17 - 98 - COLD INJURIES Flashcards
Superficial frostbite involves the skin and immediately subcutaneous tissues.
It includes the previously described signs but with the pain subsiding to feelings of warmth. This is a sign of severe involvement.
The skin has a waxy appearance, but deeper tissues remain soft and resilient.
Clear blebs form, accompanied by edema and erythema within 24 to 36 hours after thawing. Lesions may become eroded (Fig. 98-4).
Frostnip involves only the skin and damage is reversible (Fig. 98-3).
There is a sensation of severe cold progressing to numbness followed by pain.
Erythema is usually present on the cheeks, ears, nose, fingers, and toes.
There is no edema or bleb formation.
Deep frostbite extends to the deep subcutaneous tissue. The injured skin becomes white or bluish white with a variable degree of anesthesia.
Most often the affected skin becomes deceptively pain free, and the discomfort of feeling cold vanishes.
The tissue is totally numb, indurated with immobility of joints and extremities. Muscles may be paralyzed. Nerves, large blood vessels, and even bone may be damaged.
Large blisters form 1 to 2 days after rewarming, and they can be classified according to depth, as in heat-induced burns (Fig. 98-5).
the only form of frostbite that can be treated safely in the field with first aid measures
Frostnip
Good prognostic signs of Frostbite
Poor prognostic signs of Frostbite
Large, clear blebs extending to the tips of the digits.
Good or Poor prognostic sign?
GOOD
True or False: Rewarming should be done slowly to decrease tissue damage
FALSE
Slow rewarming increases tissue damage, making rapid rewarming the keystone of treatment.
Rewarming should be performed in a water bath between 37°C and 39°C (98.6°F and 102.2°F) until the most distal parts of the body are flushed.
Because of the low temperatures of inhalants, frostbite has been observed on the face, fingers, forearms, oral, laryngeal, and tracheal surfaces (Fig. 98-8A).
This may present as well-demarcated edema, erythema, cyanosis, and vesiculation concentrated around the nose, mouth, or even periorbital area (Fig. 98-8B).
Because of the low temperatures of inhalants, frostbite has been observed on the face, fingers, forearms, oral, laryngeal, and tracheal surfaces (Fig. 98-8A).
This may present as well-demarcated edema, erythema, cyanosis, and vesiculation concentrated around the nose, mouth, or even periorbital area (Fig. 98-8B).
