Take Home Points
- Frostbite is a severe, localized cold-induced injury due to freezing and thawing of tissue.
- We usually see these injuries affecting the ears, nose, cheeks, chin, fingers, and toes. Patients will complain of cold, numb or stiff sensations and discoloration of the skin.
- Critical ED treatment starts with rewarming in a warm, NOT HOT, water bath, analgesia and wound care.
- More extensive treatments include blister debridement, tPA, prostacyclin analogues and fasciotomy. Patients with severe frostbite will likely require multidisciplinary care with surgery and critical care so consider early consults.
- And last, be sure to check the patients core temp and treat hypothermia complications, such as diuresis
REBEL Core Cast 48.0 – Frostbite
For More on This Topic Checkout:
- emDOCS.net: Brrr! ED Presentation, Evaluation, and Management of Cold Related Injuries
- EP Monthly: Frostbite: How to Classify and Treat It
- EM in 5: Frostbite
References:
- Cauchy E et al. Retrospective study of 70 cases of severe frostbite lesions: a proposed new classification scheme. Wilderness Environ Med. 2001 Winter. PMID: 11769921.
- Geng Q et al. Temperature limit values for touching cold surfaces with the fingertip. Ann Occup Hyg. 2006. PMID: 16777911.
- Grieve AW et al. A clinical review of the management of frostbite. J R Army Med Corps. 2011. PMID: 21465915.
- Handford C et al. Frostbite. Emerg Med Clin North Am. 2017 May. PMID: 28411928.
Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)
Shownotes Created By: Miguel Reyes, MD (Twitter: @miguel_reyesMD)
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