k. Treatment of the affected area.
(1) Submerge the affected area in a 5-10 gallon vessel of water at 100-
110F, initial temperature and maintain that temperature.
Affected area should float freely without touching sides of the vessel.
Circulate water manually or with whirlpool.
Use a thermometer to monitor water temperature throughout the thawing
(5) Maintain water temperature above 100F by alternately bailing out cooler
water and adding hot to prevent additional tissue injury.
(a) Temperatures higher than 110F may add burns to the injury.
Do not pour hot water directly on the extremity.
l. Continue the process until the distal tips of the extremity are flushed
(hyperemic); this may require 45 minutes.
m. Monitor the patient's heart; be alert for arrhythmias if hypothermia
n. When more than one extremity is involved, assign one person to each
container to maintain the temperature and circulate the water.
o. Once the tissue has thawed, handle the part gently and with sterile technique-
-advise the patient not to use the extremity.
p. During the rewarming, aspirin provides sufficient analgesia for some patients;
others require as much as 100 mg of meperidine hydrochloride (Demoral) or 15 mg of
morphine sulfate in order to tolerate the treatment.
q. Administer an antitetanus injection.
r. Absolute bed rest for the patient in a warm area must be enforced following
s. If the feet are involved, prescribe bed rest and a cradle to keep bed clothes
off the injury.