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Frostbite: What It Is, What to Do

by Berkeley Wellness  

Frostbite occurs from exposure to cold weather. Temperature and length of exposure determine how quickly frostbite occurs. The wind-chill factor is also critical: At 30?F, with no wind, exposed hands would only become frostbitten after prolonged exposure. But at the same temperature in a 40-mile-an-hour wind, the wind-chill equivalent is 4?F, and frostbite becomes a real risk.

Risk of frostbite also increases if you are wearing damp clothing, have consumed alcohol, have a below-average percentage of body fat, or have a previous history of frostbite.

Signs of frostbite

Frostbite can be insidious—if you’ve been out in the cold a while and your skin and extremities already feel cold and numb, you may not notice that it has set in. Once it has set in, symptoms can progress from mild to serious, designated by the following categories:

Frostnip. The first hint of frostnip is numbness, followed by a whitening of the tissue—a change that can take place very quickly. Skin may also start to harden. Frostnip usually affects the nose, ears, hands, or feet.

Superficial frostbite. If frostnip progresses to superficial frostbite, the area will appear very white and waxy and will feel hard on the surface, yet will have its normal resilience in the lower layers.

Deep frostbite. At this stage, the tissues can turn blotchy or blue and will be very hard, without any underlying resilience. Blistering may also occur.

Immediate care for frostbite

If you do not get out of the cold, frostnip will progress to frostbite—and at that point, medical attention is required to avoid severe damage to skin. If you notice signs of either superficial or deep frostbite, contact the nearest doctor or hospital emergency room.

Treatment for each type of frostbite varies. But until medical aid is available, several guidelines apply to all three types:

  • Never massage or rub frostbitten areas (with or without snow).
  • Do not apply any ointments.
  • Get out of the cold, if possible.
  • Don’t drink alcoholic beverages.
  • When checking any frostbitten part of the body, press very gently. Be careful not to hit, bump, or rub the area.
  • For frostnip, apply warmth directly. Blow on the areas, or get someone else to do so; if your nose is frostnipped, apply your hands. If it’s your hands that are freezing, put them in your armpits. Your skin will probably burn and tingle as it warms, but there should be no lasting injury.
  • For superficial frostbite, warm the affected areas. Superficial frostbite requires medical attention, but there are some steps you should take first. Once you’ve gotten out of the cold, warm the area, preferably by immersion in warm water (100?F to 105?F—a temperature that should feel comfortably warm, but not hot, to undamaged skin). The warming process may be uncomfortable. Keep adding warm water as necessary, but take care that the water doesn’t get too hot. Avoid dry heat or uncontrolled heat sources such as campfires, since the affected area is numb and can be easily burned. Also, don’t try to walk on frostbitten feet, and avoid the temptation to rub frostbitten hands or fingers. On the way to the doctor, keep the area warm.
  • For deep frostbite, get to an emergency room. Don’t try to administer first aid or thaw the tissue. Wrap the frozen area in a blanket or other soft material to prevent bruising, and keep it elevated if you can on the way to the hospital.

Tips for preventing frostbite

  • Proper clothing and some commonsense precautions are the key to preventing frostbite.
  • Be careful when temperatures dip below 20?F. The risk of frostbite is much higher, so plan carefully before going outside. A cold wind will accentuate the chilling of tissue, and altitude is also a factor: it’s generally colder at higher elevations.
  • Use skin moisturizer before going outside. This will slow the loss of body heat. Apply it to your hands, face, and any other body part that may become exposed to the cold.
  • Dress appropriately for the conditions. Dress in layers; make sure that the outer layer is windproof and waterproof. Footwear should be watertight. Make sure ears, nose, and face are adequately covered. For extra protection, wear a face mask.
  • Wear heavy mittens instead of gloves. When the fingers are together in the mitten, their collective body heat keeps the hand warmer.
  • Don’t drink alcoholic beverages. Although alcohol gives the illusion of warmth, it causes heat loss by dilating the blood vessels; it may also cause you to ignore critical frostbite signals.
  • Don’t smoke. Nicotine impairs blood flow by constricting small blood vessels in the skin.
  • Never touch very cold metal with your bare hands. Moisture on the skin will cause it to stick to the metal, leading to damaged skin.
  • Be careful at the gas pump. Gasoline splashed on exposed skin in freezing temperatures lowers skin temperature, making it more susceptible to frostbite.
  • Equip your car. When traveling during the winter, keep a blanket or sleeping bag in your car at all times. If weather conditions force you to pull over to the side of the road, use the covers or bag to keep warm. Unless you’re properly dressed, don’t leave the car in frigid weather; you put yourself at higher risk.

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