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The Do’s and Don’ts of Treating Frostbite

By Jeffrey Sterling, MD May 22, 2019

Introduction

This Straight, No Chaser focuses on the do’s and don’ts of treating frostbite.

hypotherm1

There’s a cold front coming. You can’t avoid the exposure. Some of you will end up cold as ice. Would you really know what to do if you caught frostbite? I thought not, and the bad news is some of your instinctive tendencies are exactly what you ought not to do in this situation. Here are some do’s and don’ts if you ever find yourself or a loved one in this particularly precarious position.

managing frostbite hands

The Do’s

A lot of this depends on the circumstances.

  • Give warm fluids if possible.
  • If the person is wet, remove wet clothing.
  • If s/he is wearing tight clothing, remove whatever’s constricting.
  • Move to as warm of a climate as feasible; if not possible, then shelter the person from the cold. Avoid movement of the frostbitten parts to the extent possible.
  • Gently separate affected fingers and toes, and if you can, wrap them loosely in sterile dressing.
  • If you have transportation, get to an emergency room as soon as possible.
  • If immediate care or transportation is not available, soak the affected areas in warm (preferably circulating and never hot) water. Alternatively, place warm coverings to affected areas for up to 30 minutes at a time. If skin is soft and feeling returns, you’ve done a good job.
    • Be mindful that burning pain and swelling will occur during rewarming.
  • Apply dry, loose and preferably sterile dressings to the frostbitten areas. Keep frostbitten fingers or toes separated with dressings.
  • Delay rewarming if you are not in an area safe from the risk of refreezing. Refreezing of thawed extremities is even more dangerous than the initial freeze.  

frostbitefeet

DO NOT

  • Rub or massage the frostbitten area.
  • Peel or pop any blisters that may be present.
  • Use dry heat, such as from a hair dryer, a radiation, heating pad, electric blanket or campfire. These heat source may be ok to keep the rest of you warm (particularly your core), but this type of direct heat can further damage frostbitten tissue.
  • Rewarm until you can be sure it can stay thawed.
  • Smoke or drink alcohol during recovery. These activities can interfere with blood circulation and cause additional problems.

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