Frostbite and cold weather-related injuries facts
Introduction to frostbite and cold weather-related injuries
Winter cold and snow provide a number of opportunities to get outside and participate in activities such as skiing, sledding, and snowmobiling. However, without proper protection, cold weather-related injuries can occur even when temperatures are above freezing (32 F, 0 C). This is especially true if there are high winds or if clothing is wet. In general, however, it is both the temperature and the duration of exposure that play a role in determining the extent and severity of cold weather-related injuries. This information describes the different types of cold weather-related injuries, as well as what to do to prevent and treat them prior to reaching a health care practitioner.
What type of injuries can be caused by cold weather?
Cold weather-related injuries can be divided into two general categories.
Hypothermia is a medical condition characterized by a core body temperature that is abnormally low.
What are the signs and symptoms of frostbite?
The signs and symptoms of frostbite depend on the extent and depth of tissue injury. Individuals with superficial frostbite may experience the following signs and symptoms to the affected area:
As the degree of injury progresses to involve deeper tissue structures, the signs and symptoms of deep frostbite can develop, which may include the following:
With advanced frostbite injuries, the affected area can subsequently appear blackened and gangrene can develop, placing the affected individual at high-risk for infection.
What are cold weather-related injuries without tissue freezing?
Cold weather-related injuries that do not involve tissue freezing include:
Chilblains
Chilblains (also known as pernio) are a common type of cold weather-related injury that can develop in predisposed individuals after exposure to nonfreezing temperatures and humid conditions. Chilblains typically develop because of an abnormal vascular response several hours after the area exposed to cold is re-warmed. Chilblains are itchy, painful, reddish, or purplish areas of swelling that usually affect the fingers, toes, nose, or ears. In some individuals, blisters or small open sores may also form, increasing the risk for developing an infection. Chilblains usually last for several days, and the affected area usually heals after several weeks. Though the affected area may remain sensitive to the cold in the future, there is usually no permanent damage. It is not uncommon for chilblains to recur in susceptible individuals.
Frostnip
Frostnip is a mild cold weather-related injury that typically affects the face, ears, toes, and fingers.
Symptoms of frostnip usually occur after exposure to cold weather. The affected area(s) may:
Simple rewarming restores normal color and sensation, and there is no subsequent permanent tissue damage.
Trench foot
Trench foot also referred to as immersion foot was named after the condition suffered by many soldiers in the trenches during World War I, though it is a condition still encountered today, often in homeless individuals. Trench foot develops after a prolonged exposure to a wet, cold, environment and is typically a more serious condition than chilblains. Tight-fitting, constricting boots and footwear serve to exacerbate the condition. Trench foot does not require freezing temperatures, and can occur with temperatures of up to 60 F (15.5 C).
The symptoms of trench foot may include:
The affected foot may appear red or blotchy (red and pale areas mixed together) or even bluish-black with advanced injury.
As with chilblains, blisters and open sores can develop. With severe trench foot, the tissue dies and sloughs off, and the development of gangrene can occur, sometimes requiring amputation. The usual recovery period for uncomplicated trench foot can be several weeks.
Frostbite: Cold weather-related injuries with tissue freezing
Frostbite occurs when there is freezing of body tissue, and it is the most serious of the cold weather-related injuries. Frostbite usually affects the hands, feet, nose, ears, and cheeks, though other areas of the body may also be affected. This type of injury results from decreased blood flow and heat delivery to body tissues resulting in damaging ice crystal formation, which ultimately leads to cell death. Upon rewarming of the affected tissue, vascular damage and complex cellular metabolic abnormalities lead to tissue death.
Damage to tissue is most pronounced when there is prolonged cold weather exposure, the affected area slowly freezes, and the subsequent rewarming process is slow. Repeated thawing and refreezing of the affected tissue is particularly damaging, and should always be avoided.
Frostbite injuries can be classified as either superficial or deep, depending on the tissue depth of injury.
Superficial frostbite injuries have a better prognosis than deep frostbite injuries.
What does frostbite look like (frostbite pictures)?
The appearance of frostbite may gradually change over time; the extent of the change depends on how severely the tissue is damaged. Figure 1 shows a hand with severe frostbite changes at the tips of the fingers and thumb (dark to black-appearing tissue) that gradually decreases in severity on the digits.
Figure 1. Frostbite on digits and thumb
Picture of the Stages of FrostbiteHow should frostbite and other cold weather-related injuries be treated?
The initial treatment for any cold weather-related injury involves removing yourself or others from the precipitating cold environment, if possible, to prevent further heat loss.
It is important to note that some of these individuals may also be suffering from hypothermia, a potentially life-threatening condition.
Chilblains treatmentWhat are the signs and symptoms of frostbite?
The signs and symptoms of frostbite depend on the extent and depth of tissue injury. Individuals with superficial frostbite may experience the following signs and symptoms to the affected area:
As the degree of injury progresses to involve deeper tissue structures, the signs and symptoms of deep frostbite can develop, which may include the following:
With advanced frostbite injuries, the affected area can subsequently appear blackened and gangrene can develop, placing the affected individual at high-risk for infection.
What are cold weather-related injuries without tissue freezing?
Cold weather-related injuries that do not involve tissue freezing include:
Chilblains
Chilblains (also known as pernio) are a common type of cold weather-related injury that can develop in predisposed individuals after exposure to nonfreezing temperatures and humid conditions. Chilblains typically develop because of an abnormal vascular response several hours after the area exposed to cold is re-warmed. Chilblains are itchy, painful, reddish, or purplish areas of swelling that usually affect the fingers, toes, nose, or ears. In some individuals, blisters or small open sores may also form, increasing the risk for developing an infection. Chilblains usually last for several days, and the affected area usually heals after several weeks. Though the affected area may remain sensitive to the cold in the future, there is usually no permanent damage. It is not uncommon for chilblains to recur in susceptible individuals.
Frostnip
Frostnip is a mild cold weather-related injury that typically affects the face, ears, toes, and fingers.
Symptoms of frostnip usually occur after exposure to cold weather. The affected area(s) may:
Simple rewarming restores normal color and sensation, and there is no subsequent permanent tissue damage.
Trench foot
Trench foot also referred to as immersion foot was named after the condition suffered by many soldiers in the trenches during World War I, though it is a condition still encountered today, often in homeless individuals. Trench foot develops after a prolonged exposure to a wet, cold, environment and is typically a more serious condition than chilblains. Tight-fitting, constricting boots and footwear serve to exacerbate the condition. Trench foot does not require freezing temperatures, and can occur with temperatures of up to 60 F (15.5 C).
The symptoms of trench foot may include:
The affected foot may appear red or blotchy (red and pale areas mixed together) or even bluish-black with advanced injury.
As with chilblains, blisters and open sores can develop. With severe trench foot, the tissue dies and sloughs off, and the development of gangrene can occur, sometimes requiring amputation. The usual recovery period for uncomplicated trench foot can be several weeks.
Frostbite: Cold weather-related injuries with tissue freezing
Frostbite occurs when there is freezing of body tissue, and it is the most serious of the cold weather-related injuries. Frostbite usually affects the hands, feet, nose, ears, and cheeks, though other areas of the body may also be affected. This type of injury results from decreased blood flow and heat delivery to body tissues resulting in damaging ice crystal formation, which ultimately leads to cell death. Upon rewarming of the affected tissue, vascular damage and complex cellular metabolic abnormalities lead to tissue death.
Damage to tissue is most pronounced when there is prolonged cold weather exposure, the affected area slowly freezes, and the subsequent rewarming process is slow. Repeated thawing and refreezing of the affected tissue is particularly damaging, and should always be avoided.
Frostbite injuries can be classified as either superficial or deep, depending on the tissue depth of injury.
Superficial frostbite injuries have a better prognosis than deep frostbite injuries.
What does frostbite look like (frostbite pictures)?
The appearance of frostbite may gradually change over time; the extent of the change depends on how severely the tissue is damaged. Figure 1 shows a hand with severe frostbite changes at the tips of the fingers and thumb (dark to black-appearing tissue) that gradually decreases in severity on the digits.
Figure 1. Frostbite on digits and thumb
Picture of the Stages of FrostbiteHow should frostbite and other cold weather-related injuries be treated?
The initial treatment for any cold weather-related injury involves removing yourself or others from the precipitating cold environment, if possible, to prevent further heat loss.
It is important to note that some of these individuals may also be suffering from hypothermia, a potentially life-threatening condition.
Chilblains treatmentSource: http://www.rxlist.com
Hypothermia is a medical condition characterized by a core body temperature that is abnormally low.
Source: http://www.rxlist.com
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