How is frostbite treated?

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

The goal of frostbite treatment is to salvage as much tissue as possible, to achieve maximal return of function, and to prevent complications. [39] If treating personnel are unfamiliar with the management of frostbite and its sequelae, transfer of the patient to another facility should be considered. In some settings, burn units have particular expertise in managing severe frostbite injuries. In one report, 29% of homeless patients admitted to a burn unit were admitted for frostbite. [40] Therefore, transfer to a facility with a burn unit may be an option.

Prehospital care starts with taking the patient to a warm environment. If needed, pad or splint the affected area to minimize injury en route. Remove wet clothing. Avoid walking on frostbitten tissue. Do not rewarm frostbitten tissue if there is a possibility of refreezing before reaching definitive care. Lastly, do not rub or use a stove/fire to rewarm frostbitten tissues.

Be sure to correct the ABCs (A irway, B reathing, and C irculation) and life-threatening conditions before treating frostbite. Make sure that the frostbitten area does not refreeze. Rewarm the frostbitten area as quickly as possible to salvage as much tissue and function as possible. Rewarming is most effectively accomplished by immersing the affected area in water heated to 37-39 °C (98.6-102.6 F). Do not allow the water to get too hot or too cold. Avoid premature termination of the rewarming process. Remember to treat pain associated with rewarming.

Avoid early amputation until after the nonviable tissue is clearly demarcated. Inform patients that the injury site is more prone to recurrent damage when exposed to even moderate changes in environmental temperature.

Consider obtaining a photographic record on admission, 24 hours after admission, and serially every 2-3 days until discharge.

The management of frostbite itself may be divided into 3 phases: field management, rewarming, and postrewarming management. [24]


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