparing for cold weather exposure.

For patient education resources, see the Environmental Exposures and Injuries Center and the Infections Center, as well as Frostbite and Tetanus.


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