It's getting cold again! The holiday season is upon us and winter sport lovers are rubbing their hands in excitement for the upcoming snow. There is a lot to look forward to. But as Mainers know, our long winter is only enjoyable if you prepare for it.
With decreasing temperatures, the incidence and risk of frostbites increase and it is always useful to have a working knowledge of how to manage them when they occur.
A frostbite consists of damage to a body part caused by cold and it can occur on a spectrum of very mild to very severe and limb threatening. It is most common on the ears, the nose, cheeks, chin, fingers, and toes. The skin affected usually initially looks white and feels numb. It also tends to feel hard or waxy. Patients who are affected usually have trouble moving the area. Occasionally, you might see blisters which contain blood in them. Most severe frostbites will exhibit dark areas that signify necrosis and tissue loss.
What to do when you suspect a person has frostbite? The first step is always to move them to a warmer area and take off any wet clothing. The affected organ needs to be submerged in a warm bath. The water temperature should be comfortable enough for a non-affected person to touch. Avoid hot water. If water is not available, use body heat such as armpits or your own hands.
Avoid doing some things that will make the frostbite worse such as walking on feet that have frostbite, using flame or a stove to warm the area as numb skin may burn very easily or even rubbing the area. You also want to avoid re-exposing the area to the cold as this will exacerbate the tissue damage.
If you notice that the affected area is large or it does not go back to normal within a few minutes, you should seek medical care. Doctors can help frostbite by providing pain control as this can be a very painful condition. When frostbite is very severe, it may be of benefit to get medication that improves the blood flow to the affected area such as t-PA or Iloprost. Not everyone is a candidate but these are medications that can only be administered in a hospital setting.
Tissue that is injured by frostbite is very vulnerable to bacteria in the soil and a tetanus shot may be indicated. Also if an infection were to occur, doctors may have to give antibiotics. In very severe cases, when tissue loss is irreversible, an amputation may be indicated to prevent infection from progressing.
But as always with injury and trauma, the best treatment is prevention. It is crucial to not expose ourselves to this danger as the temperatures decrease. Arm yourselves with hats, mittens, goggles and layers of clothing. I always stress avoiding alertness-affecting substances when you are facing the elements and knowing the weather. You could also get frostbite indoors if you expose a body part to ice or severe cold.
Enjoy the upcoming winter and stay safe.