Frostbite

Updated Tuesday December 22, 2015 by Cheryl Erickson.

                                                     Frostbite 

                     Thermal injury to the skin caused by cold exposure. 
Recognition:

Stage Signs Symptoms 
Frostnip Only the outer layer of skin is frozen. Skin appears white and waxy or possibly gray or mottled. It may have sensation or may be numb. May be painful. 
Superficial Frostbite Skin appears white, mottled or gray. It feels hard or rubbery on the surface, but deeper tissue is still soft. Skin is insensitive to touch. 
Deep Frostbite   


Management: It is very important to note that refreezing newly thawed frostbitten tissue can cause extensive tissue damage. If it is not absolutely certain that the tissue will stay warm after rewarming, do not rewarm it. Once the tissue is frozen, the major harm has been done. Keeping it frozen for a longer period of time will not cause significant additional damage. 
 

Overview:

  • Do not rub the area.
  • Gently rewarm the area by blowing warm air onto the area, placing the area against a warm body part, or placing the affected area into warm (101 - 108 degrees F) water for several minutes.
  • If not absolutely certain that the tissue will stay warm after rewarming, do not rewarm it. Refreezing newly thawed frostbitten tissue can cause extensive tissue damage!
  • If a person is also suffering from hypothermia, the first concern is core rewarming. 

Details: The following describes the management of frostbite relative to severity

  • Frostnip - Rewarm the area gently by blowing warm air onto the area or placing it against a warm body part or place in a warm (101 degrees - 108 degrees F) water bath for several minutes. Never rub the area. This can damage the affected tissue by increasing the friction on the ice crystals in the cell, causing tearing of the tissue.
  • Superficial frostbite - If a small area is involved, it can be treated the same as indicated for frostnip; if it is a larger area, follow the management for deep frostbite.
  • Deep frostbite - Rewarm by removing restrictive clothing and immersing the affected body part in a water bath of 105 degrees - 110 degrees F for 25-40 minutes. Refer deeply frostbitten athletes to the emergency room. Do not rewarm the tissue unless absolutely certain that it will stay warm after rewarming.