Frostbite

From Guide to YKHC Medical Practices

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Frostbite is, for obvious reasons, a common problem. If someone is in a village with frostbite and there is a chance of refreezing - DO NOT THAW. If you can guarantee the affected extremity can be kept warm and at body temperature (95-100 degree) a bath can be used to rewarm the affected area. If it’s just blisters, they usually stay in the village with local (pun intended) care there. If you elect to transport the patient in, don’t let the affected area get bumped on the way.

Once here, the patient may need daily whirlpools, they will need NSAIDS and avoidance of all pressure to the area. Bear in mind that the longer you wait and treat conservatively, the less tissue damage will occur. A foot that initially looks bad enough that all the toes may be lost will often do much better than expected. (A toe saved, a toe earned - be patient and do no harm). Both clear and hemorrhagic blisters often occur-the books will tell to unroof the hemorrhagic blisters; practical experience shows that keeping them intact until they break on their own is better. Debride as needed to prevent bacterial trapping. Of note, aloe gel is helpful as a dressing. We also have very experienced physical therapists skilled in wound care. Use these resources.

Warn patients that paresthesias are common and they have a high risk of re-injuring the area in future exposures. Avoid all tobacco to increase blood flow.

Update Tetanus vaccination.

Alteplase and Frostbite

Resources/References


YKHC Clinical Guidelines
Common/Unique Medical Diagnoses