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  • Frostbite Facts

  • David Harrington, MD, director of the Rhode Island Burn Center, discusses frostbite.
    Frostbite is caused by extreme cold-an hour of exposure at 20 degrees Fahrenheit is all it takes. Even colder temperatures, or exacerbating factors such as moisture or wind, will increase the likelihood of frostbite setting in.

    At Rhode Island Hospital's Burn Center, we use specific drug treatments to help save living tissue after exposure to extreme cold.

    "What we do is give people a very powerful vaso-thrombolytic drug, which will dissolve developing clots," says David Harrington, MD, director of the Rhode Island Burn Center." With this drug, we can prevent progression of disease. Bloody blisters equal loss of tissue; this thrombolytic allows us to save 80 percent of tissue that would have otherwise been lost."

    Common signs of frostbite include numbness, tingling and pain in the exposed areas (usually extremities, or fingers, toes and the nose), followed by painful blistering. Cell damage occurs both at the time of exposure (ice crystals form in the space outside of the cells), and after exposure, which results in damage to the blood vessels due to lack of oxygen in affected tissue.

    There are three degrees of frostbite, similar to a hot burn scale: first degree, signified by irritation and redness; second degree, which results in clear, painful blisters; and third degree, the most severe, in which bloody blisters eventually result in black, dead tissue.

    Although frostbite can affect anyone who is out in cold conditions, people with poor circulation or alcoholism are much more likely to develop injuries. Throughout history frostbite, especially in times of war, has led to significant mortality and morbidity. During the year 1812-1813, Napoleon's army suffered great casualties due to cold injuries. He began the war with 250,000 men, returning approximately 6 months later with only 350 fully functioning soldiers. More recently, during both World War II and the Korean War, frostbite accounted for more than 10 percent of all American casualties.

    First Aid for Frostbite

    If you or someone you know believes they may have frostbite, use the following steps to reduce the damage it can cause:

    • Move to a warm environment, if possible. If the victim is also experiencing hypothermia, make sure to keep their core body warm. Saving a life is more important than saving a limb.
    • Remove all wet or constrictive clothing and jewelry to encourage blood flow to the affected area.
    • Keep extremities elevated in order to reduce swelling.
    • Rewarm the affected area with a 40-degree water bath. Do not try to rewarm the frostbitten tissue with hot water. The cells are more fragile, and the tissue is less sensitive to temperature, and this can result in severe burns.
    • Do NOT rewarm the injured area if there is any chance that it will refreeze. Ice crystals formed in between cells will be larger the second time they form.
    • Get to the hospital as soon as possible. The final amount of tissue damage is proportional to the time it remains frozen, not to the absolute temperature to which it was exposed.