Most often frostbite is exposed to open (ears, nose) and parts of the body that are distant from the body (hands, feet). Frostbite of the upper or lower extremities as a whole is more rare.
Frostbite, causes and symptoms, first emergency first-aid and medical care for frostbite.
Like burns, frostbite is divided into degrees. The difference between frostbite and burns is that it is quite difficult to determine the degree of frostbite immediately after exposure to cold. The degree of frostbite is determined within 12-24 hours.
Causes of frostbite.
Frostbite occurs if a cold affects a part of the body. Under the influence of low temperature, there is an upset circulation of the skin, and then tissues lying deeper. Then there is necrosis of the skin and deeper tissues. General freezing is currently quite rare. More often it occurs in victims who fell into cold water in winter or autumn, in drunks who fell asleep in the snow, in case of accidents. It leads to impaired functions of the cardiovascular and respiratory systems, the central nervous system.
During an external examination of the victim, pallor and cyanosis of the skin are noted, there is no cold and pain sensitivity, or it is sharply reduced. If you grind and warm the affected area, then intense pain will appear. After 12-24 hours, you can determine the depth of frostbite. For the I degree of frostbite, redness is characteristic, and in the future – blueness of the skin. The fingers and toes are swollen. When frostbite II degree on the skin appear blisters with bloody contents.
With the III degree of frostbite, if you open the bubble, you can see the wound surface with dark areas of tissue necrosis. For the IV degree of frostbite, damage to the fingers or hands and feet as a whole is characteristic. They turn black, with swelling at first, and then wrinkling. When frostbite is accompanied by general cooling of the body, the victim develops lethargy, indifference to the environment, pallor of the skin. Possible loss of consciousness. The limbs are cold, the pulse becomes rare, blood pressure decreases.
4 phases are distinguished in total freezing.
In phase I, there is a pronounced narrowing of the peripheral blood vessels, an increase in the body’s heat production. Body temperature rises slightly. When the freezing phase II develops, then, despite the high heat production, the victim tries to move more and more actively, he develops muscle tremors, his body temperature decreases by 1-2 degrees. Pallor and severe soreness of the skin occur. The pulse becomes weak and rare. Consciousness and reflexes are preserved. There may be a little excitement..
During phase III, body temperature drops to 34–27 degrees. The victim becomes inactive. The heat production of the body decreases due to depletion of its reserves. Initially, muscle tremors are noted, which is then replaced by muscle paralysis. The patient ceases to feel pain. Weakening of reflexes occurs, confusion is noted. Breathing becomes shallow. At a body temperature below 30 degrees, cardiac activity is significantly reduced. In phase IV, body temperature drops below 27 degrees. Slow breathing and pulse, the absence of reflexes and pain sensitivity are noted. If cooling continues, death occurs.
First aid for frostbite.
Freezing should be delivered as soon as possible to a warm room, to a car. It is necessary to take off his clothes, if they are frozen and wet, as well as shoes, cover them with a warm blanket and drink hot sweet tea. With severe freezing, the health worker injects the patient with an intravenously heated solution of glucose with insulin up to 40 degrees. Give him moistened oxygen in the form of inhalation. Apply cardiac and respiratory agents (strophanthin solution, cordiamine). Then the patient is quickly taken to the surgical or burn ward of the hospital.
When frostbite, it is necessary to bring the victim into a warm room, remove shoes and outerwear from him. A limb that has undergone frostbite, first of all, needs to be rubbed slightly with your hands, without injuring the skin. If the victim is conscious and frostbite is supposed to be shallow, you can place the limb in a container (basin) with warm water. If the pain that occurs when warming up quickly passes and the fingers return to normal or if slight swelling is noted, then the skin’s sensitivity has been restored. After this, the limb must be wiped dry, wiped with a 30% solution of ethyl alcohol and put on dry cotton socks, and on top – woolen.
When frostbite hands wear gloves or mittens. In the event that when the limbs are heated, pain intensifies, and the fingers remain cold and pale (which is a sign of deep frostbite), warm baths are contraindicated. The victim can be given painkillers (metamizole sodium, tramadol) in tablets, but an intramuscular injection is preferable. In case of severe pain, an ambulance doctor administers narcotic painkillers. The victim must be taken to the burn, trauma or purulent surgical department of the hospital..
Based on Quick Help in Emergencies.