Injuries from frostbite are extremely painful, and recovery or amputation depends on the degree of frostbite damage. Read this post to learn more about the classifications of frostbite.
Prevention is always better than treatment, especially in the case of frostbite. Treatment is very particular for frostbite. It is not a simple as rubbing your hands together to warm them up. In fact, you should never rub a frostbite area.
There are definitely times when you should thaw, and when you shouldn’t thaw. And there are different but very particular methods to use when thawing frostbite. But exactly when and how should one do this in the backcountry far away from help? We make it clear in this post and in our online outdoor safety course.
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- Evaluate and determine if injury should/can be thawed
- If thawing, determine if it will be via Active or Passive thawing
- Perform appropriate thawing technique
- Do not rupture blisters
- Apply aloe vera gel, if available
- Dress site loosely in clean, bulky gauze
- Protect from further damage and refreezing
- Elevate affected area
- Encourage the victim to drink fluids
- Ibuprofen for pain as instructed on medication label
When treating frostbite in the field, a decision will have to be made whether or not to thaw the frozen tissue.
- If the likelihood of refreezing is high, then it is best to not thaw and wait until thawing can be maintained. Refreezing of tissue will increase damage significantly. Frozen tissue should be protected from further damage such as rubbing, trauma, or excessive use. The injury can be padded and loosely wrapped in clean bulky gauze and even splinted for protection.
- If likelihood of refreezing is low, then the tissues should be thawed. This can be done either actively or passively as described below.
- Active Thawing - This should only be performed if the possibility of refreezing is low, if the equipment and resources to maintain thawed tissue are available. And if the hospital is more than 2 hours away. You will need equipment to heat water, like a camp stove. Submerge the frostbite site in heated water. The water temperature should be between 37C to 39C. Careful attention will be needed to maintain this temperature range. A thermometer is useful in this situation, but if one is not available then test the water temperature for 30 sec with your own hand. This entire process may take up to 30 minutes. Thawed tissue will be soft, pliable and red or purple in color. Air dry, do not rub. Wrap loosely in clean gauze.
- Passive Thawing - Passive thawing is simply allowing the frozen tissue to thaw on it’s own. This will be slower and all other treatments remain the same.
Do not rupture any blisters and if available, aloe vera ointment can be applied. Elevate affected area, and encourage hydration. The victim can Ibuprofen as directed in the medication label for pain control. Always assess and treat for hypothermia in all frostbite patients. Hypothermia treatment takes priority over frostbite treatment. Learn about how to treat and prevent hypothermia here.
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