Frostbite

Staying aware in the cold

Iowans should be on their guard outside during winter months, particularly against damage to the nose, ears, toes, and fingers, explains Hans House, MD, an emergency medicine physician at University of Iowa Hospitals & Clinics.

Factors that impact frostbite

Several factors determine how much damage is done by the cold, he notes. Temperature, dampness, and the duration of exposure are among factors, of course, but, also, immobility of the victim--a person injured in a fall, for example--increases the chance of significant injury. Tight clothing restricts blood flow that would ordinarily warm the skin's surface, and wind quickly cools the arms and legs.

What does frostbite look like?

Although the victim may experience numbness, stiffness and pallor, the signs of frostbite become apparent upon re-warming the area.

1. First-degree frostbite is diagnosed when swelling and redness occur. 

2. Second-degree frostbite also includes blistering of the skin.

3. More severe cases are indicated by a dark discoloration of the skin, a sign that tissue is badly injured and necrotic. 

4. In extreme cases, gangrene may appear and make amputation necessary.

Treating frostbite

Treatment for frostbite includes rapid re-warming of the affected area in warm--not hot--water. The water should be only slightly warmer than body temperature--about 110 degrees F--and the area should be warmed only when it can be kept warm afterward. More damage will result if an area is warmed and then chilled again. The injured area should be elevated and protected, and the victim should be given protection against tetanus.

Specialized wound care, available at burn centers like the Burn Treatment Center at UI Hospitals & Clinics, can help the healing process. Be sure to seek medical attention for any frost-bitten extremity, House says.