Frostbite and Hypothermia
Overview
When tissues freeze, frostbite occurs. Exposure of the skin to temperatures below the freezing point this condition develops abnormally. Frostbite is a trauma where exposure to freezing temperatures and actual freezing of the tissue fluids in the cell and intercellular spaces takes place. The result would be a vascular damage. Any part of the body may be affected by this cold injury but certain body parts are more prone to frostbite such as:
- Feet
- Hands
- Nose
- Ears
Clinical manifestations
The affected part or extremity may be hard, cold, and insensitive to touch and appear white or mottled blue-white. During the early stage of frostbite, when the skin has thawed out, the affected area becomes red and is very painful. In more severe cases, when the tissue has started to freeze, the skin may appear white and numb. For very severe cases, blisters may occur. The tissue may be blackened and die resulting to gangrene. Damage to deeper layers of the skin would result to injury of the tendons, muscles, nerves and bones.
Possible Nursing Diagnosis
- Hypothermia
- Risk for infection
- Altered tissue perfusion
- Sensory alteration
Emergency Management (F-R-O-S-T-B-I-T-E)
The main goal of emergency management for frostbite is the restoration of normal body temperature.
F – For injuries in the lower extremities, do not allow the patient to walk. Move the person to a warmer place and shelter him or her from cold.
R – Remove all constricting clothing and jewelries. These items may impair circulation.
O – Observe the patient for signs of hypothermia or lowered body temperature and manage the condition accordingly.
S – Sterile dressings should be used to wrap the affected part if immediate medical help is available before rushing the patient to the emergency department for further care. It is important for the nurse to remember to separate the fingers and toes in doing so.
T – The extremity can be rewarmed using controlled and rapid rewarming. Rewarming fist aid may be given in cases where immediate care is unavailable. To do this, the affected area is placed and soaked for 30 to 45 minutes in a 37 to 40 degree Celsius whirlpool until the tips of the injured part flushes. The flush would indicate that the circulatory flow is re-established. To aid the warming process, the water should be kept circulating.
Daisy Jane Antipuesto RN MN
Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.
