c. Treatment--Ischemic Stage.
Gently wash, dry, and powder feet in a warm environment.
(2) Lay or sit the victim down, elevate and expose the feet to cool air,
keeping the rest of the body warm.
(3) Do not massage, immerse in water, or attempt uncontrollable, rapid
rewarming. Any of these will hasten the development of the hyperemic stage and
subsequent formation of blisters, with the potential for the development of infection and
Section III. FREEZING COLD INJURY: FROSTBITE
Frostbite results from crystallization of tissue water in the skin and adjacent
tissues and is produced by exposure to temperatures below the freezing point. The
depth and severity of the injury is a function of the temperature and the duration of
exposure--the lower the temperature, the shorter the time required to produce injury. At
low temperatures, in the presence of wind, freezing of exposed skin can occur within a
few seconds. Deep injury affects muscles, vessels, cartilages, and bones.
In frostbite, there is tissue damage during freezing with possible damage during
the thawing process. Changes in intracellular and extracellular biochemistry take place.
Tissue dehydration occurs with local oxygen depletion and eventually disruption of the
function of the blood corpuscles. Thrombosis (clotting within the small blood vessels)
takes place, and if the condition is not relieved, eventually gangrene occurs.
Frostbite is identified from the history of exposure to freezing temperature in
addition to clinical signs and the appearance of an affected part of the body. Even
severely frostbitten tissue may appear almost normal while still frozen.
a. Before thawing, the affected area appears hard, white, and bloodless. The
skin is rigid and the depth of freezing is difficult to determine. Sometimes a slight
purplish discoloration and insensitivity to light touch are the only indications that a part
of the body is frostbitten.