Dr. George 14.6:Frostbite

Mont Sainte Anne, Quebec, February 4, 2000″It was a sunny, windy day. My friend Bob and I decided to go riding at Mont Sainte Anne. It was something like negative 68 degrees Farenheit, which is pretty normal for the area. Usually I take care to cover my ears well, but this time I must’ve forgotten. After one hour of riding, I touched the lower part of my ear. It was stiff like a piece of wood, and I couldn’t feel myself touching it. I became terrified.

“After shooting straight to the lift station, my ear began to thaw and hurt like hell. My ear was swollen like a marshmallow for more than a week. Even though my ear looks normal now, it’s still very sensitive to the cold.”-Jeff Paquet

What is frostbite?
The diagnosis of frostbite is straightforward and can usually be made by the patient. Frostbite includes the direct effects of cold (freezing of tissues) and vascular responses (tightening and closing up of small blood vessels). Most often, frostbite affects your fingers, toes, nose, ears, and cheeks.

How severe is frostbite?
There are different stages of frostbite. The first stage begins with a feeling of cold and numbness. This numbness is an important alert sign to help avoid further damage. Grade-one frostbite is harmless but hurts quite a bit while warming up, and the skin stays red and swollen for a few days. If the signs of grade one are neglected and exposure to the cold continues, tissue damage can occur, but is reversible. A typical side effect of grade-two frostbite is the formation of a blister while warming up. If very extensive cold exposure occurs, grade-two frostbite can feasibly transform into grade-three frostbite, which is a serious situation with irreversible tissue damage that can, in the worst cases, lead to the loss of a body part-even a hand or foot. When warming up, the skin remains bluish and pale, there’s no blister formation, and the sensitivity to touch is minimal or even gone. Even minor frostbite can lead to increased sensitivity to cold for a long time.

How do you treat frostbite?
The first step is always to get out of the cold as soon as possible.To avoid further damage, warm the frozen body part up quickly! Use clean, warm (as close to 98.6 degrees Farenheit as possible) water if available. If you have frostbite on your feet while in a remote area with no shelter or help nearby, don’t warm them up because you won’t be able to walk. If there’s no heat source available, place the frozen foot or hand on the abdominal area of a person who’s with you. This can avoid further damage. Grade-two and grade-three frostbite needs to be seen and treated by a physician as soon as possible. Blisters should always be coverd with a sterile cloth or gauze to avoid infection.

What can you do to prevent frostbite?
Awareness is the best prevention. Adapt your clothing to your outdoor activity and the weather conditions. Always cover your ears, wear warm, waterproof gloves, and don’t wear tight shoes or clothing that’s too small-they support the effects of cold temperatures. Also, don’t forget to drink plenty of water to prevent blood clots from forming in your vessels, which increase the risk of frostbite.

There are five main factors you should be aware of:
_ Humidity can increase the effect of cold by fourteen times
_ Wind can increase the effect of cold by ten times
_ High altitude can increase the risk of closing off small blood vessels
_ Fatigue
_ Individual sensitivity to cold

Important Note:
Hypothermia: a life-threatening danger.
During long-term exposure to cold (for example, being trapped in a snowstorm because of an accident or the mountain closing), the body temperature drops lower than 98.6 degrees Farenheit, sinking from the outside to the inside. In most cases, blood circulation is restricted to the main organs in the middle of the body. The blood of the outer, larger circulatory system can be extremely cold, while the temperature of the inner, smaller blood vessels is still warm enough to keep the person alive. If the body of the saved victim is moving too much (on its own or by someone else), the differently tempered blood can blend and the victim could die after his “salvation” from hypothermia. This effect is the so-called “after drop.” People such as entirely buried avalanche victims must be transported with minimal movement and without effort (via helicopter, snowcat, et cetera) to an adequate hospital as soon as possible.

What to do in case one of your friends suffers from hypothermia: Isolate against ground cold, protect against wind, and warm with the help of clothing or body heat.
Measures for conscious victims: apply hot packs, give drinks (hot and sweet), and allow minimum movement.
Measures for awake but apathetic victims: apply hot packs, but give no drinks, and allow no movement.
Measures for unconsciousness (respiration and cardiac function sufficient) victims: do not apply hot packs before helicopter transport. However, if helicopter transport is impossible, warm up by any means, but give no drinks and allow no movement.