Pathogenesis (development of disease) In 1st degree frostbite, redness, there is only superficial damage to the skin. This always regresses without consequences. 2nd-degree frostbite causes plasma to leak from the vessels, resulting in blistering. 3rd degree frostbite, in contrast to the previous stages, affects all skin layers as well as soft tissues. They are damaged … Frostbite: Causes
General measures If frostbite and hypothermia (hypothermia) are present simultaneously, treat the hypothermia first! If possible, simultaneous treatment is also permitted. The hypothermia always has priority! The patient is to be wrapped in an insulating blanket (aluminum vaporized rescue blanket) Attention! The silver side of the rescue blanket (so seems one side, if you hold … Frostbite: Therapy
The following symptoms and complaints may indicate frostbite: Frostbite stages Degree of frostbite Symptoms Grade I Redness (congelatio erythematosa), numbness. Grade II Edema/blistering (congelatio bullosa) on reddened skin Grade III Necrosis (cold burn; congelatio gangraenosa s. escharotica). Grade IV Icing The acras (fingers, toes, ears, nose) are particularly affected. Hypothermia stages Hypothermia stages Body temperature … Frostbite: Symptoms, Complaints, Signs
Medical history (history of illness) represents an important component in the diagnosis of frostbite/hypothermia. Family history Social history What is your occupation? Current medical history/systemic history (somatic and psychological complaints). What symptoms have you noticed? Have you noticed any changes in the skin? Redness? Swelling? Blistering? Are you in pain? How long have these changes … Frostbite: Medical History
Skin and subcutaneous (L00-L99). Bullous (blistering) skin disease, unspecified. Skin diseases associated with erythema (areal redness of the skin), unspecified Injuries, poisonings, and other sequelae of external causes (S00-T98). Burns Chemical burns
The following are the most important diseases or complications that may be contributed to by frostbite: Injuries, poisoning, and other sequelae of external causes (S00-T98). Skin atrophy Hyper/parakeratoses – excessive or disturbed keratinization of the skin. Immersion foot (trench foot) – disease of the foot due to prolonged exposure to water (wet freezing). Perniones (frostbite) … Frostbite: Consequential Diseases
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin and mucous membranes Head and extremities – especially affected are the acras (ears, nose, fingers, toes) [redness, swelling, bumps]. Auscultation (listening) of the heart. Auscultation of the lungs … Frostbite: Examination
As a rule, laboratory diagnostics are not required in frostbite. Second-order laboratory parameters-depending on the results of the history, physical examination, and obligatory laboratory parameters-for differential diagnostic clarification in cases of unclear impaired consciousness Small blood count Inflammatory parameters – CRP (C-reactive protein). Fasting glucose (fasting blood sugar) Blood gas analysis (BGA) Liver parameters – … Frostbite: Lab Test
Medical device diagnostics are usually not required. Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Radiographs of the affected areas of the body Computed tomography of the skull (cranial CT, cranial CT or cCT) – in the … Frostbite: Diagnostic Tests
Surgical measures should be postponed until it is clear which tissue has sufficient blood supply or is necrotic (“dead”). 1st order For 3rd degree frostbite, amputation of the affected body region must usually be performed
To prevent frostbite, attention must be paid to reducing individual risk factors. The following factors have a predisposing effect on frostbite: Behavioral risk factors Tight-fitting clothing/shoes Immobility Disease-related risk factors. Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99). Immobility Medication Therapy with vasocontrictive drugs, unspecified. The following factors predispose to hpothermia: Biographic … Frostbite: Prevention
