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The Essentials Of Understanding Frostbite

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Winter is just great! Long walks in nature, hiking, skiing, snowboarding, or sledding are just some of the outdoor activities we all enjoy. The first breath of the freezing air once you go out in the morning is an amazing experience! I’m not sure if all people like it, but I think a man can not wake up before he fills the lungs with one deep subzero breath. Having that said, I guess you can guess what do I think of summer.

Anyway! Have you ever wondered how long does it take to turn a winter fairytale into the freezing horror? If the conditions are right- not over 30 minutes!

Gloves lost in the snow, and you are an hour or two walking distance away from a hotel on a windy subzero day- that is all it takes to get a frostbite. One study found that a prevalence of frostbite among homeless people is 2% (in simple words-a lot!)

I’m not homeless, why is this relevant to me?– you may ask.

Well, if you are stuck outside in the snow with inadequate equipment, an hour or two away from people- you are homeless!

Read on, until the end of this article; you will learn how to prevent, recognize and treat frostbites!

Cold winter conditions can cause frostbite.

zima by Las Golczewski| Creative Commons 4

How long does it take to get a frostbite?

Depending on the environmental conditions and body’s compensatory capabilities- anywhere from a few minutes to a few hours (see the above).

Why do we get frostbites?

On subzero temperatures, blood vessels in exposed parts of the body constrict (to redirect warm blood to the vital organs). As the temperature drops, water in the tissues freeze, forming tiny sharp crystals which tear the cell membranes, killing the cells. The damage triggers the inflammatory response which “finishes” the frozen and damaged tissue.

Risk factors

Weather and the time of exposure

If the temperature is 5°F with 30mph wind, it takes less than 30 minutes for a frostbite to occur. Wind is your worst enemy on subzero temperatures! Most vulnerable are ears, nose, fingers, and toes. In extreme situations, frostbite can affect the whole extremity.

Age and overall health

Children will get frostbites quicker than a healthy adult- body and blood volume are a lot smaller in children; therefore, they cool faster. Seniors are vulnerable to low temperatures as well (those with heart disease and bad peripheral blood circulation).

Raynaud’s disease

It is a condition that causes sudden, vasoconstriction in blood vessels that supply the skin of the fingers and toes. The trigger for the attack may be physical and emotional stress. Persons with Raynaud’s disease are more sensitive to cold. The attacks are sometimes so severe that fingers go numb and cyanotic. It is more frequent in females than males. Most often, occur in people who live in cold climates.

Frostbites Prevention

The tip of the nose, ears, and hands needs to be tucked if you get stuck outside for a few hours on a subzero windy day. These parts of the body are prone to frostbites.

Keep the exposed parts of the body dry- runny nose can cause a nasty frostbite.

If you don’t have gloves, hide your hands into the sleeves (rather than pockets). It’s less warm, but having hands locked in the pockets during winter is a bad idea- if you fall, the first thing touching the ground will be the nose.

Remember- the wind is your worst enemy! Protect your self the best you can.

Avoid alcohol, nicotine, and caffeine since they cause vasoconstriction increasing the risk of frostbites.

Mild exercise can increase peripheral vasodilatation (the warm blood will rush to fingers and prevent freezing of the skin and deeper tissues). Why not heavy exercise?– you may ask. Sweating on a subzero temperature increases the risk of hypothermia. Vigorous exercise could exhaust you (not a good idea in an emergency).

Frostbites classification (by grades)

I Swelling, redness, tingling, prickling, burning, discomfort/ painful movements in the affected joints.
II On top of symptoms mentioned above, blisters filled with clear fluid occur. The tissue damage at this stage is still superficial.
III As the tissue damage progresses, blisters filled with blood, discoloration of affected tissue (blue-gray) and necrosis occur. At this stage, extensive surgical processing of the affected tissue is needed, and partial amputation of the affected tissue may be required.
IV Deep tissues are affected (bones and muscles). At this stage, amputation is the only treatment option.

Blisters filled with blood are the first sign of serious trouble. That is a red flag you shouldn’t miss.

Frostbites treatment

Before we dive into the treatment algorithm, I want to give you advice about decision making in emergencies.
While I was working in a central train station ambulance, every day we had emergency calls. Every time the same scenario- an unconscious person on a sidewalk, a crowd would gather, stare and comment about what should be done. More than once I faced a situation in which someone (untrained medical professional) from a crowd was trying to give me (trained medical professional) instructions what to do.
Being put under an emergency is hard! If you jump in and help, you have to be prepared to rely on your own decisions (not someone else).

Frostbite? Is that a blister? Filled with blood or clear fluid, looks pink, but I’m not sure if it’s blood…  It’s your call until someone more experienced jumps in!

For an adequate first aid on frostbites, follow these simple guidelines:

A tip about frostbite treatment from a Ranger School:

We were always told that we could put the affected area to the torso of another person (affected hands in someone’s shirt again), but to NEVER rub the affected area.

I can’t stress enough how important it is not to rub the frostbite! Rubbing would cause further tissue damage. It would literally peel the frozen skin layers from the deeper tissue.

Grade I
Gradually warm up affected part of the body. You can use a bottle filled with warm water or submerge hands/feet in cold water and slowly increase the water temperature. Do not use hot water!
Grade II
If the blisters are tight and filled with clear fluid, do not open them if professional medical help will be available within the next 12-24h. Otherwise, cut the blister on the edges, remove the excess skin and keep the wound clean. Slowly warm up the affected tissue.
Grade III and IV
The most distinctive feature is blisters filled with blood. Do not cut open them! Because of excessive tissue damage, emergency medical treatment is needed. Warm up the affected tissue (to prevent the further destruction).

One more thing

Frostbite is just one of the so-called “cold injuries.” Others, (the most common) include the Trench Foot and Hypothermia. Do you want to be prepared for all those small winter time inconveniences that can turn into the life-threatening situations?

Read more:

Trench Foot: Still A Very Serious Condition

Preparing For And Dealing With Hypothermia

Best Survival Flashlight

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