The frostbite experts-traumatologists called pathological destruction of cells and tissues that occurs as a result of long-term destructive effects of low for human body temperatures. Frostbite is classified by doctors according to the depth of tissue damage, and depending on the location and area of coverage on the victim’s body – full or partial. This injury is dangerous because even patients who are in consciousness, it is difficult to notice it. On the nerve cells responsible for signal transmission of the dangerous influence of temperature on the skin, low temperatures have a strong anesthetic effect.
The victim understands that severely injured after fatal exposure to cold has ceased to reduce the sensitivity of nerve cells and numbness, pain, burning sensation, and sometimes convulsions.
Part of therapy is determined by the doctor depending on what condition is the patient who received frostbite and how deeply affected body tissue. In some cases, due to necrosis of the doctor no choice, like cutting off the damaged section from the body of the patient.
Causes of frostbite
To people experienced in their organs and tissues devastating effect of cold, you should the damaging effects of the following factors:
- directly greatly reduced temperature;
- in some cases, long exposure to strong winds and high humidity on the street with insufficient low temperature;
- uncomfortable, damp from water or sweat clothes;
- warm enough, low-quality shoes;
- forced long presence in adverse conditions without an opportunity to warm up or in any way change the position;
- physical exhaustion;
- a long, unbearable hunger;
- alcoholic or narcotic intoxication;
- weakness is the result of aggravation of chronic pathologies.
The most terrible cases of frostbite occur when a combination of several negative environmental factors and lack of awareness of their condition. Very often, these dangerous combinations are fatal.
Depending on how it manifested in the victim symptoms and signs of frostbite, doctors-traumatologists acquired pathology is divided into four stages:
- First degree. The upper layers of the skin after frostbite gradually become pale, sometimes cyanotic, and edematous. Warming, a sore spot will gradually acquire an intense crimson hue. Gradually, the patient will feel increasing discomfort, pain and burning. The first stage doctors even suggest to treat it at home without damaging the psyche of the victim even more hospital treatment. Signs of disease gradually disappear in a relatively short time, however, a few days skin on the affected location will retain sensitivity to cold;
- Second degree. The victim will require a more thorough inspection, and detailed advice and recommendations of the expert-traumatologist. Frostbitten limbs and other damaged areas of the body for a short time you will lose sensitivity and will retain a bluish tint, when you touch will seem cold. With the gradual warming of the patient on the frostbitten areas will occur swelling. The main symptom of this stage is the formation of little blisters with clear fluid on frostbitten. The implementation of the instructions given by the doctor, and proper treatment methods will help to restore the cover to the affected areas after a week;
- The third degree. In the same way as the second, characterized by the formation on the skin of bubbles, but by their color – red-brown – you can see how deep the affected tissue. The skin gradually loses sensitivity and in the absence of proper treatment scarred. After this damage, the skin will remain distinctive, jagged scars that follows the contours of frostbite;
- The fourth degree. Has the most destructive effect on the affected tissue of the patient. Is characterized by necrosis at the site of frostbite. The only treatment in the case of destruction of the limb is amputation because of poor blood circulation can lead to serious pathologies of the tissues and blood.
What to do for frostbite
The most important thing for frostbite was to end the damaging effects of cold on tissues and organs of the victim. It is necessary to return blood circulation to the frostbitten area normal speed, and prevent occurrence of a secondary pathology that can be caused by listed infection.
The first thing to do is to transfer the patient in a warm, dry room and as soon as possible to get rid of the wet, cold, icy clothes and shoes, to offer him some dry clothes. It is best suitable cotton clothing, not able to leave additional damage.
After this the patient should drink as much hot liquid. This will help to restore the speed of blood flow and warm the victim.
In any case, it must call the ambulance crew to determine the stage of the patient’s condition.
In the first stage, will help careful grinding of damaged areas, slow and stretched. Frost damaged part of the body must be wrapped with a sterile bandage, and the patient warmly wrapped blanket.
It is important
If frostbite hand, foot, or toes on the extremities, you can try to lower them in a bowl of warm, clean water. To interrupt the heating prior to arrival of the ambulance Smoking – it can worsen the condition.
The second stage is a dangerous bubble, which some decide to self-pierce. This can not be done, as in non-sterile conditions can aggravate the condition of the patient to bring additional infection. Best of all, after measures to warm the patient, gently apply on the place bubbles with a sterile gauze pad and not touch it until the arrival of the doctor.
In the third and fourth stages , the primary task is to stabilize the victim in the same position, bringing it into consciousness, if there is such a possibility, and immediate hospitalization.
What not to do for frostbite
Strictly prohibited conduct the following manipulations, which are erroneously considered to be an effective aid for frostbite at any stage:
- try to warm the frostbitten area with hot water bottles trying to keep them over an open flame and by leaning against the radiators and heaters;
- conduct RUB and massage the affected area in cases when bubbles appear or there is a risk of necrosis or decomposition of tissues. Even at the first stage of frostbite rubbing movements are made slowly and gently;
- you cannot allow the patient to take in very hot, causing redness even healthy skin, water
- To rubbing of the skin, dialing up snow. Small needles of ice, trash, sand and dirt contained in the snow, can create further injury to damaged tissue and provoke the penetration under the skin infection;
- it is strictly forbidden to pierce, wash towel, loofah or scrubs, mechanical peeling, tear off the nails formed on the skin in more severe stages of frostbite bubbles;
- it is impossible to treat frost-bitten areas of the skin oil, alcohol, urine. Additional chemical attack will only hurt injured cells and tissues.
The further treatment
In the first stage, a fairly simple first aid measures, namely, to the warm and attentive attitude to the patient is impossible to get hypothermic. If the patient complains of pain and itching in recovering tissues, then it is permissible to offer him a couple of pills anaesthetic: Next, Pentalgin, Nalgesin.
In the second stage the surgeon will reveal the bubbles formed in parallel continuously treating the affected surface of the skin antiseptic preparations. Later will be assigned daily dressings only sterile bandages, treatment of the affected area with antiseptics (Miramistin, Miramistin) and applying to them an antimicrobial ointment (levomicetinom and sintomitsinovoy ointment). Ointment for more effective impact and better hygiene cover with a sterile gauze piece, recorded with the help of non-woven patch. If frostbite is close to the third stage, the doctor may prescribe intramuscular injections of antibiotics.
At the third stage of trauma puncture the bubbles formed and define the boundaries of lesions of the upper layer of the epidermis. Therapy is the laying on of bandages soaked in hypertonic solutions and slow surgical removal of damaged tissues.
After healing the doctor prescribes physiotherapy treatment, involving therapy, magnetic therapy manipulation and other methods of recovery of feeling in the affected and gradually recovering tissues.
In the case of the fourth degree the patient helps only a surgical procedure to trim dead limbs — amputation. After surgery, the wound is carefully bandaged in a hospital. Need for additional daily treatment to accelerate healing of this area of the body.
Irina Kuznetsova, medical columnist