How to treat frostbite. What to do with frostbite? III phase - stabilization

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

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

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

In the place of hypothermia of the tissues, a spasm of the arteries occurs, as a result of which the surface layers no longer receive enough heat and nutrients, and the 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.

Frostbite degrees

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

With mild frostbite, there is a change in skin color in a small area. Usually it takes on a whitish hue, and as it warms up, it becomes a bright red color. External manifestations are accompanied by itching, slight soreness, burning or numbness.
In the second degree, the depth of tissue damage increases, and therefore, blisters 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 are often formed.
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.

First Aid Principles

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

Basic steps to follow when providing first aid:

Stop the effect of cold on a person. Warming is best in a warm room, but during transportation it is necessary to minimize heat loss, for example, cover the victim with a warm blanket or clothing.
After moving to a warm room, the victim should be undressed, as it will take longer to warm up in clothes and shoes.
Try to warm the areas that are damaged to a greater extent. However, you can not do it 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 hot tea or milk to drink.
If there are skin defects, they should be covered with a dry sterile napkin. The patch is not recommended, as the damaged epidermis may peel off along with the adhesive layer.
If a person falls into the water far from settlements in winter, he should be undressed, wiped dry and dressed in other clothes. If there is no spare clothing, then you need to dry the available things by the fire, while not 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. Be sure to consult a doctor in the following situations:

A child or an elderly person has been exposed to cold. This is due to the peculiarities 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 palm of the victim).

What is forbidden to do with frostbite?

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

Give alcohol to drink. Despite the fact that a person experiences subjective improvement with alcohol intake, the degree of hypothermia is usually aggravated. This is due to the fact that under the influence of alcohol there is an expansion of peripheral vessels, and heat loss only intensifies.
Too quickly warm the patient or rub him, as these actions increase the area of necrosis due to mechanical damage and the spread of toxic substances.
Contrary to popular belief, it is not recommended to rub the skin with snow during frostbite.
Open 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.

Frostbite Prevention

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

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

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frostbite- This is a local tissue damage that develops when exposed to cold. Frostbite has a latent and reactive period that occurs after warming. Pathology is manifested by a change in color, pain, sensory disturbances, the appearance of blisters and foci of necrosis. Damage III and IV degree 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; relief of pain syndrome is carried out by novocaine blockades.

General information

frostbite- tissue damage that develops when exposed to cold. In Russia, the frequency 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 subject to frostbite, the hands are in second place, and the protruding parts of the face (nose, auricles, cheeks) are in third place. Treatment of pathology 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 extremely low temperature (contact frostbite) and long-term periodic cooling in conditions of high air humidity ("trench foot", chilliness). Factors contributing to the development of frostbite are strong winds, high air humidity, a decrease in local and general immunity (as a result of illness, injury, beriberi, malnutrition, etc.), alcohol intoxication, tight clothing and shoes that cause circulatory disorders.

Pathogenesis

Exposure to low temperatures causes persistent vasospasm. The rate of blood flow decreases, blood viscosity increases. Formed elements "clog" small vessels, 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 vessels. Local circulatory disorders provoke violations of 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).

Frostbite symptoms

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

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

There are four degrees of frostbite:

With frostbite of the 1st degree, moderate edema appears in the reactive period. The affected area becomes cyanotic or becomes marbled. The patient is disturbed by burning pains, paresthesias and pruritus. All signs of frostbite disappear on their own within 5-7 days. Subsequently, the increased sensitivity of the affected area to the action of cold is often preserved.
Frostbite II degree is accompanied by necrosis of the surface layers of the skin. After warming, the affected area becomes cyanotic, sharply edematous. On days 1-3, blisters with serous or serous-hemorrhagic contents appear in the area of frostbite. When the blisters open, a painful wound is exposed, which heals on its own in 2-4 weeks.
With frostbite III degree necrosis extends to all layers of the skin. In the pre-reactive period, the affected areas are cold, pale. After warming, the site of the lesion becomes sharply edematous, blisters filled with hemorrhagic fluid appear on its surface. When opening the blisters, wounds with a painless or slightly painful bottom are exposed.
Frostbite IV degree 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 I-III degrees. Areas of frostbite IV degree pale, cold, sometimes slightly edematous. There is no sensitivity.

With frostbite III and IV degree dry or wet gangrene develops. Dry gangrene is characterized by gradual drying of tissues and mummification. The area of deep frostbite becomes dark blue. In the second week, a demarcation furrow is formed, separating necrosis from "living" tissues.

Spontaneous rejection of fingers usually occurs 4-5 weeks after frostbite. With 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 bone diaphysis. After rejection, the wound is filled with granulations and heals with the formation of a scar.

Chilling occurs with periodic cooling (usually at temperatures above 0) and high humidity. On the peripheral parts of the body (hands, feet, protruding parts of the face), dense cyanotic-purple swellings appear. The sensitivity of the affected areas is reduced. The patient is worried about itching, bursting or burning pain. Then the skin in the area of chilliness becomes rough and cracked. 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.

Chilliness develops with moderate, but prolonged and continuous exposure to damp cold. Initially, there are violations of sensitivity in the area of the big toe, gradually spreading to the entire foot. The limb becomes edematous. With repeated cooling and warming, wet gangrene is possible.

frostbite treatment

The victim must be moved to a warm room, warm, give tea, coffee or hot food. Frostbite areas should not be rubbed vigorously or warmed quickly. When rubbing, multiple microtraumas of the skin occur. Too rapid warming 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 malnourished tissues. The best result is achieved when warming "from the inside" - applying heat-insulating cotton-gauze dressings to the area of frostbite.

Upon admission to the traumatology department, the patient with frostbite is warmed. A mixture of solutions of novocaine, aminophylline and nicotinic acid is injected into the artery of the injured limb. Prescribe drugs to restore blood circulation and improve microcirculation: pentoxifylline, antispasmodics, vitamins and ganglionic blockers, in severe lesions - corticosteroids. Solutions of rheopolyglucin, glucose, novocaine and saline solutions warmed up to 38 degrees are administered intravenously and intraarterially. A patient with frostbite is prescribed broad-spectrum antibiotics and anticoagulants (heparin for 5-7 days). Carry out a case novocaine blockade.

To reduce the stimulation of recovery processes, reduce swelling and pain syndrome, physiotherapy is carried out (magnetotherapy, ultrasound, laser irradiation, diathermy, UHF). Bubbles are pierced without being removed. Alcohol-chlorhexidine and alcohol-furatsilin wet-drying dressings are applied to the frostbite area, with suppuration - dressings with antibacterial ointments. With significant edema, orthopedic traumatologists perform fasciotomy to eliminate tissue compression and improve blood supply to the area of frostbite. With the preservation of pronounced edema and the formation of areas of necrosis, 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 tissues remain under the damaged skin in the zone of demarcation, therefore, with dry necrosis, expectant management is usually chosen to save more tissues. With wet necrosis, there is a high probability of developing infectious complications with the spread of the process "up" through healthy tissues, so expectant management is not applicable in such cases. Surgical treatment for frostbite IV degree is to remove dead areas. Amputation of necrotic fingers, hands or feet is performed.

Forecast and prevention

With superficial frostbite, the prognosis is conditionally favorable. Limb functions are restored. In the remote period, increased sensitivity to cold, malnutrition and vascular tone in the area of the affected area persist for a long time. Perhaps the development of Raynaud's disease or obliterating endarteritis. With deep frostbite, the outcome is the amputation of a part of the limb. Prevention includes the choice of clothes and shoes, taking into account weather conditions, the rejection of a long stay on the street in cold weather, especially when intoxicated.

frostbite is damage to any part of the body (up to necrosis) under the influence of low temperatures. If you stay outdoors for a long time, especially with high humidity and strong wind, you can get frostbite in autumn and spring when the air temperature is above zero.

lead to frostbite in the cold tight and damp clothes and shoes, physical fatigue, hunger, forced long-term immobility and uncomfortable position, previous cold injury, weakening of the body as a result of previous diseases, sweating of the legs, chronic diseases of the vessels of the lower extremities and the cardiovascular system, severe mechanical damage with blood loss, smoking, etc.

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

Under the influence of cold, complex changes occur in the tissues, the nature of which depends on the level and duration of the decrease in temperature. When the temperature is below -30 degrees C, the main value in frostbite is the damaging effect of cold directly on the tissue, and cell death occurs. Under the action of temperatures up to -10-20 degrees C, at which most frostbite occurs, vascular changes in the form of a spasm of the smallest blood vessels are of paramount importance. As a result, blood flow slows down, 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, severe pain, redness and swelling of soft tissues appear;

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

With general hypothermia, a person is lethargic, indifferent to the environment, his skin is pale, cold, his pulse is frequent, blood pressure is lowered, body temperature is below 36 ° C

There are several degrees of frostbite:

Frostbite I degree(most mild) usually occurs with short exposure to cold. The affected area of the skin is pale, reddened after warming, in some cases it has a purple-red tint; edema develops. Skin necrosis does not occur. By the end of the week after frostbite, slight peeling of the skin is sometimes observed. Full recovery occurs by 5-7 days after frostbite. The first signs of such frostbite are a burning sensation, tingling, followed by numbness of the affected area. Then there is skin itching and pain, which can be both minor and pronounced.

Frostbite II degree occurs with prolonged exposure to cold. In the initial period, blanching appears, the skin becomes cold, sensitivity is lost, but these phenomena are observed at all degrees of frostbite. Therefore, the most characteristic sign is the formation of blisters filled with transparent contents in the first days after the injury. Full restoration of the integrity of the skin occurs within 1-2 weeks, granulation and scarring are not formed. With frostbite of the II degree after warming, the pain is more intense and longer than with frostbite of the I degree, skin itching, burning are disturbing.

With frostbite III degree the duration of the period of cold exposure and decrease in temperature in the tissues increases. The blisters formed in the initial period are filled with bloody contents, their bottom is blue-purple, insensitive to irritations. There is a death of all elements of the skin with the development of granulations and scars as a result of frostbite. Descended nails do not grow back or grow deformed. Rejection of dead tissues ends on the 2nd-3rd week, after which scarring occurs, which lasts up to 1 month. The intensity and duration of pain is more pronounced than with frostbite II degree.

Frostbite IV degree occurs with prolonged exposure to cold, the decrease in temperature in the tissues with it is the greatest. It is often combined with frostbite III and even II degree. All layers of soft tissues become dead, bones and joints are often affected.

The damaged area of the limb is strongly cyanotic, sometimes with a marble color. Edema develops immediately after warming and increases rapidly. The temperature of the skin is much lower than that of the tissues surrounding the area of frostbite. Blisters develop in less frostbitten areas where there is frostbite III-II degree. The absence of blisters with significantly developed edema, loss of sensitivity indicate frostbite IV degree.

Under conditions of a long stay at low air temperature, not only local lesions are possible, but also a general cooling of the body. Under the general cooling of the body, one should understand the state that occurs when the 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 parts of the body with hands, tissues, alcohol, and even more so with snow! (Such recipes are extremely tenacious and still exist among the people.) The fact is that these measures contribute to thrombosis in the vessels, deepening the processes of destruction of the affected tissues.

The injured need wrap in a warm blanket(with general hypothermia) or (with frostbite) apply a heat-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 thermally insulating bandage allows several times to slow down the external warming of the affected area while ensuring the general warming of the body.

If an arm or leg is frostbitten, it can be warmed in the bath, gradually increasing the water temperature from 20 to 40 ° C and within 40 minutes gently (!) massaging the limb. On the inner surface of the thigh or shoulder, you can additionally put a warm heating pad y. To the injured give plenty of warm drink like 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 tinctures of valerian or motherwort (5-10 drops) as soothing.

If warming after frostbite is accompanied by moderate pain (the victim gradually calms down), sensitivity, temperature and color of the skin are restored, independent full-fledged movements, then the limb is wiped dry, the skin is treated with 70% alcohol (or vodka) and a dry bandage is applied with cotton wool. The ear, nose or cheek are liberally lubricated with petroleum jelly 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 a large loss of heat. An additional factor is the inability to focus 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 clothing- It promotes normal blood circulation. Dress like a "cabbage" - while between the layers of clothing there are always layers of air that perfectly retain heat.

Tight shoes, lack of insoles, damp dirty socks often serve as the main prerequisite for the appearance of scuffs and frostbite. Particular attention should be paid to shoes for those who often sweat feet. You need to put warm insoles in boots, and wear woolen ones instead of cotton socks - they absorb moisture, leaving your feet dry.

- Do not 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 of natural materials, although comfortable, do not save from frost. Cheeks and chin can be protected with a scarf. In windy cold weather, before going outside, lubricate open areas of the body with a special cream.

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

- Get help from a friend: keep an eye on your friend's face, especially the ears, nose, and cheeks, for any noticeable changes in color, and he or she will keep an eye on yours.

- Don't take off your shoes in the cold from frostbitten limbs - they will swell and you will not be able to put on shoes again. It is necessary to reach a warm room as soon as possible. If your hands are cold, try warming them under 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 the extremities during a walk, you need to go to any warm place as soon as possible- shop, cafe, entrance - for warming and inspection of places potentially vulnerable to frostbite.

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

- Don't wet your skin 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 fell into the water) must be removed, the water wiped off, if possible, put on dry ones and bring the person to heat as soon as possible. In the forest, it is necessary to kindle a fire, undress and dry clothes, during this time vigorously doing physical exercises and warming up 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 a child go for a walk in the cold outside, 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 not to get into it. In severe frost, try not to leave the house unless absolutely necessary.

There are enough cold regions in Russia: more than two-thirds of the population is constantly at risk of freezing. It happens that people die even when the air temperature is above zero, to say nothing of 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 the normal state, the temperature of the human body ranges from 36.4 to 37.5 ° C, falling below 25 and rising above 43 ° C is deadly. At rest, heat is generated 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. Here, for example, the Eskimos have a basic metabolism - chemical thermoregulation is 30% higher than that of the inhabitants of central Russia, and is genetically fixed.

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

Frostbite 1 degree- the skin on the frostbitten area is pale, when heated, it takes on a reddish or purplish-red hue, 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 site turns pale, loses sensitivity, in the first days after frostbite bubbles form with transparent contents. When warming, itching and pain are more pronounced. Recovery requires 1-2 weeks.

Frostbite 3 degrees

Frostbite 3 degrees- vesicles in the area of frostbite are filled with bloody contents with a blue-purple bottom, there is no sensitivity. Warming up causes severe pain. Skin elements die with subsequent scarring. The nail plate may not grow or grows deformed. Dead tissue is sloughed off after 2-3 weeks, scarring occurs within 1 month.

Frostbite 4 degrees

Frostbite 4 degrees- the area of frostbite is cyanotic with a marble color. After warming, immediately there is a strong swelling without blisters, the sensitivity is not restored. All layers of soft tissues 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 - take the person to the nearest warm room, remove frozen shoes, socks, gloves. First aid for frostbite - the victim is given a hot drink and food, a tablet of acetylsalicylic acid, an anesthetic, drotaverine and papaverine. As for alcohol, in the cold, in no case should you give it to the victim! Alcohol causes vasodilation and significantly increases heat transfer. But indoors, a small amount of alcohol may be in place, because in this case, the expansion of spasmodic peripheral vessels is what needs to be achieved as soon as possible in order to prevent tissue death.

First aid for frostbite:

First aid for frostbite - with frostbite of the 1st degree, the chilled areas should be warmed to redness with warm hands, light massage, breathing, and then apply a cotton-gauze bandage. At 2-4th degree, on the contrary, one should not use rapid warming and massage, but it is necessary to get to the hospital as soon as possible, in many cases minutes count, and if you delay, it becomes impossible to save, for example, fingers. Before medical assistance, it is better to apply a heat-insulating bandage on the affected surface (a layer of gauze, a thick layer of cotton wool, again a layer of gauze, and on top of oilcloth and rubberized fabric, you can use padded jackets, sweatshirts, woolen fabric) and fix the affected limbs with improvised means over the bandage.

What not to do with frostbite:

rub frostbitten areas with snow - this injures the skin and capillaries, even if the damage is not visible to the eye;
apply rapid warming (heating pads, batteries, etc.), this only worsens the course of frostbite;
rubbing oils, grease, rubbing alcohol on tissues with deep frostbite, this is not only ineffective, but can also damage tissues even more.

With general hypothermia of a mild degree, 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 degrees, when breathing and blood circulation are disturbed (pulse up to 60 beats per minute or less), the victim must be urgently taken to the hospital, and not try to treat on his own, which cannot be done with frostbite.

Children are a special risk group - their thermoregulation is still imperfect, they lose heat through the skin faster than adults, and they may not have the common sense to return home on time to prevent frostbite. Attention is also required for older people, often their microcirculation is no longer so effective. Therefore, it is advisable for children and the elderly walking in the cold every 15-20 minutes to return to warmth and keep warm. In 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.

The degrees of frostbite vary in symptoms. Each of them is characterized by certain symptoms and suitable treatment. What is frostbite and what to do when it occurs?

The concept of frostbite

Frostbite is damage to the skin that occurs as a result of exposure to low temperatures. The protruding parts of the body are most often affected - limbs, ears, nose, face skin. There are certain factors that can provoke the appearance of frostbite of varying degrees.

Factors:

vascular disease,
Intensive body heat transfer,
Injuries, weakened body, alcohol intoxication,
Violation of blood circulation.

People under the influence of alcohol suffer from frostbite quite often. At this moment, a 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 listed in the International Classification of Diseases and has its own ICD-10 code - T33-T35 - frostbite.

signs

What are the symptoms 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 reddens,
There is a feeling of tingling and burning,
There is numbness of the skin,
There are painful sensations
The dermis may itch.

There are two periods of frostbite.

Kinds:

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

In a person with frostbite, first there is a violation of mobility, numbness, and a decrease in sensitivity. When thawed, a burning sensation occurs, gradually turning into pain. The skin changes color from pale to bright red. With severe frostbite, blackening of the dermis is subsequently noted.

During the period of thawing and recovery, regardless of the degree of the disease, itching is noted. Often patients comb damaged areas to the blood.

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 stay in the cold for a short period of time. At grade 1, it is noted in adults and in children there is a blanching of the dermis. After warming, it becomes red (sometimes burgundy). After a certain time, peeling begins. The presence of mild pain, itching, tingling is noted. There may be swelling. 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 stronger painful sensations. There is itching, burning sensation, tingling, numbness stronger than in the first stage. Blisters form on the skin during frostbite, filled with a clear liquid. The recovery period at this degree lasts about a couple of weeks, scars and scars do not appear.
The third stage of frostbite is considered more dangerous. In this case, a person feels more severe manifestations of pain and burning. The limbs are numb. On the damaged areas, the appearance of blisters with blood contents is noted. Frostbite of the 3rd degree is characterized by a decrease in the overall body temperature, the death of the skin and nails. The recovery period is at least three weeks, scars 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 a death of soft tissues, bones and joints. The skin becomes blue, almost black. Blisters with bloody contents are formed. There is practically no sensitivity, body temperature can rise to 39 degrees. Frostbite of the limbs at grade 4 in most cases ends with gangrene and amputation.

The appropriate treatment is selected depending on the degree of frostbite.

Causes of frostbite

There are several reasons for this phenomenon.

List:

Prolonged stay in the cold
Contact with a substance cooled to a very low temperature,
Periodic exposure to adverse conditions - high humidity and low temperatures.

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

Diseases:

Vascular problems - endarteritis, thrombosis. There is a violation of the blood supply to certain areas, which reduces heat generation.
Heart diseases. Often provoke the development of swelling in the limbs, which leads to a decrease in the resistance of tissues to cold temperatures.
Liver diseases also provoke circulatory disorders in various body systems.
Diabetes. The skin in this disease loses its sensitivity, as a result, it is not able to perceive hypothermia in the early stages.
Various injuries with the formation of edema lead to the fact that blood flow is disturbed in the damaged areas. This increases the chance of developing frostbite. In case of fractures, the applied gypsum is able to quickly cool 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 with alcohol intoxication. Certain factors can provoke the development of frostbite of varying degrees, which should be avoided.

First aid

When frostbite of any degree occurs, a person needs.

First aid:

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

With a mild degree of frostbite, recovery occurs in a week. The remaining degrees of the disease are treated in the hospital.

How not to freeze and prevention

If the person is outside. That in order to avoid frostbite, it is worth doing any exercises. You cannot stand in one place. You can do bends, swing on your feet, perform jumps. If there is any warm room nearby, then it is worth going into it and warming up.

It is worth remembering that with 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.
Do not leave the house in severe frosts, drive a car.
You can not smoke in the cold, drink alcohol and drinks with caffeine.
Exposed areas of the skin can be lubricated with a greasy cream or lard, but not with moisturizing creams.
At the first sign of frostbite, you need to take cover in a warm room.
You should not let go in the cold some children and the elderly.
When hiking, in the mountains, you need to have extra clothes, a supply of food and water with you. If necessary, immediately call the rescuers.
No need to wear metal jewelry and 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, giving it the opportunity to warm up.

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