Frostbite is becoming common during cold winter weather. Fortunately, most cases are nothing more serious than “frost-nip” at the tip of the nose or the edge of an ear. Victims momentarily feel stinging pain in the involved skin, which thereafter becomes white and painless as ice crystals form in the affected tissue. Quick cure is obtained by warming the nipped skin (by touching it) right away and thereafter shielding it against the cold.
Serious frostbite is usually due to wet socks or gloves. After an initial painful coldness, there is a progressive loss of sensation. This is misleading because the victim may not complain again until stiffness and loss of function set in (when the frostbite spreads deeper to involve bones and joints). The affected skin becomes pale, hard, and pulseless as the blood in the involved arteries freezes solid, thereby locally arresting the circulation.
Serious frostbite is treated by rapid rewarming in a tub or sink. The water temperature, according to Conn’s Current Therapy, should be kept between38° and 40° C (100°-105°F). Make sure it is not too hot because the victim has no sensation and is easily burned. Pain pills are best given before the victim complains, because sensation will suddenly return during rewarming (two aspirins can be quite helpful).
Rewarming should be continued until the skin looks pink (it will look redder than normal), and the tissues feel soft again. This usually takes 30 to 45 minutes. Do not rub the affected part while it is being rewarmed; this only damages the skin. After rewarming, gently dab the part dry (no rubbing), cover it with sterile dressings, and keep it at rest with the fingers or toes separated with cotton or gauze. Skin blisters usually develop in a day or two and are not necessarily a bad sign. If the blister fluid becomes cloudy or bloody, however, seek medical attention right away so that antibiotics, etc., can be given.
During cold weather, older people or anyone with heart trouble, regardless of age, should keep the lower face covered with a scarf. This is very important because cold air in the lungs reflexly constricts the coronary arteries and can thereby trigger a heart attack.