Frostbite - an optimal management
Frostbite is a cold thermal injury, with tissues exposed to temperatures below their freezing point (−0.55°C) or even 2°C for a sustained period of time. Severity of injury depends on wheather factors and patient comorbidities (smoking, peripheral vascular disease, neuropathies, mental health issues, substance abuse). Alcohol consumption, for example, causes heat loss through peripheral vasodilatation and also impairs judgement. Authors from UK published a detailed review for hospital management. Immediate and general care should include hypothermia correction, to bring core temperature above 35°C. It is followed by rehydration (oral or intravenous), depending on the ability of the patient to tolerate oral fluids. Prophylactic antibiotics use is not proven but should be considered in severe injuries (grades 3 and 4). Since extremities rewarming can be extremely painful, non-steroidal anti-inflammatory drugs or opiates should be administered.