REBEL Core Cast 48.0 Frostbite

Take Home Points

• Frostbite is a severe, localized cold-induced injury due to freezing and thawing of tissue.
• We usually see these injuries affecting the ears, nose, cheeks, chin, fingers, and toes. Patients will complain of cold, numb or stiff sensations and discoloration of the skin.  
• Critical ED treatment starts with rewarming in a warm, NOT HOT, water bath, analgesia and wound care.
• More extensive treatments include blister debridement, tPA, prostacyclin analogues and fasciotomy.  Patients with severe frostbite will likely require multidisciplinary care with surgery and critical care so consider early consults.
• And last, be sure to check the patients core temp and treat hypothermia complications, such as diuresis

REBEL Core Cast 48.0 – Frostbite

For More on This Topic Checkout:

• emDOCS.net: Brrr! ED Presentation, Evaluation, and Management of Cold Related Injuries
• EP Monthly: Frostbite: How to Classify and Treat It
• EM in 5: Frostbite

References:

1. Cauchy E et al. Retrospective study of 70 cases of severe frostbite lesions: a proposed new classification scheme. Wilderness Environ Med. 2001 Winter. PMID: 11769921.
2. Geng Q et al. Temperature limit values for touching cold surfaces with the fingertip. Ann Occup Hyg. 2006. PMID: 16777911.
3. Grieve AW et al. A clinical review of the management of frostbite. J R Army Med Corps. 2011. PMID: 21465915.
4. Handford C et al. Frostbite. Emerg Med Clin North Am. 2017 May. PMID: 28411928.

Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)

Shownotes Created By: Miguel Reyes, MD (Twitter: @miguel_reyesMD)