Frostbite - a Preventable Disease
Frostbite occurs when your tissue freezes at 28°F. Ice crystals are formed, circulation is disrupted and tissue dies.
We generally don't travel to places where frostbite is a concern, but Leaders should familiarize themselves with this topic.
Exposed skin is at highest risk:
Feet & hands at greatest risk
Nose and ears also at risk
Our bodies are surrounded by warmed air. When the wind blows, it blows away this warm air. Heat is lost through warming of the cooler air next to your skin.
Wind doesn’t lower air temperature. It just hastens cooling.
The faster the wind, the less time it takes to cool your body or cause tissue freezing.
Frostbite can appear black and mummified in late stages, but generally doesn't look this way in the field.
There are more than one way to categorize the levels of Frostbite. In a hospital, they may use a 1st-4th degree rating system. In the field, we generally use a 2-tierd system:
Superficial
Deep
No or minimal anticipated tissue loss
First-degree frostbite
Numbness
Erythema (red skin)
Mild swelling
Raised plaque - Firm, raised area of white or yellow skin
Second-degree frostbite
Superficial blisters - clear or milky fluid
Blisters surrounded by redness and swelling
Anticipated tissue loss
Third-degree frostbite
Deeper blood filled blisters
May appear waxy and white
Fourth-degree frostbite
Damage extends into muscle and bone
Eventually appears black
Deep Frostbite
Frostbite is generally preventable and Prevention is far better than Treatment! Frostbite is often not improved with treatment.
Cover Exposed Skin
Keep Core Temperature Up
Remove jewelry
Remove wet clothing
Place dry dressings between digits otherwise tissue will get wet and icky (tissue maceration during demarcation)
Elevate (to reduce swelling)
Evacuate to a Hospital
If evacuation is delayed greater than two hours, consider rewarming.
Keep victim warm
Dry heat is difficult to regulate and is not recommended
Fires and heaters and result in burns and further damage
Buddy system can be considered
Skin to skin contact
Soak in warm water (37-39°C / 98.6-102.2°F) for 15-30 minutes
Use thermometer or rescuer's hand to measure temperature
Evacuation by Walking and Extensive Frostbite (entire foot)
OR
If Refreezing is Expected
Water needs to feel nice and warm to the Rescuer. Not Lukewarm and Not Burning HOT! You are gong for the nice hot tub feel.
NOTE: Use the Rescuer's Hand and not a frostbitten hand to test for heat. A frostbitten hand may not feel anything and get burned in hot water.