How to treat frostbite. What to do if you have frostbite? Phase III – stabilization

Develops in remote areas of the body (feet, hands, tips of the ears) with reduced blood circulation.

With general exposure to cold (being in the cold or in an unheated room), low-temperature tissue damage may be accompanied by general hypothermia of the body. If the cold acts locally (prolonged contact with a very cool surface at normal ambient temperature), signs of frostbite are not accompanied by symptoms of general hypothermia.

The development of frostbite is promoted by: tight shoes and clothes, wet clothes, lack of physical activity in the cold, forced posture, alcohol intoxication, smoking, concomitant diseases accompanied by deterioration of peripheral blood circulation (sugar diabetes, atherosclerosis, etc.).

In the place of tissue hypothermia, a spasm of the arteries occurs, as a result of which the surface layers cease to receive sufficient heat and nutrients, and metabolic processes in them slow down. After a significant decrease in the temperature of the cells, the water in them turns into ice crystals, which leads to irreversible destruction and necrosis.

Degrees of frostbite

As with burns, depending on the depth of tissue damage, four degrees can be distinguished:

Mild frostbite causes a change in skin color in a small area. It usually takes on a whitish tint, and as it warms it turns bright red. External manifestations include itching, slight soreness, burning or numbness.
In the second degree, the depth of tissue damage increases, and therefore, bubbles with transparent contents form in the altered areas.
The third degree of frostbite is characterized by damage to all layers of the skin, so the blisters are often filled with dark or bloody contents. After healing, defects and scars often form.
With the most severe degree of frostbite, necrosis of soft tissues, joints and even bones develops. The skin acquires a bluish or brownish tint, and subsequently turns black.

Principles of First Aid

First aid for frostbite helps reduce the degree of tissue damage and speed up further recovery.

Basic actions to be performed when providing first aid:

Stop exposure to cold. It is best to warm up in a warm room, but during transportation it is necessary to reduce heat loss as much as possible, for example, cover the victim with a warm blanket or clothing.
After moving to a warm room, you should undress the victim, since he will stay warm longer in clothes and shoes.
Try to warm the areas that are most damaged. However, you cannot do this quickly, for example, using heating pads or a hot bath.
Since there is a risk of general hypothermia, it is necessary to give the person to drink hot tea or milk.
If there are skin defects, they should be covered with a dry, sterile cloth. The use of the patch is not recommended, since the damaged epidermis may peel off along with the adhesive layer.
If a person falls into water far from populated areas in winter, he should be undressed, wiped dry and dressed in different clothes. If there is no spare clothing, then you need to dry the existing things by the fire, without allowing the victim to freeze.

After providing first aid for frostbite, it is advisable to consult a doctor, even if the victim’s condition has improved and there are no external changes. You should definitely consult a doctor in the following situations:

A child or an elderly person has been exposed to cold. This is due to the characteristics of their immune system.
There are signs of third and fourth degree frostbite.
Sensitivity in the affected limbs is not restored for a long time.
The area of the frostbite area is more than 1% (according to the “rule of the palm”, 1% of the body surface is equal to the area of the victim’s palm).

What is forbidden to do if you have frostbite?

It should be remembered that some actions during hypothermia and frostbite can worsen the victim’s condition. In these situations you cannot:

Give alcoholic drinks. Despite the fact that a person experiences subjective improvement when drinking alcohol, the degree of hypothermia usually worsens. This is due to the fact that under the influence of alcohol, peripheral blood vessels dilate, and heat loss only intensifies.
Warm or rub the patient too quickly, as these actions increase the area of necrosis due to mechanical damage and the spread of toxic substances.
Contrary to popular belief, if you have frostbite, it is not recommended to rub your skin with snow.
Open the blisters and treat them with an antiseptic, as this opens the entrance gate for infection.

If you provide the necessary first aid for frostbite in time and then take the patient to the hospital, you can save the health and sometimes the life of the victim.

Prevention of frostbite

To prevent hypothermia and cold damage to soft tissues, several rules should be followed:

do not drink alcohol outdoors in cold weather;
smoking also makes a person more vulnerable;
do not use tight shoes and light clothing, as the layer of air slows down cooling;
wear a hat, mittens and scarf;
When going outside in winter, do not wear metal jewelry;
in cold weather, periodically examine the face, especially the tip of the nose, and limbs;
at the first signs of frostbite, try to return to a warm room;
do not wet the skin, as this will increase heat loss.

Particular attention should be paid to young children and the elderly, because their thermoregulation system usually does not work at full capacity. It is not advisable for them to stay outside in severe frosts for more than 20 minutes at a time.

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Frostbite- This is local tissue damage that develops when exposed to cold. Frostbite has a latent and reactive period that occurs after warming up. The pathology is manifested by a change in color, pain, sensory disturbances, the appearance of blisters and foci of necrosis. Damage of the III and IV degrees leads to the development of gangrene and spontaneous rejection of the fingers. Treatment is carried out with vascular drugs (pentoxifylline, nicotinic acid, antispasmodics), antibiotics, physiotherapy; pain relief is carried out by novocaine blockades.

General information

Frostbite– tissue damage that develops when exposed to cold. In Russia, the incidence of frostbite is about 1% of all injuries, with the exception of some regions of the Far North, where it rises to 6-10%. The feet are most often affected by frostbite, the hands are in second place, and the protruding parts of the face (nose, ears, cheeks) are in third place. Pathology treatment is carried out by specialists in the field of combustiology, traumatology and orthopedics.

Causes of frostbite

The cause of tissue damage can be frost, direct contact with an object cooled to an ultra-low temperature (contact frostbite) and prolonged periodic cooling in conditions of high air humidity ("trench foot", chills). Factors contributing to the development of frostbite are strong winds, high humidity, decreased local and general immunity (as a result of illness, injury, vitamin deficiency, malnutrition, etc.), alcohol intoxication, tight clothing and shoes that cause circulatory problems.

Pathogenesis

Exposure to low temperatures causes persistent vasospasm. The speed of blood flow decreases, blood viscosity increases. The formed elements “clog” small vessels, and blood clots form. Thus, pathological changes during frostbite occur not only as a result of direct exposure to cold, but also as a result of a reaction from the blood vessels. Local circulatory disorders provoke disturbances in the autonomic nervous system, which regulates the activity of all internal organs. As a result, inflammatory changes develop in organs remote from the site of frostbite (respiratory tract, bones, peripheral nerves and gastrointestinal tract).

Symptoms of frostbite

Clinical manifestations are determined by the degree and period of damage. The latent (pre-reactive) period of frostbite develops in the first hours after injury and is accompanied by scant clinical symptoms. Minor pain, tingling, and sensory disturbances are possible. The skin in the frostbite area is cold and pale.

After tissue warming, a reactive period of frostbite begins, the manifestations of which depend on the degree of tissue damage and complications caused by the underlying pathology.

There are four degrees of frostbite:

With frostbite of the first degree, moderate swelling appears in the reactive period. The affected area becomes cyanotic or acquires a marbled color. The patient is bothered by burning pain, paresthesia and itching. All signs of frostbite disappear on their own within 5-7 days. Subsequently, increased sensitivity of the affected area to cold often remains.
Frostbite of the second degree is accompanied by necrosis of the superficial layers of the skin. After warming up, the affected area becomes bluish and sharply swollen. On days 1-3, blisters with serous or serous-hemorrhagic contents appear in the area of frostbite. When the blisters are opened, a painful wound is exposed, which heals on its own in 2-4 weeks.
With frostbite of the third degree, necrosis spreads to all layers of the skin. In the pre-reactive period, the affected areas are cold and pale. After warming, the affected area becomes sharply swollen, and blisters filled with hemorrhagic fluid appear on its surface. When the blisters are opened, wounds with a painless or slightly painful bottom are exposed.
IV degree frostbite is accompanied by necrosis of the skin and underlying tissues: subcutaneous tissue, bones and muscles. As a rule, areas of deep tissue damage are combined with areas of frostbite of the I-III degree. Areas of IV degree frostbite are pale, cold, and sometimes slightly swollen. There is no sensitivity.

With frostbite of degrees III and IV, dry or wet gangrene develops. Dry gangrene is characterized by gradual drying of tissue and mummification. The area of deep frostbite turns dark blue. In the second week, a demarcation groove is formed, separating necrosis from “living” tissue.

Spontaneous finger rejection usually occurs 4-5 weeks after frostbite. In case of extensive frostbite with necrosis of the feet and hands, rejection begins at a later date, especially in cases where the demarcation line is located in the area of the diaphysis of the bones. After rejection, the wound is filled with granulations and heals with the formation of a scar.

Chill occurs during periodic cooling (usually at temperatures above 0) and high air humidity. Dense bluish-purple swellings appear on peripheral parts of the body (hands, feet, protruding parts of the face). The sensitivity of the affected areas decreases. The patient is bothered by itching, bursting or burning pain. Then the skin in the area of chills becomes rough and covered with cracks. When the hands are affected, physical strength decreases, the patient loses the ability to perform delicate operations. In the future, erosion or development of dermatitis is possible.

Chill develops with moderate, but prolonged and continuous exposure to damp cold. Initially, sensory disturbances appear in the area of the big toe, gradually spreading to the entire foot. The limb becomes swollen. With repeated cooling and warming, wet gangrene is possible.

Treatment of frostbite

The victim must be moved to a warm room, warmed up, and given tea, coffee or hot food. Frostbitten areas should not be intensively rubbed or warmed quickly. When rubbing, multiple microtraumas of the skin occur. Warming too quickly leads to the fact that the normal level of metabolic processes is restored faster than the blood supply to the affected areas. As a result, necrosis may develop in tissues deprived of nutrition. The best result is achieved by warming “from the inside” - applying heat-insulating cotton-gauze bandages to the frostbite area.

Upon admission to the traumatology department, a patient with frostbite is warmed up. A mixture of solutions of novocaine, aminophylline and nicotinic acid is injected into the artery of the damaged limb. Drugs are prescribed to restore blood circulation and improve microcirculation: pentoxifylline, antispasmodics, vitamins and ganglion blockers, and for severe lesions - corticosteroids. Solutions of rheopolyglucin, glucose, novocaine and saline solutions heated to 38 degrees are administered intravenously and intra-arterially. A patient with frostbite is prescribed broad-spectrum antibiotics and anticoagulants (heparin for 5-7 days). A sheath novocaine blockade is performed.

To reduce stimulation of recovery processes, reduce swelling and pain, physiotherapy is carried out (magnetic therapy, ultrasound, laser irradiation, diathermy, UHF). The bubbles are punctured without being removed. Alcohol-chlorhexidine and alcohol-furacilin wet-dry bandages are applied to the area of frostbite; in case of suppuration, bandages with antibacterial ointments are applied. If there is significant swelling, orthopedic traumatologists perform fasciotomy to eliminate tissue compression and improve blood supply to the frostbite area. If pronounced edema persists and areas of necrosis form, necrectomy and necrotomy are performed on days 3-6.

After the formation of the demarcation line, the volume of surgical intervention is determined. As a rule, viable soft tissue is preserved under damaged skin in the demarcation zone, so for dry necrosis, a wait-and-see treatment approach is usually chosen to preserve more tissue. With wet necrosis, there is a high probability of developing infectious complications with the process spreading “up” through healthy tissues, so wait-and-see tactics are not applicable in such cases. Surgical treatment for grade IV frostbite involves removing dead areas. Amputation of necrotic fingers, hands or feet is performed.

Prognosis and prevention

For superficial frostbite, the prognosis is conditionally favorable. The functions of the limb are restored. In the long-term period, increased sensitivity to cold, disturbances in nutrition and vascular tone in the area of the affected area persist for a long time. The development of Raynaud's disease or obliterating endarteritis is possible. With deep frostbite, the outcome is amputation of part of the limb. Prevention includes choosing clothes and shoes taking into account weather conditions, avoiding prolonged stay outside in cold weather, especially while intoxicated.

Frostbite represents damage to any part of the body (even death) under the influence of low temperatures. If you stay outdoors for a long time, especially in high humidity and strong winds, frostbite can occur in the fall and spring when the air temperature is above zero.

Frostbite leads to frostbite tight and wet clothes and shoes, physical fatigue, hunger, forced long-term immobile and uncomfortable position, previous cold injury, weakening of the body as a result of previous diseases, sweating of the feet, chronic vascular diseases of the lower extremities and the cardiovascular system, severe mechanical damage with blood loss, smoking, etc.

Statistics show that almost all severe frostbite leading to amputation of limbs occurred in a state strong alcohol intoxication .

Under the influence of cold, complex changes occur in tissues, the nature of which depends on the level and duration of the temperature decrease. When exposed to temperatures below -30 degrees C, the main significance in frostbite is the damaging effect of cold directly on the tissue, and cell death occurs. When exposed to temperatures down to -10-20 degrees C, at which most frostbites occur, vascular changes in the form of spasm of the smallest blood vessels are of leading importance. As a result, blood flow slows down and the action of tissue enzymes stops.

Signs of frostbite and general hypothermia:

The skin is pale bluish;

Temperature, tactile and pain sensitivity are absent or sharply reduced;

When warming up, severe pain, redness and swelling of soft tissues appear;

With deeper damage, blisters with bloody contents may appear after 12-24 hours;

With general hypothermia, a person is lethargic, indifferent to his surroundings, his skin is pale, cold, his pulse is rapid, his blood pressure is low, his body temperature is below 36°C

There are several degrees of frostbite:

Frostbite I degree(the mildest) usually occurs with short exposure to cold. The affected area of the skin is pale, turns red after warming, and in some cases has a purplish-red tint; swelling develops. There is no dead skin. By the end of the week after frostbite, slight peeling of the skin is sometimes observed. Full recovery occurs 5-7 days after frostbite. The first signs of such frostbite are a burning sensation, tingling sensation followed by numbness of the affected area. Then skin itching and pain appear, which can be either minor or severe.

Frostbite II degree occurs with prolonged exposure to cold. In the initial period, paleness appears, the skin becomes cold, sensitivity is lost, but these phenomena are observed with all degrees of frostbite. Therefore, the most characteristic sign is the formation of blisters filled with transparent contents in the first days after injury. Complete restoration of the integrity of the skin occurs within 1-2 weeks, granulations and scars are not formed. In case of frostbite of the second degree after warming up, the pain is more intense and lasting than with frostbite of the first degree, skin itching and burning are disturbing.

For third degree frostbite the duration of the period of cold exposure and decrease in temperature in tissues increases. The blisters that form in the initial period are filled with bloody contents, their bottom is blue-purple, insensitive to irritation. The death of all skin elements occurs with the development of granulations and scars as a result of frostbite. Fallen nails do not grow back or grow deformed. The rejection of dead tissue ends in the 2-3rd week, after which scarring occurs, which lasts up to 1 month. The intensity and duration of pain is more pronounced than with frostbite of the second degree.

Frostbite IV degree occurs with prolonged exposure to cold; the decrease in temperature in the tissues is the greatest. It is often combined with frostbite of the third and even second degree. All layers of soft tissue die, bones and joints are often affected.

The damaged area of the limb is very bluish, sometimes with a marbled color. Swelling develops immediately after warming and increases rapidly. The skin temperature is significantly lower than the tissue surrounding the frostbite area. Bubbles develop in less frostbitten areas where there is frostbite of III-II degree. The absence of blisters with significant swelling and loss of sensitivity indicate degree IV frostbite.

In conditions of prolonged exposure to low air temperatures, not only local damage is possible, but also general cooling of the body. General cooling of the body should be understood as a condition that occurs when body temperature drops below 34 degrees C.

First aid for frostbite

First of all, it is necessary to warm the victim in a warm room. Warming of the affected part of the body should be gradual, slow, mostly passive. Unacceptable(!) rub frostbitten areas of the body with hands, tissues, alcohol, and even more so with snow! (Such recipes are extremely tenacious and are still popular among the people.) The fact is that these measures contribute to the formation of blood clots in the vessels, deepening the processes of destruction of the affected tissues.

The victim needs wrap yourself in a warm blanket(with general hypothermia) or (with frostbite) apply a thermal insulating cotton-gauze bandage to the affected part of the body(7 layers) to accumulate heat and prevent premature warming of superficial tissues (and, accordingly, the formation of a temperature difference between superficial and deep tissues). The use of a thermal insulating bandage makes it possible to slow down the external warming of the affected area several times while ensuring general warming of the body.

If your arm or leg is frostbitten, you can warm it up in the bath, gradually increasing the water temperature from 20 to 40 ° C and for 40 minutes gently (!) massaging the limb. On the inner surface of the thigh or shoulder you can additionally put a warm heating pad u. To the victim give plenty of warm drinks- for example, sweet tea.

From drug treatment It is advisable to use an anesthetic (analgin - 0.1 g) and a vasodilator (eufillin - 1/4 tablet, noshpa - 0.005 g or nicotinic acid - 0.01 g) agents, as well as tincture of valerian or motherwort (5-10 drops) as calming.

If warming up after frostbite is accompanied by moderate pain (the victim gradually calms down), sensitivity, temperature and color of the skin, and independent full movements are restored, then the limb is wiped dry, the skin is treated with 70% alcohol (or vodka) and a dry bandage with cotton is applied. The ear, nose or cheek are generously lubricated with Vaseline and a dry warming bandage with cotton wool is applied.

Prevention of hypothermia and frostbite

There are a few simple rules that will allow you to avoid hypothermia and frostbite in severe frost:

- Don't drink alcohol- Alcohol intoxication causes greater heat loss. An additional factor is the inability to concentrate on the signs of frostbite.

- Don't smoke in the cold- smoking reduces peripheral blood circulation, and thus makes the limbs more vulnerable.

- Wear loose clothes- this promotes normal blood circulation. Dress like a cabbage - in this case, between the layers of clothing there are always layers of air that perfectly retain heat.

Tight shoes, lack of insoles, and damp, dirty socks are often the main prerequisites for the appearance of abrasions and frostbite. Special attention should be paid to shoes for those whose feet often sweat. You need to put warm insoles in your boots, and wear woolen socks instead of cotton ones - they absorb moisture, leaving your feet dry.

- Don't go out into the cold without mittens, a hat and a scarf. The best option is mittens made of water-repellent and windproof fabric with fur inside. Gloves made from natural materials, although comfortable, do not protect against frost. The cheeks and chin can be protected with a scarf. In windy, cold weather, before going outside, lubricate exposed areas of the body with a special cream.

- Do not wear metal ones in the cold(including gold, silver) jewelry.

- Use a friend's help: Watch your friend's face, especially the ears, nose and cheeks, for any noticeable changes in color, and he or she will watch yours.

- Don't take off your shoes in the cold from frostbitten limbs - they will swell and you will not be able to put your shoes back on. It is necessary to get to a warm room as soon as possible. If your hands are cold, try warming them with your armpits.

Returning home after a long walk in the cold, be sure to make sure there is no frostbite on the limbs, back, ears, nose, etc.

As soon as you feel hypothermia or freezing of your extremities while walking, you must go to any warm place as soon as possible- shop, cafe, entrance - for warming up and inspecting areas potentially vulnerable to frostbite.

- Hide from the wind- the likelihood of frostbite in the wind is much higher.

- Don't get your skin wet- water conducts heat much better than air. Don't go out into the cold with wet hair after a shower. Wet clothes and shoes (for example, a person has fallen into water) must be removed, wiped off the water, if possible, put on dry ones and bring the person into warmth as quickly as possible. In the forest, you need to light a fire, undress and dry your clothes, during which time you vigorously exercise and warm yourself by the fire.

- Before going out into the cold, you need to eat.

- Children and the elderly are more susceptible to hypothermia and frostbite. When letting your child walk outside in the cold, remember that it is advisable for him to return to a warm room every 15-20 minutes and warm up.

Finally, remember that the best way to get out of an unpleasant situation is to not get into it. In severe frost, try not to leave the house unless absolutely necessary.

There are quite a few cold regions in Russia: more than two-thirds of the population are constantly at risk of freezing. It happens that people die even when the air temperature is above zero, let alone frost! To know how to keep warm, let's figure out what happens in the human body when the thermometer outside the window drops lower and lower.

In a normal state, a person’s body temperature ranges from 36.4 to 37.5°C; falling below 25 and rising above 43°C are deadly. At rest, heat is produced mainly by the abdominal cavity, up to 55%, and with an average muscular load, priority is given to the muscles, up to 75% of the total heat generation. It is believed that the lowest air temperature that a person can endure for a long time without clothes is 2°C. But do not try to repeat this experience; it requires long professional training, good health and good heredity. For example, the Eskimos have a basic metabolism - chemical thermoregulation that is 30% higher than that of the inhabitants of central Russia, and is fixed genetically.

Among people who are not particularly resistant to cold, the number of frostbites jumps sharply at a temperature of -10°C. In this case, exposed or poorly protected areas of the body (ears, nose, fingers and toes) are most often affected. Additionally, the risk is increased by wet and tight clothing, hunger, physical fatigue, alcohol intoxication, chronic heart and vascular diseases, blood loss, smoking and some similar factors. There are 4 degrees of frostbite.

Frostbite 1st degree- the skin on the frostbitten area is pale, when heated, it takes on a reddish or purplish-red tint, and swells. Symptoms: tingling, numbness, burning, minor but severe itching and pain. The cells remain viable. After 1 week peeling may occur.

Frostbite 2nd degree

Frostbite 2nd degree- the area turns pale, loses sensitivity, and in the first days after frostbite, bubbles with transparent contents form. When warming up, itching and pain are more pronounced. Recovery requires 1-2 weeks.

Frostbite 3rd degree

Frostbite 3rd degree- the blisters at the frostbite site are filled with bloody contents with a blue-purple bottom, there is no sensitivity. When warming up, severe pain occurs. Elements of the skin die, followed by the formation of scars. The nail plate may not grow or grows deformed. Dead tissue is rejected after 2-3 weeks, scarring occurs within 1 month.

Frostbite 4th degree

Frostbite 4th degree- the frostbite area is bluish with marble coloring. After warming up, severe swelling without blisters immediately occurs, sensitivity is not restored. All layers of soft tissue undergo necrosis, joints and bones suffer.

First aid for frostbite

First aid for frostbite depends on the severity of the victim’s condition. But what should definitely be done right away is to take the person to the nearest warm room, remove frozen shoes, socks, and gloves. Providing first aid for frostbite - the victim is given hot drink and food, a tablet of acetylsalicylic acid, anesthetic, drotaverine and papaverine. As for alcohol, in the cold you should never give it to the victim! Alcohol causes vasodilation and significantly increases heat transfer. But indoors, a small amount of alcohol may be appropriate, since in this case the expansion of spasmodic peripheral vessels is what needs to be achieved as soon as possible in order to prevent tissue necrosis.

First aid for frostbite:

First aid for frostbite - in case of frostbite of the 1st degree, the cooled areas should be warmed until reddened with warm hands, light massage, breathing, and then apply a cotton-gauze bandage. With grades 2-4, on the contrary, you should not use quick warming and massage, but you need to get to the hospital as soon as possible; in many cases, minutes count, and if you delay, it turns out to be impossible to save, for example, fingers. Before seeking medical help, it is better to apply a heat-insulating bandage to the affected surface (a layer of gauze, a thick layer of cotton wool, another layer of gauze, and on top an oilcloth and rubberized fabric; you can use quilted jackets, sweatshirts, woolen fabric) and fix the affected limbs with improvised means over the bandage.

What not to do if you have frostbite:

rubbing frostbitten areas with snow - this injures the skin and capillaries, even if the damage is not noticeable to the eye;
use quick warming (heating pads, radiators, etc.), this only worsens the course of frostbite;
rubbing oils, fat, rubbing alcohol into tissues in case of deep frostbite is not only ineffective, but can also damage the tissues even more.

In case of mild general hypothermia, it is enough to warm the victim in a warm bath at a water temperature of 24°C, gradually raising it to normal body temperature. In moderate and severe cases, when breathing and blood circulation are impaired (pulse up to 60 beats per minute or less), the victim must be urgently taken to the hospital, and not try to treat it yourself, which cannot be done in case of frostbite.

Children are a special risk group - their thermoregulation is still imperfect, they lose heat through their skin faster than adults, and they may not have the common sense to return home in time to prevent frostbite. Older people also need attention; often their microcirculation is no longer as effective. Therefore, it is advisable for children and the elderly walking in the cold to return to the warmth and warm up every 15-20 minutes. During the cold season, you need to take special care of each other, and then winter with its sparkling beauty, games and walks will only be a joy.

Degrees of frostbite vary in symptoms. Each of them has certain symptoms and appropriate treatment. What is frostbite, and what to do if it occurs?

Frostbite concept

Frostbite is damage to the skin caused by exposure to low temperatures. Most often it affects protruding parts of the body - limbs, ears, nose, facial skin. There are certain factors that can provoke the occurrence of frostbite of varying degrees.

Factors:

Vascular diseases,
Intense heat transfer from the body
Injuries, weakened body, alcohol intoxication,
Impaired blood circulation.

People who are intoxicated suffer from frostbite quite often. At this moment, the person is poorly oriented in space. He has inhibited reactions to many stimuli; he may not feel discomfort in the freezing parts of the body.

Frostbite is included in the International Classification of Diseases and has its own code according to ICD-10 - T33-T35 - frostbite.

Signs

What are the signs of frostbite? How many degrees of the disease are there? Regardless of the degree of the disease, there are a number of common signs.

Symptoms:

The skin first becomes pale, then turns red,
There is a feeling of tingling and burning,
There is numbness of the skin,
Painful sensations occur
The dermis may be itchy.

There are two periods of frostbite.

Types:

Hidden. At this moment, the disease practically does not manifest itself, there are no obvious symptoms. There is soreness, pallor and coldness of the skin.
Reactive period. Manifestations in this case depend on what degree of frostbite is diagnosed.

When a person experiences frostbite, they first experience impaired mobility, numbness, and decreased sensitivity. When thawing, a burning sensation occurs, which gradually turns into pain. The skin changes color from pale to bright red. With severe frostbite, blackening of the dermis is subsequently observed.

During the period of thawing and recovery, regardless of the degree of the disease, the presence of itching is noted. Often patients scratch the damaged areas until they bleed.

How many degrees of frostbite are there? Experts distinguish four stages. For each of them there are certain symptoms.

Degrees:

The first degree is considered the easiest. Appears as a result of a person’s exposure to the cold for a short period of time. At grade 1, pallor of the dermis is observed in adults and in children. After warming up, it becomes red (sometimes burgundy). After a certain time, peeling begins. The presence of mild pain, itching, and tingling is noted. Swelling may occur. At this degree, tissue death is not diagnosed. Proper therapy allows you to recover in about a week.
Frostbite of the 2nd degree is characterized by more severe painful sensations. There is itching, burning sensation, tingling, and numbness that are stronger than in the first stage. During frostbite, blisters filled with clear liquid form on the skin. The recovery period for this degree lasts about a couple of weeks, scars do not appear.
The third stage of frostbite is considered more dangerous. In this case, the person feels stronger manifestations of pain and burning. Limbs go numb. In the damaged areas, blisters with blood content appear. Stage 3 frostbite is characterized by a decrease in overall body temperature and death of the skin and nails. The recovery period is at least three weeks, and scars may occur in the affected areas.
The fourth degree of frostbite is considered the most severe. The person feels severe numbness and pain in the affected areas. There is death of soft tissues, bones and joints. The skin becomes blue, almost black. Blisters with bloody contents form. There is practically no sensitivity, body temperature can rise to 39 degrees. Frostbite of the extremities in grade 4 in most cases ends in gangrene and amputation.

Depending on the degree of frostbite, appropriate treatment is selected.

Causes of frostbite in the body

There are several reasons for this phenomenon.

List:

Prolonged exposure to frost
Contact with a substance cooled to a very low temperature
Periodic exposure to unfavorable conditions - high humidity and low temperatures.

Very often, frostbite of varying degrees occurs due to the fact that people dress unsuitably for the weather, in thin, easily blown and wet clothes. There are a number of diseases that increase the risk of frostbite of any degree.

Diseases:

Problems with blood vessels – endarteritis, thrombosis. There is a disruption in the blood supply to certain areas, which reduces heat generation.
Heart diseases. They often provoke the development of swelling in the extremities, which leads to a decrease in tissue resistance to cold temperatures.
Liver diseases also provoke circulatory disorders in various body systems.
Diabetes mellitus. With this disease, the skin loses its sensitivity and, as a result, is not able to perceive hypothermia in the early stages.
Various injuries with the formation of edema lead to the disruption of blood flow in damaged areas. This increases the likelihood of developing frostbite. In case of fractures, the applied plaster can quickly cool down and expose the limb located under it to this.

It is worth noting that the likelihood of frostbite increases in the third trimester of pregnancy and during alcohol intoxication. Certain factors that should be avoided can provoke the development of frostbite of varying degrees.

First aid

When frostbite of any degree occurs, a person needs to.

First aid:

The victim must be moved to a warm, dry, windless place.
It is necessary to remove all cold clothing and shoes from him.
The patient is wrapped in a blanket, and heating pads with warm water are allowed inside.
The victim should be given a warm drink. The exceptions are coffee and alcohol. It is better to choose tea, milk, fruit drinks.
Do not warm the damage under hot water, blow on it with a hairdryer, or apply it to the battery.
After the operations, the patient is allowed to take a warm bath. Water temperatures are increased gradually.
After this procedure, the skin is wiped dry, warm, dry clothes are put on, and wrapped in a blanket.
In the absence of blisters, bandages are allowed; in other cases, it is necessary to contact a medical institution.

With mild frostbite, recovery occurs within a week. Other degrees of the disease are treated in hospital.

How not to freeze and prevention

If a person is on the street. To avoid frostbite, you should do some exercises. You can't stand in one place. You can bend over, swing on your feet, and jump. If there is any warm room nearby, then it’s worth going into it and warming up.

It is worth remembering that during intense physical exercise, sweat appears on the skin, which will also cool and lower body temperature.

Prevention

To avoid frostbite, you should follow simple preventive rules.

Rules:

You need to dress according to the weather. All clothing should be tucked into each other. It is better to use natural fabrics. Mittens warm better than gloves; the sole should be at least one centimeter thick. Clothing should be true to size, not small.
You should not leave the house in severe frosts or drive a car.
You cannot smoke, drink alcohol or drink caffeinated drinks in the cold.
Exposed areas of skin can be lubricated with greasy cream or lard, but not with moisturizing creams.
At the first signs of frostbite, you need to take shelter in a warm room.
You should not let only children and elderly people go out into the cold.
When hiking or in the mountains, you need to have extra clothing, food and water with you. If necessary, you should immediately call rescuers.
There is no need to wear metal jewelry or give children toys with metal parts; they cool quickly.

Animals often suffer in severe frosts. There is no need to remain indifferent; if possible, it is worth helping the animal, feeding it, and giving it a chance to warm up.

Degrees of frostbite differ in symptoms and possible consequences. It is worth remembering that even mild frostbite can lead to problems in the body.