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Frostbite

Taking the Chill Off

During these cold winter days students need to be aware of how to protect themselves against frostbite. What exactly is frostbite? It is the freezing of superficial skin and or the bodily tissues under the skin. It is caused by frigid air or icy winds. This cold exposure decreases the blood flow to the extremities increasing the risk of frostbite. The most common parts of the body affected are the fingers, toes, ears, face and nose.

Frostbite actually freezes and crystallizes the fluids in the body tissues and cellular spaces. This can damage the blood vessels causing blood clotting and lack of oxygen to the affected area and deeper tissues. In severe cases, frostbite can kill and damage tissue to the extent that an amputation may be required.

Factors that influence how severe frostbite can be include: the length of time a person is exposed to the cold, the temperature outside, the wind chill factor (force of the wind), the amount of humidity in the air, dampness of clothing, high altitudes and whether the person has ingested alcohol or other drugs. Alcohol and drugs can impair a persons thinking, which can cause more damage due to lack of common sense in caring for the affected area. It can also cause further constriction of blood vessels, which prevents warm blood from reaching affected areas, worsening the frostbite. Frostbite can occur in just a few minutes if conditions are cold enough with a high wind-chill factor on unprotected body parts, for example, the ears.

Some people are at higher risk of frostbite. Those at risk include the elderly, a person with circulation problems, history of previous frostbite, those who ingest alcohol, use nicotine and beta-blocker medications, and someone who has had a recent injury or blood loss. Those people who do not take precautionary measures, such as wearing the appropriate protective clothing to prevent frostbite are also at high risk.

Proper winter clothing insulates from the cold and lets perspiration evaporate while protecting you from the wind, rain and snow. Preventing frostbite is much easier than treating it. Use the following guidelines when bundling up to go outside.

  1. Wear several layers of light loose clothing. This will trap air yet provide adequate ventilation. This is better than one big, bulky covering. The best fabrics to wear include water-repellent, not waterproof (this can hold in perspiration), wool and polyester substitutes like Poly Propylene.
  2. Coverings for the head and neck. These include hoods, hats, scarves, facemasks and earmuffs. Wear waterproof skin moisturizer in exposed areas.
  3. Protect your feet and toes. Wear two layers of socks- cotton underneath a pair of wool socks are best, with a pair of well-fitted boots that come above the ankle.
  4. Hand protection is vital. Mittens are warmer than gloves, but can limit your dexterity in things you can do. You can wear a pair of gloves under a pair of mittens for warmth, and the mittens can be removed so you can use your gloved fingers as needed.
  5. Common sense. When temperatures are severe, dress appropriately in well fitted clothing and boots. Things that are too tight can restrict blood flow and put you at higher risk of frostbite. Stay near adequate shelter; avoid alcohol, drugs, and nicotine. Also, avoid remaining in the same position for long periods of time; move around as much as possible.

Signs and symptoms of frostbite include:

  1. Mild Frostbite (frostnip): affects the outer skin layer and appears as a blanching or whitening of the skin. These symptoms usually disappear as the affected area warms. The skin may appear red for several hours.
  2. Superficial Frostbite: In this stage, blistering can occur. The skin feels numb, waxy and frozen, and can look grayish-yellow, grayish-blue or white. Ice crystals form in the skin cells and the rest of the skin remains flexible.
  3. Deep Frostbite: This is the most serious of frostbite cases. Sensation is usually absent in the affected area and blistering usually does not occur. The blood vessels, muscles, tendons, nerves and bone may be frozen. This can lead to permanent damage, blood clots and gangrene, which can ultimately lead to amputation if professional medical attention is not obtained as soon as possible.
  4. Other symptoms that indicate frostbite: are swelling, itching, burning and deep pain as the area is warmed. It is NORMAL to feel pain in the affected area as it is rewarmed.

Treatment of frostbite is best by trained medical professionals. But if you cannot get to help right away you can do some simple things to warm up. It is best to get to a warm place where you can stay dry and warm after thawing. Use warm (100F-38C), not hot water for 30-45 minutes until a good "flush" of color has returned to the skin. Do not place affected extremities near a fire. It can cause burns due to the lack of sensation in the affected area. You can place affected areas under the armpits or groin area for re-warming as well. One must also rest the injured areas (i.e. avoid walking on frostbitten feet). If blisters have occurred, do not break them open. Cover them with a sterile clean cloth if protection is needed to prevent them from rupturing. Keep affected areas clean to prevent infection. Elevating the affected area above the level of the heart can also decrease any swelling that occurs. It is also crucial that you are current on your tetanus booster, which is due every 10 years.

Once an area is re-warmed, it is imperative to keep the area from re-freezing. If re-freezing occurs, this is very serious and can cause permanent damage. It is better to delay warming if there is a chance the area can refreeze while trying to make it to permanent shelter. Do not thaw the injury with melted snow or ice. Do not rub the area with snow. Finally, avoid alcohol, nicotine and other drugs that can further restrict the blood flow to the affected area.

In summary, frostbite is a serious condition that can be prevented if you plan ahead and dress appropriately. Keep safety in mind when you are traveling, participating in winter sports or just walking to and from class.

If you have any further questions or have a particular topic you would like to learn more about, do not hesitate to call and let us know. Call the Campus Health Service with any suggestions you may have at (217) 206-6676.