t. Elevate frostbitten hands on pillows or with slings. Separate frozen digits with
small wedges of cotton.
u. Avoid dressing, but loosely wrapped sterile towels are permissible to help
protect the extremity.
v. After rapid rewarming, the mainstay of therapy is vigorous treatment.
(1) Whirlpool baths in a solution to which an antiseptic such as povidone
iodine (Betadine) or hexachlorophene has been added.
Repeated whirlpool therapy of 20-30 minutes.
(3) Debride the injury two to three times daily to alleviate pain and help
w. While the patient is in the whirlpool, active, continuous complete range of
motion physical therapy should be done to prevent flexion contracture during the
Section IV. HYPOTHERMIA
5-11. GENERAL PROCEDURES
An individual suffering from a cold injury resulting in hypothermia has a body
temperature which is lower than normal. The primary intent in treating this individual is
to restore the core temperature of the body to normal levels. The means of rewarming
the person can be divided into two broad categories: external or surface methods and
internal or core methods. In external or surface methods, the body shell is warmed
before the core of the body is warmed. In the second method--internal or core
rewarming--the core of the body is warmed before the body shell.
5-12. EXTERNAL OR SURFACE REWARMING METHOD
This method of rewarming may be accomplished actively by immersion in 40C
water, heating blankets, hot water bottles, or heat cradles.
a. The preferred method of active rewarming is to immerse the patient partially
in warm water (40C). Immerse just the torso, rigging a sling system to keep the head,
legs, and arms out of the water. This may prevent some after drop in temperature.
When frostbite of the feet or hands is a complication, you may immerse the whole body.