Cold Injuries Flashcards
Signs and Symptoms
1) Patients may complain of pruritus and burning paresthesia.
2) Localized edema,
3) Erythema,
4) Cyanosis,
5) Plaques,
6) Nodules,
7) In rare cases, ulcerations, vesicles, and bullae.
Initial examination:
1) The skin is pale, mottled, anesthetic, pulseless, and immobile, which initially does not change after rewarming.
Chilblains (Trench foot)
Treatment
1) Management of chilblains is supportive.
2) The affected skin should be rewarmed, gently bandaged, and elevated.
3) Topical corticosteroids (0.025% fluocinolone cream)
4) Or even a brief burst of oral corticosteroids, such as prednisone, have been shown to be useful.
Chilblains prevention
1) Keeping ____,
2) Ensuring good ______ fit,
3) Changing out of wet ______ several times a day.
4) Never sleeping in wet ________ .
5) Once early symptoms are identified, maximizing efforts to warm, dry, and elevate the feet.
1) warm
2) boot
3) socks
4) socks and boots
What degree of frostbite?
a) Transient stinging and burning, followed by throbbing.
b) Partial skin freezing, erythema, mild edema, lack of blisters, and occasional skin desquamation several days later.
c) Prognosis is excellent
First Degree
What degree of frostbite?
a) The patient complains of numbness, followed later by aching and throbbing.
b) Full-thickness skin freezing, formation of substantial edema over 3 to 4 h, erythema, and formation of clear blisters.
c) Prognosis is good
Second Degree
What degree of frostbite?
a) The patient may complain that the involved extremity feels like a “block of wood,” followed later by burning, throbbing, and shooting pains.
b) Hemorrhagic blisters form and are associated with skin necrosis and a blue gray
discoloration of the skin.
c) Prognosis is often poor.
Third Degree
What degree of frostbite?
a) The patient may complain of a deep, aching joint pain.
b) The skin is mottled, with little edema and nonblanching cyanosis, and eventually forms a deep, dry, black, mummified eschar.
c) Vesicles often present late, if at all, and may be small, bloody blebs that do not extend to the digit tips.
d) Prognosis is extremely poor
Fourth Degree
Frost bite Treatment
Field management
1) Wet and constrictive clothing should be _____.
2) The involved extremities should be ______.
3) Carefully in dry sterile gauze, with affected fingers and toes ________.
4) Further cold injury should be avoided.
1) removed
2) elevated and wrapped
3) separated
Clinical Management
1) Rapid rewarming is the core of frostbite therapy and should be initiated a soon as possible.
2) The injured extremity should be placed in gently circulating water at a temperature of 104°-107.6°F (40° to 42°C) for approximately 10 to 30 min, until the distal extremity is pliable and erythematous.
3) Clear blisters should be debrided or at least aspirated
4) Hemorrhagic blisters should not be debrided because this often results in tissue desiccation.
5) Blister types should be treated with topical aloe vera cream every 6hrs.
6) Digits should be separated with cotton and wrapped with sterile, dry gauze.
7) Elevation of the involved extremities helps decrease edema and pain.
Frost bite Clinical Management
1) Rapid rewarming is the core of frostbite therapy and should be initiated a soon as possible.
2) The injured extremity should be placed in gently circulating water at a temperature of 104°-107.6°F (40° to 42°C) for approximately 10 to 30 min, until the distal extremity is pliable and erythematous.
3) Clear blisters should be debrided or at least aspirated
4) Hemorrhagic blisters should not be debrided because this often results in tissue desiccation.
5) Blister types should be treated with topical aloe vera cream every 6hrs.
6) Digits should be separated with cotton and wrapped with sterile, dry gauze.
7) Elevation of the involved extremities helps decrease edema and pain.
Hypothermia is defined as a core temperature below ____
95°F
Hypothermia Temperature stages
1) Mild – ____ºF
2) Moderate – ____ºF
3) Severe below _____ºF
1) Mild – 90-95ºF
2) Moderate – 82-90ºF
3) Severe below 82ºF
What Hypothermia clinical stage?
a) Normal mental status with shivering.
b) Functioning normally.
c) Able to care for self.
d) Estimated core temperature 35 to 37°C (95 to 98.6°F).
Cold stressed (not hypothermic):
What Hypothermia clinical stage?
a) Alert, but mental status may be altered.
b) Shivering present.
c) Not functioning normally.
d) Not able to care for self.
e) Estimated core temperature 32 to 35°C (90 to 95°F).
Mild hypothermia
What Hypothermia clinical stage?
a) Decreased level of consciousness.
b) Conscious or unconscious, with or without shivering.
c) Estimated core temperature 28 to 32°C (82 to 90°F).
Moderate hypothermia
What Hypothermia clinical stage?
a) Unconscious.
b) Not shivering
c) Estimated core temperature <28°C (<82°F).
Severe/profound hypothermia
