Frostbite

Thermal lesions include not only burn injuries, but also frostbite, which occurs as a result of the action of cold on the body, resulting in a prolonged decrease in body temperature, damage to anatomical structures( up to necrosis).Frostbites are classified according to their degree depending on the depth of tissue damage.

I degree. In this case the frostbitten skin after warming acquires a bluish or purple hue.

II degree. In this case, immediately after warming or( less often) in a few days, bubbles appear, filled with serous fluid.

III degree is characterized by the appearance of blue-purple discoloration of the skin of the affected area, expressed by swelling of the tissues. Bubbles are filled with hemorrhagic fluid. The necrosis extends to the entire thickness of the skin.

IV degree is characterized by necrosis of all tissues, including bones. Without rendering urgent help, a damp or dry gangrene develops 7-8 days after injury.

As a rule, in the same anatomical region, along with frostbite I V degree, lighter degrees of frostbite are observed.

Frostbites:

• latent( pre-reactive), during which the frosted area is pale, cold to the touch, insensitive. The patient complains of a feeling of numbness;

• A reactive period during which, after warming the frostbitten area, the victim experiences severe pain, the frost-bitten skin becomes swollen, with a cyanotic shade. Patients experience a burning sensation, heat, stinging, sensations of necrosis in frost-bitten areas.

The most common frostbite is the lower extremities, with the fingers usually frostbite, and frostbite does not spread above the ankle or wrist joint. Ears, nose, cheeks are frost-bitten much less often. Frostbites occur at an air temperature of -10 ° C or lower. Most often frostbite( up to the IV degree) people are exposed to strong alcohol intoxication, who received severe trauma and with epileptic seizure and other, i.e.unconscious without assistance. In such situations, heavy frostbites are possible.

In addition, as a chronic frostbite of the 1st degree, the refreshing that occurs with prolonged repeated exposure to cold is accompanied by swelling of the skin, their tension, cold snap. Festering as a professional disease is found among fishermen, sailors, timber rafters, i.e.people who are constantly exposed to the effects of cold.

Emergency care at the prehospital stage is reduced to warming the affected area. This can be done in a warm room, in a container with warm water, the temperature of which increases to 39-40 ° C for 15-20 minutes from 36-37 ° C.The effectiveness of the procedure is significantly increased if, in parallel with warming, massage the affected area from the periphery to the center. Warming in water should be about 30-40 minutes, and then the affected area should be wiped dry and rubbed with 70% alcohol, and then apply dry sterile dressings with a thick layer of cotton wool outside. Instead of a pelvis or a bath with water, you can use other warming agents, such as a heating pad, build a fire and warm the victim. Brushes of hands, for example, can be warmed in the armpit or between the hips of the victim himself. Wet clothes and shoes should be dried or replaced dry and clean.

In case the victim has his ears and facial parts frostbitten, they should be rubbed with a clean hand or a soft cloth until the skin turns pink and then treated with alcohol and oiled the damaged areas with oil. Snow for grinding frost-bitten areas of the skin can not be used in any case, as one can not only cool the skin even more, but also damage the upper layer of the skin, infect, etc.

After the above measures, the victim should be given hot drink, food or vodka( 50-100 g).In order to prevent tetanus, the patient is injected with tetanus antiserum. Anesthetics are prescribed( promedol, etc.), vasodilators( general measures in the first aid are reduced to giving the affected person) hot( platifillin, papaverine, etc.), as well as agents that prevent thrombosis.