In this episode, the hosts discuss frostbite, its different degrees, initial management options, and prognostic indicators. They also explore various aspects related to the face, including fascinating insights. The importance of addressing core body temperature and rewarming the entire body in frostbite cases is emphasized, along with discussions on imaging, antibiotics, surgical management, and treatment recommendations.
Frostbite is classified into four stages: first degree, second degree, third degree, and fourth degree, with consistent treatment involving rapid and gentle re-warming of the affected area.
Assessment of frostbite involves evaluating color changes, presence of blisters, and prognostic indicators such as normal skin color and sensation, with non-blanching cyanosis and hard, non-deforming skin indicating poor prognosis.
Deep dives
Frostbite and its Stages
Frostbite is a freezing injury that occurs when tissues are exposed to temperatures below their freezing point, leading to ice crystal formation, cellular lysis, and microvascular occlusion. Frostbite is classified into four stages: first degree (numbness, erythema, edema), second degree (clear blisters, erythema, edema), third degree (hemorrhagic blisters, deep numbness), and fourth degree (necrosis, gangrene). Despite the staging, the treatment for frostbite remains consistent: rapid and gentle re-warming of the affected area with consistent warm water between 37 to 39 degrees Celsius.
Prognostic Indicators and Assessment
When assessing frostbite, it is important to look for color changes, firmness, presence of blisters, and evaluate prognostic indicators for a favorable outcome. These indicators include normal skin color, large blisters with clear fluid (better prognosis than hemorrhaging fluid), and sensation (light touch or pinprick). Non-blanching cyanosis, dark fluid blisters, and hard, non-deforming skin are concerning for a poor prognosis. The assessment of frostbite focuses on the affected areas and the severity of tissue damage.
Treatment and Management
The initial management for frostbite involves rapid re-warming of the affected area using consistently warm water. It is crucial to avoid using hot water or direct heat sources, as they can cause burns and further tissue damage. Re-freezing should also be prevented. Antibiotics are not necessary for mild frostbite, but in severe cases, vascular or plastic surgeons may be consulted. Surgical management, such as debridement and amputation, is reserved for cases with compartment syndrome, significant infection, or non-responsive wounds. Overall, the most common situation is acute frostbite that can be successfully treated with re-warming and appropriate wound care.
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Cite this podcast as: Briggs, Blake. 207. Frostbite & chill? January 8th, 2024. Accessed [date].
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