Frostbite degree first aid. Frostbite

There are quite a few cold regions in Russia: more than two-thirds of the population are constantly at risk of freezing. It happens that people die even when the air temperature is above zero, let alone frost! To know how to keep warm, let's figure out what happens in the human body when the thermometer outside the window drops lower and lower.

In a normal state, a person’s body temperature ranges from 36.4 to 37.5°C; falling below 25 and rising above 43°C are deadly. At rest, heat is produced mainly by the abdominal cavity, up to 55%, and with an average muscular load, priority is given to the muscles, up to 75% of the total heat generation. It is believed that the lowest air temperature that a person can endure for a long time without clothes is 2°C. But do not try to repeat this experience; it requires long professional training, good health and good heredity. For example, the Eskimos have a basic metabolism - chemical thermoregulation that is 30% higher than that of the inhabitants of central Russia, and is fixed genetically.

Among people who are not particularly resistant to cold, the number of frostbites jumps sharply at a temperature of -10°C. In this case, exposed or poorly protected areas of the body (ears, nose, fingers and toes) are most often affected. Additionally, the risk is increased by wet and tight clothing, hunger, physical fatigue, alcohol intoxication, chronic heart and vascular diseases, blood loss, smoking and some similar factors. There are 4 degrees of frostbite.

Frostbite 1st degree- the skin on the frostbitten area is pale, when heated, it takes on a reddish or purplish-red tint, and swells. Symptoms: tingling, numbness, burning, minor but severe itching and pain. The cells remain viable. After 1 week peeling may occur.

Frostbite 2nd degree

Frostbite 2nd degree- the area turns pale, loses sensitivity, and in the first days after frostbite, bubbles with transparent contents form. When warming up, itching and pain are more pronounced. Recovery requires 1-2 weeks.

Frostbite 3rd degree

Frostbite 3rd degree- the blisters at the frostbite site are filled with bloody contents with a blue-purple bottom, there is no sensitivity. When warming up, severe pain occurs. Elements of the skin die, followed by the formation of scars. The nail plate may not grow or grows deformed. Dead tissue is rejected after 2-3 weeks, scarring occurs within 1 month.

Frostbite 4th degree

Frostbite 4th degree- the frostbite area is bluish with marble coloring. After warming up, severe swelling without blisters immediately occurs, sensitivity is not restored. All layers of soft tissue undergo necrosis, joints and bones suffer.

First aid for frostbite

First aid for frostbite depends on the severity of the victim’s condition. But what should definitely be done right away is to take the person to the nearest warm room, remove frozen shoes, socks, and gloves. Providing first aid for frostbite - the victim is given hot drink and food, a tablet of acetylsalicylic acid, anesthetic, drotaverine and papaverine. As for alcohol, in the cold you should never give it to the victim! Alcohol causes vasodilation and significantly increases heat transfer. But indoors, a small amount of alcohol may be appropriate, since in this case the expansion of spasmodic peripheral vessels is what needs to be achieved as soon as possible in order to prevent tissue necrosis.

First aid for frostbite:

First aid for frostbite - in case of frostbite of the 1st degree, the cooled areas should be warmed until reddened with warm hands, light massage, breathing, and then apply a cotton-gauze bandage. With grades 2-4, on the contrary, you should not use quick warming and massage, but you need to get to the hospital as soon as possible; in many cases, minutes count, and if you delay, it turns out to be impossible to save, for example, fingers. Before seeking medical help, it is better to apply a heat-insulating bandage to the affected surface (a layer of gauze, a thick layer of cotton wool, another layer of gauze, and on top of oilcloth and rubberized fabric, you can use quilted jackets, sweatshirts, woolen fabric) and fix the affected limbs with improvised means over the bandage.

What not to do if you have frostbite:

• rubbing frostbitten areas with snow - this injures the skin and capillaries, even if the damage is not noticeable to the eye;
• use quick warming (heating pads, radiators, etc.), this only worsens the course of frostbite;
• rubbing oils, fat, rubbing alcohol into tissues in cases of deep frostbite is not only ineffective, but can also damage the tissues even more.

In case of mild general hypothermia, it is enough to warm the victim in a warm bath at a water temperature of 24°C, gradually raising it to normal body temperature. In moderate and severe cases, when breathing and blood circulation are impaired (pulse up to 60 beats per minute or less), the victim must be urgently taken to the hospital, and not try to treat it yourself, which cannot be done in case of frostbite.

Children are a special risk group - their thermoregulation is still imperfect, they lose heat through their skin faster than adults, and they may not have the common sense to return home in time to prevent frostbite. Older people also need attention; often their microcirculation is no longer so effective. Therefore, it is advisable for children and the elderly walking in the cold to return to the warmth and warm up every 15-20 minutes. During the cold season, you need to take special care of each other, and then winter with its sparkling beauty, games and walks will only be a joy.

A patient who has suffered frostbite needs to eat well and, above all, increase the intake of protein and vitamins. If a person has lost his appetite, then one should not force food down. In the first days after injury, the main thing is to drink plenty of fluids, which will help remove viruses and toxins from the body. It is useful to drink warm, not strongly sealed tea, berry fruit drinks (previously diluted with warm boiled water), infusions of rose hips, hawthorn, and chamomile flowers.

In the first few days, it is better to give preference to chicken broth or light soup cooked with it. This dish reduces the level of white blood cells, thereby reducing irritation and inflammation.

At elevated temperatures, you should add herbs and spices to your food (coriander, cinnamon, ginger, pepper, cloves, garlic). They will increase sweat production, thereby helping to reduce the temperature.

For frostbite, the following foods and dishes will be useful: milk, kefir, sour cream, cottage cheese, cheese, vegetables (potatoes, carrots, tomatoes, cauliflower, beets), vegetable broths, lean meat and fish, ground porridge, white bread. Sweets include honey, jam, marmalade, and a little sugar.

The patient should eat in small portions, the number of meals should be at least 6 times.

First aid for frostbite

After identifying a person with frostbite, first aid must be provided.

The first step is to place the patient in a warm room, remove shoes, socks, gloves, and replace wet clothes with dry ones (depending on the situation). Give him a warm drink and feed him hot food, restore blood circulation.

At first degree frostbite, the victim needs to massage the damaged areas of the body or limb (you can use woolen products). Apply a cotton-gauze bandage.

At 2, 3, 4 degrees frostbite, under no circumstances should rubbing or warming massage be performed. You need to put a layer of gauze on the damaged pieces of skin, then a layer of cotton wool, then gauze and wrap it with oilcloth or rubberized cloth.

If limbs (especially fingers) are damaged, secure them with available things (you can use plywood, a ruler, a board).

Do not rub the patient with snow and fat. When frostbite occurs, the blood vessels are very fragile and can become damaged, forming microcracks that can easily become infected.

In case of general hypothermia, it is necessary to take a warming bath (first, the water temperature should not exceed 24 degrees Celsius, then you need to add hot water and gradually bring it to the normal temperature of the human body - 36.6).

After taking the above measures, you should call a doctor so that he can assess all the damage and recommend the correct treatment.

In folk medicine for frostbite:

• lubricate frostbitten areas of the body with celandine juice three times a day;
• for frostbite of the extremities, you need to boil 1.5 kilograms of celery in a liter of water, let the water cool a little and dip the sore area, keep in water until it cools, then dip in cold water and wipe thoroughly, put on thermal underwear (repeat the procedure 7-10 times at night );
• Apply alcohol tincture of rowan or calendula berries to damaged skin;
• lubricate frostbitten skin with an ointment made from Vaseline and calendula flowers (25 grams of Vaseline requires a teaspoon of crushed flowers);
• make lotions from decoctions prepared from shepherd's purse, tartar or spruce needles;
• lubricate the damaged skin three times a day with a mixture prepared with 100 grams of wax, half a liter of sunflower oil, a handful of sulfur, spruce needles and 10 onion “butts” (the first three ingredients are mixed into a bowl, boiled for an hour over low heat, add onions, cook for another 30 minutes, let cool, filter);
• make compresses with mashed potatoes, boiled with peels (the puree should be warm so as not to burn the skin; it is applied to the sore areas and wrapped with a simple cloth or bandage, after the potatoes have cooled, it is necessary to remove the compress and lubricate the skin with lemon juice after diluting it in warm water in ratio 1 to 5).

To prevent frostbite, you need to dress warmly in woolen or natural fabrics. Shoes should be spacious and not constrictive. It is better to take a thermos with hot drinks with you. This can be tea, herbal decoctions or compote from fruits or medicinal herbs.

Develops in remote areas of the body (feet, hands, tips of the ears) with reduced blood circulation.

With general exposure to cold (being in the cold or in an unheated room), low-temperature tissue damage may be accompanied by general hypothermia of the body. If the cold acts locally (prolonged contact with a very cool surface at normal ambient temperature), signs of frostbite are not accompanied by symptoms of general hypothermia.

The development of frostbite is promoted by: tight shoes and clothes, wet clothes, lack of physical activity in the cold, forced posture, alcohol intoxication, smoking, concomitant diseases accompanied by deterioration of peripheral blood circulation (sugar diabetes, atherosclerosis, etc.).

In the place of tissue hypothermia, a spasm of the arteries occurs, as a result of which the surface layers cease to receive sufficient heat and nutrients, and metabolic processes in them slow down. After a significant decrease in the temperature of the cells, the water in them turns into ice crystals, which leads to irreversible destruction and necrosis.

Degrees of frostbite

As with burns, depending on the depth of tissue damage, four degrees can be distinguished:

1. Mild frostbite causes a change in skin color in a small area. It usually takes on a whitish tint, and as it warms it turns bright red. External manifestations include itching, slight soreness, burning or numbness.
2. In the second degree, the depth of tissue damage increases, and therefore bubbles with transparent contents form in the affected areas.
3. The third degree of frostbite is characterized by damage to all layers of the skin, so the blisters are often filled with dark or bloody contents. After healing, defects and scars often form.
4. With the most severe degree of frostbite, necrosis of soft tissues, joints and even bones develops. The skin acquires a bluish or brownish tint, and subsequently turns black.

Principles of First Aid

First aid for frostbite helps reduce the degree of tissue damage and speed up further recovery.

Basic actions to be performed when providing first aid:

1. Stop exposure to cold. It is best to warm up in a warm room, but during transportation it is necessary to reduce heat loss as much as possible, for example, cover the victim with a warm blanket or clothing.
2. After moving to a warm room, you should undress the victim, since he will stay warm longer in clothes and shoes.
3. Try to warm the areas that are most damaged. However, you cannot do this quickly, for example, using heating pads or a hot bath.
4. Since there is a risk of general hypothermia, it is necessary to give the person to drink hot tea or milk.
5. If there are skin defects, they should be covered with a dry, sterile cloth. The use of the patch is not recommended, since the damaged epidermis may peel off along with the adhesive layer.
6. If a person falls into water far from populated areas in winter, he should be undressed, wiped dry and dressed in different clothes. If there is no spare clothing, then you need to dry the existing things by the fire, without allowing the victim to freeze.

After providing first aid for frostbite, it is advisable to consult a doctor, even if the victim’s condition has improved and there are no external changes. You should definitely consult a doctor in the following situations:

1. A child or an elderly person has been exposed to cold. This is due to the characteristics of their immune system.
2. There are signs of third and fourth degree frostbite.
3. Sensitivity in the affected limbs is not restored for a long time.
4. The area of ​​the frostbite area is more than 1% (according to the “rule of the palm”, 1% of the body surface is equal to the area of ​​the victim’s palm).

What is forbidden to do if you have frostbite?

It should be remembered that some actions during hypothermia and frostbite can worsen the victim’s condition. In these situations you cannot:

1. Give alcoholic drinks. Despite the fact that a person experiences subjective improvement while drinking alcohol, the degree of hypothermia usually worsens. This is due to the fact that under the influence of alcohol, peripheral blood vessels dilate, and heat loss only intensifies.
2. Warm or rub the patient too quickly, as these actions increase the area of ​​necrosis due to mechanical damage and the spread of toxic substances.
3. Contrary to popular belief, if you have frostbite, it is not recommended to rub your skin with snow.
4. Open the blisters and treat them with an antiseptic, as this opens the entrance gate for infection.

If you provide the necessary first aid for frostbite in time and then take the patient to the hospital, you can save the health and sometimes the life of the victim.

Prevention of frostbite

To prevent hypothermia and cold damage to soft tissues, several rules should be followed:

• do not drink alcohol outdoors in cold weather;
• smoking also makes a person more vulnerable;
• do not use tight shoes and light clothing, as the layer of air slows down cooling;
• wear a hat, mittens and scarf;
• When going outside in winter, do not wear metal jewelry;
• in cold weather, periodically examine the face, especially the tip of the nose, and limbs;
• at the first signs of frostbite, try to return to a warm room;
• do not wet the skin, as this will increase heat loss.

Particular attention should be paid to young children and the elderly, because their thermoregulation system usually does not work at full capacity. It is not advisable for them to stay outside in severe frosts for more than 20 minutes at a time.

Frostbite or frostbite is damage to body tissues caused by exposure to low temperatures. Frostbite is often accompanied by general hypothermia of the body and especially often affects protruding parts of the body, such as the ears, nose, and insufficiently protected limbs, especially fingers and toes. Spreads from more distant areas (fingertips, nose, ears) of organs to less distant ones.

Most often, frostbite occurs in the cold winter when the ambient temperature is below −20-10 °C. If you stay outdoors for a long time, especially in high humidity and strong winds, frostbite can occur in the fall and spring when the air temperature is above zero.

Signs, symptoms and stages of frostbite

In order to ensure that first aid for frostbite is provided effectively, you should know that all skin frostbite is divided into degrees of severity:

1st mild degree. If you get mild frostbite, its signs are a feeling of slight tingling, burning, and numbness of the skin. The skin on the affected areas turns pale, after it is warmed, a slight swelling appears, having a purplish-red tint, then peeling begins. The skin usually recovers within a week, leaving no other marks.

2nd degree. In this case, signs of frostbite in the extremities, in addition to redness and flaking of the skin, include blisters containing clear liquid. When warming up, a person experiences pain and itching. Full recovery may take about 2 weeks.

3rd degree. This kind of frostbite is very dangerous. Its sign is the appearance of blisters filled with blood; such frostbite often ends in necrosis. Skin restoration takes a long time, sometimes taking a month or more, and ends with the formation of scars.

4th degree. Frostbite affects all layers of soft tissue, is characterized by pronounced swelling, loss of sensitivity, and often ends in necrosis and tissue necrosis. According to statistics, frostbite of the 4th degree is caused by amputation of limbs.

Causes of frostbite

Frostbite in the cold is caused by tight and wet clothes and shoes, physical fatigue, hunger, forced long-term immobile and uncomfortable position, previous cold injury, weakening of the body as a result of previous diseases, sweating of the feet, chronic diseases of the blood vessels of the lower extremities and the cardiovascular system, severe mechanical damage with blood loss, smoking, etc.

When drinking alcohol, peripheral blood vessels dilate, which is characterized by increased heat loss, while normally they narrow when exposed to cold. Quite often, severe frostbite leading to amputation of limbs occurs precisely in a state of strong alcohol intoxication, for reasons that are not likely of a physiological nature, but primarily due to the inability of a drunk person to take timely measures against freezing; in the case of severe intoxication, the ability to move normally is lost, awareness of danger disappears, and a person can simply fall asleep in the cold, which often leads to death.

First aid for frostbite

First aid does not exclude professional medical assistance and is intended only as an emergency measure. If you suspect frostbite, you should seek qualified medical care. Early treatment reduces the severity of consequences.

Actions to provide first aid vary depending on the degree of frostbite, the presence of general cooling of the body, age and concomitant diseases.

First aid actions vary depending on the degree of frostbite, the presence of general cooling of the body, age and concomitant diseases.

First aid consists of stopping cooling, warming the extremities, restoring blood circulation in cold-damaged tissues and preventing the development of infection. The first thing to do if there are signs of frostbite is to take the victim to the nearest warm room, remove frozen shoes, socks, and gloves. At the same time as carrying out first aid measures, it is necessary to urgently call a doctor or an ambulance to provide medical assistance.

In case of frostbite of the first degree, the cooled areas should be warmed until reddened with warm hands, light massage, rubbing with a woolen cloth, breathing, and then apply a cotton-gauze bandage.

In case of frostbite of II-IV degree, rapid warming, massage or rubbing should not be done. Apply a heat-insulating bandage to the affected surface (a layer of gauze, a thick layer of cotton wool, another layer of gauze, and oilcloth or rubberized fabric on top). The affected limbs are fixed using available means (a board, a piece of plywood, thick cardboard), applying and bandaging them over the bandage. Padded jackets, sweatshirts, woolen fabric, etc. can be used as heat-insulating material.

It is not recommended to rub patients with snow, since the blood vessels of the hands and feet are very fragile and therefore may be damaged, and the resulting micro-abrasions on the skin contribute to infection. You should not use quick warming of frostbitten limbs by the fire, or uncontrolled use of heating pads and similar heat sources, as this worsens the course of frostbite. An unacceptable and ineffective first aid option is rubbing oils, fats, rubbing alcohol into tissues for deep frostbite.

For mild general cooling, a fairly effective method is to warm the victim in a warm bath at an initial water temperature of 24°C, which is raised to normal body temperature. With moderate and severe degrees of general cooling with impaired breathing and circulation, the victim must be taken to the hospital as soon as possible.

When going for a long walk in the cold, wear several layers of clothing - the air between them will retain heat. Take with you spare woolen socks, insoles, and mittens. It is not recommended to wear metal jewelry in the cold, as metal cools much faster than the human body. Before going out, you need to eat a hearty meal; your body may need a lot of energy to fight the cold. It's a good idea to take a thermos with hot tea with you. “Warming up” with alcohol can lead to serious consequences, as it only gives the illusion of warmth and disrupts adequate perception. Most frostbite resulting in limb amputation occurs while intoxicated. If you feel your limbs freezing, warm yourself up in any warm room. An already frostbitten area should not be subjected to re-freezing - the injury will be much more serious.

Classification and types of frostbite

There are several classifications of frostbite based on different principles.

General classification of damage due to low temperatures

• Acute cold injury
• Freezing (damage to internal organs and body systems)

• Frostbite (development of local necrosis with extensive secondary changes)

• Chronic cold damage

• Cold neurovasculitis
• chills

There are mild, moderate and severe degrees of general frostbite.

• Easy degree: The skin is pale, bluish, “goose bumps” appear, chills, difficulty speaking. The pulse slows down to 60-66 beats per minute. Blood pressure is normal or slightly elevated. Breathing is not impaired. Frostbite of I-II degree is possible.

• Average degree: body temperature 29-32 °C, characterized by severe drowsiness, depression of consciousness, blank look. The skin is pale, bluish, sometimes marbled, and cold to the touch. The pulse slows down to 50-60 beats per minute, weak filling. Blood pressure decreased slightly. Breathing is rare - up to 8-12 per minute, shallow. Frostbite of the face and extremities of I-IV degrees is possible.

• Severe degree: body temperature below 31 °C. There is no consciousness, convulsions and vomiting are observed. The skin is pale, bluish, and very cold to the touch. The pulse slows down to 36 beats per minute, weak filling, and there is a pronounced decrease in blood pressure. Breathing is rare, shallow - up to 3-4 per minute. Severe and widespread frostbite up to glaciation is observed.

Separately allocate immersion frostbite (trench foot): damage to the feet due to prolonged exposure to cold and dampness. Occurs at temperatures above 0 °C. It was first described during the First World War (1914-1918) in soldiers who spent a long time in damp trenches. In mild cases, painful numbness, swelling, and redness of the skin of the feet appear; in cases of moderate severity - serous-bloody blisters; in severe forms, there is necrosis of deep tissues with the addition of infection, and the possible development of wet gangrene.

According to the mechanism of frostbite development

• From exposure to cold air
• Contact frostbite

According to the depth of tissue damage

• Frostbite I degree(the mildest) usually occurs with short exposure to cold. The affected area of ​​the skin is pale, has a marbled color, turns red after warming, and in some cases has a purplish-red tint; edema develops. There is no dead skin. By the end of the week after frostbite, slight peeling of the skin is sometimes observed. Full recovery occurs 5-7 days after frostbite. The first signs of such frostbite are a burning sensation, tingling sensation followed by numbness of the affected area. Then skin itching and pain appear, which can be either minor or severe.

• Frostbite II degree occurs with prolonged exposure to cold. In the initial period there is pallor, coldness, loss of sensitivity, but these phenomena are observed with all degrees of frostbite. Therefore, the most characteristic sign is the formation of blisters filled with transparent contents in the first days after injury. Complete restoration of the integrity of the skin occurs within 1 - 2 weeks, granulations and scars are not formed. In case of frostbite of the second degree after warming up, the pain is more intense and lasting than with frostbite of the first degree, skin itching and burning are disturbing.

• Frostbite III degree exposure to cold is longer and there is a greater decrease in temperature in the tissues. The blisters that form in the initial period are filled with bloody contents, their bottom is blue-purple, insensitive to irritation. The death of all skin elements occurs with the development of granulations and scars as a result of frostbite. Fallen nails do not grow back or grow deformed. The rejection of dead tissue ends in the 2nd - 3rd week, after which scarring occurs, which lasts up to 1 month. The intensity and duration of pain is more pronounced than with frostbite of the second degree.

• Frostbite IV degree occurs with prolonged exposure to cold; the decrease in temperature in the tissues is greatest. It is often combined with frostbite of the third and even second degree. All layers of soft tissue die, bones and joints are often affected. The damaged area of ​​the limb is sharply bluish, sometimes with a marbled coloration. Swelling develops immediately after warming and increases rapidly. The skin temperature is significantly lower than in the surrounding tissue areas. Bubbles develop in less frostbitten areas where there is frostbite of the III-II degree. The absence of blisters with significantly developed edema and loss of sensitivity indicate degree IV frostbite.

In conditions of prolonged exposure to low air temperatures, not only local damage is possible, but also general cooling of the body. General cooling of the body should be understood as a condition that occurs when body temperature drops below 34 °C.

Update: December 2018

Cold is one of the harmful factors that constantly affects people's health. Its effect on the body can lead to weakened immunity and the development of illness (colds), damage to soft tissues and even nerve endings. If a person is exposed to the cold for a long time and is not sufficiently protected from low temperatures, he can even receive cold injury - frostbite of one of the body parts.

What is frostbite

In medicine, this term refers to any damage to soft tissue caused by cold. Frostbite has a lot in common with a burn; at first glance, it can be quite difficult to distinguish them. Low temperatures, as well as high ones, have the ability to destroy the skin, subcutaneous tissue, muscles and nerve fibers. The peculiarity of cold is that it slows down the flow of blood through the arteries and veins. This leads to malnutrition and worsens the damage.

Frost most often affects the hands, feet or face (ears, cheeks or tip of the nose) - these are the most exposed places from low temperatures. Frostbite on the torso and neck is extremely rare, since such an injury can only be obtained after contact with a very cold object, for example, in a chemical production. Therefore, if you suspect the presence of frostbite, first of all it is necessary to inspect the places accessible to the cold.

What contributes to the development of frostbite?

The depth of the damage depends not only on the temperature and the duration of a person’s stay in the cold. There are groups of people in whom frostbite develops much more often and is more severe than in others. This is due to changes in the functioning of the heart/vessels or lifestyle features.

The most common factors contributing to the development of frostbite include:

• Weather-inappropriate clothing. To get a mild cold injury, it is enough to dress “lightly” in the cold. The lack of additional underwear, uninsulated shoes, and bare hands are the most common causes of superficial frostbite (especially among young people). Deep damage develops only with prolonged exposure to low temperatures;
• Tight clothes. Excessive tightening of a certain area of ​​the body slows down blood flow and contributes to frostbite. For example, wearing tight shoes often leads to frostbitten toes;
• Alcohol intoxication. This is the most dangerous condition for humans in winter (especially in cold and snowy regions). Deep injuries with the development of gangrene and subsequent amputation are very common in alcohol abusers. This is due to three reasons:
  • A large amount of alcohol disrupts consciousness, which is why a person cannot control his behavior. Even his instinct of self-preservation is significantly suppressed - he can fall asleep in the snow or on the street in severe frost, stay in one position for a long time, etc.;
  • Alcohol disrupts normal sensitivity, and a person does not feel extreme cold;
  • Alcohol dilates blood vessels and disrupts the process of tissue respiration. All this leads to severe heat loss from the body.
• Chronic fatigue. In a person living in constant stress or on the verge of physical exhaustion, regulatory processes in the body and normal nutrition of organs are disrupted. They become more vulnerable to harmful factors, including frost;
• Diabetes. In patients with this pathology, over time, immunity is significantly reduced and the functioning of small blood vessels is disrupted. Hypothermia is extremely dangerous for this group of people, as they often develop not only frostbite, but also wet gangrene. The reason is the penetration of pyogenic microbes and the weakness of natural protective barriers;
• Diseases of the arteries and heart(chronic heart failure, long-term hypertension, severe atherosclerosis, endarteritis, etc.). These diseases inevitably disrupt the proper flow of blood throughout the body or in a particular part of it. Lack of sufficient blood flow contributes to freezing of the skin and slows down its recovery;
• Raynaud's syndrome. This is a fairly rare pathology in which patients are contraindicated from overcooling their hands or feet. Due to disruption of the blood vessels in the hands and feet, there is a constant deficiency in nutrition of these parts of the body. In severe cases, the only treatment option is amputation. Exposure to low temperatures contributes to additional deep damage to these areas. Therefore, patients with Raynaud's syndrome should avoid them as much as possible.

The presence of signs of frostbite in a person with one of the above conditions always increases the risk of developing severe complications. First aid should be provided to those affected by the cold as quickly as possible, as this significantly improves the course of the disease and reduces the required treatment time.

Symptoms

When should first aid be given for frostbite? The answer is simple - when the first signs of this condition are detected. Since the legs, arms, or face are most often affected, they should be looked for on these parts of the body. The most typical symptoms of cold injury are:

• Redness or blueness of the skin. Directly during exposure to low temperatures, tissues often turn pale or blue. However, soon after this, they take on a bright red color due to dilation of the blood vessels. If the color of the victim’s skin does not change, this is an unfavorable sign that indicates improper functioning of the arteries;
• Bubbles appear. Damage to the vascular wall leads to the “sweating” of the liquid part of the blood into the subcutaneous tissue. Bubbles can be of different sizes and with different contents, but more often with a clear liquid (there may also be blood inside);
• Formation of edema;
• Loss/decrease in sensation. This symptom occurs when the functioning of nerve endings is disrupted. With superficial frostbite, sensitivity is restored fairly quickly after warming up;
• "Crawling" feeling. Another consequence of nerve damage;
• Sharp stabbing pain.

In extremely severe cases, the skin becomes black or dirty brown, completely loses sensitivity and takes on the ambient temperature. The only adequate tactics for this condition is amputation or excision of dead areas.

Degrees of frostbite

The degree is the depth of the damage. First aid for frostbite is carried out almost the same way, regardless of this nuance. However, to determine subsequent treatment, the need for surgery and the prognosis, it is simply necessary to find out how deeply the cold managed to affect a part of the body.

This procedure is carried out according to the usual external examination, palpation and monitoring of the condition of the frostbitten area over time. If necessary, the doctor can change tactics if the patient shows signs of more extensive damage or if infection is suspected.

The degrees, symptoms of frostbite inherent in them and the fundamental points in treatment are reflected in the table below:

I and II degrees are considered superficial frostbite, since they do not damage stem cells and the affected area can recover on its own without surgery. III and IV - represent deep injuries, the treatment of which is carried out exclusively by the surgical service.

First aid

All therapeutic measures must begin from this stage. The sooner first aid for frostbite is provided, the lower the likelihood of developing complications and deep lesions. If you find a victim of a cold injury, first of all, you must perform the following actions:

1. Avoid exposure to frost;
2. Warm the affected area with dry heat. To do this, simply place the person in a warm, dry room next to heating devices;
3. Remove all cold clothing and change the person into warm underwear;
4. If possible, the victim can be placed in a warm bath (water temperature 30 o C), gradually increasing the temperature to 40 o C;
5. Gently massage frostbitten tissues - this stimulates the blood vessels and improves blood supply;
6. Give the victim a warm/hot drink. If he is in an inhibited state, drinking 50-100 g of strong alcoholic drinks is allowed. But only in a warm room and in the specified quantity;
7. It is recommended to apply a “thermal insulating” bandage to the damaged area for 15-20 hours. It is quite simple to do - apply a layer of dry cotton wool directly to the area of ​​injury, followed by a layer of cotton wool and gauze. The resulting bandage can be covered with oilcloth and covered with a warm cloth.

The first signs of frostbite and first aid should be known to every person. You should not wait for an ambulance to carry out initial treatment measures and improve the prognosis for the victim. Doctors should leave all other actions to restore the affected tissues and rehabilitate the patient.

What not to do if you have frostbite

1. Rub your skin with snow. Since it consists of small crystals and is almost always contaminated, snow can not only damage the dermis, but also facilitate the penetration of infection;
2. Injure the hypothermic area in any way. Since local immunity in this area is significantly reduced and blood supply is slow, the penetration of even a small amount of microbes can lead to purulent complications;
3. Quickly warm a person - a sharp temperature change can further damage tissues;
4. Drink alcohol in the cold. This will only lead to an increase in heat loss and an inadequate assessment of the situation by the victims themselves.

Treatment

After providing assistance, it is recommended to begin treatment for frostbite as quickly as possible. To do this, you should consult a doctor, who will determine how deeply the tissue is affected. It is on this decision that all further actions to restore the frostbitten area and carry out therapeutic measures will depend.

Therapy for superficial frostbite

The presence of a grade I or II injury allows you to avoid the need for surgery. Since such injuries do not affect the layer of stem cells, the skin and subcutaneous tissue can recover on their own, even with fairly extensive damage. To speed up this process and prevent the development of severe complications, the following medications can be used:

If necessary, the patient can perform certain therapeutic measures that will improve his well-being and restore adequate blood flow:

• Laser therapy– a method of influencing frostbitten areas of the body, in which they are warmed up with a directed beam of thermal energy. It is excellent for treating any part of the body and treating frostbite in a child, thanks to the complete safety and painlessness of the procedure;
• Hyperbaric oxygenation– a special procedure in which the victim is placed in an environment with a high concentration of oxygen. This allows you to improve the saturation of all organs with this gas, which has a beneficial effect on metabolic and recovery processes;
• Use of galvanic currents– a technique proven over the years, designed to stimulate cell function using point currents of constant strength;
• UHF irradiation– a method of deep heating of soft tissues and acceleration of metabolic processes in them. For this purpose, a certain area is exposed to special ultra-high frequency waves.

Unfortunately, most medical institutions in the Russian Federation are not able to provide the listed procedures for the patient. However, this has virtually no effect on the prognosis, but only slows down the recovery process.

Treatment of deep injuries

All of the above measures can be carried out in patients with grade III-IV injuries, but there is one fundamental difference. With such a depth of damage, the victim almost always requires surgical operations. They have two main goals:

1. Remove all dead tissue. It is unacceptable to leave dead areas on the body without attention, as they can become a source of toxins and poisoning of the entire body. This procedure is necessarily performed under adequate anesthesia, so it is almost painless for the patient. As a rule, the operation is not performed immediately after admission to the hospital, but after a certain time. It is necessary so that the boundary between viable and dead tissues becomes more clearly visible;
2. Restore skin integrity. Since deep lesions irreversibly damage the stem cell layer, the skin must be helped to recover. For this purpose, it is transplanted from other parts of the patient’s body. This technique avoids the risk of graft rejection and completely restores the integrity of the skin.

After surgical treatment, doctors continue to rehabilitate the patient using conservative methods - using dressings, medications and without a scalpel. The duration of therapy can vary significantly, but, as a rule, it rarely takes longer than 3-4 weeks.

FAQ

Question:
How dangerous is frostbite on the cheeks?

The entire face is very well supplied with blood, so frost injuries are rarely observed in this area. In most cases, after first aid, light conservative therapy and warming procedures are sufficient to restore the skin. However, to determine the exact tactics, it is strongly recommended to consult a doctor.

Question:
What treatment will allow you to recover from frostbite on your hands if some of your fingers have turned black?

Unfortunately, black coloring is a sign of complete tissue death. In this case, the only solution is amputation.

Question:
How to prevent the development of frostbite?

To do this, you should dress appropriately for the weather, avoid tight clothing and drinking alcohol in the cold.

Question:
Do I need to go to the hospital with a first degree cold injury?

This lesion can usually be successfully treated at home. For this, proper provision of primary care and warming measures are sufficient. All symptoms should disappear within 1-3 days.