Facts about Frostbite
Courtney Carter
/ Categories: WELLNESS, 2024

Facts about Frostbite

Here in New England, we tend to glibly throw out the word frostbite when it’s cold. But the reality is that frostbite is not a joking matter. Under the right conditions, frostbite can occur within 5-10 minutes. That’s roughly the same amount of time it takes to scrape the snow and ice off a car. 

Frostbite occurs when the fluid in your skin and even the tissue under your skin becomes so cold it freezes. The ice crystals that form can damage and destroy the tissue and nearby blood vessels. Damage to blood vessels may be permanent and can lead to gangrene and even limb loss.  

Because frostbite can set in so quickly, it’s important to recognize the warning signs and take proper action to protect and preserve the body.

 

Protect your parts

Because 64% of your skin consists of water, it’s important to protect it from freezing temperatures. The parts of the body most susceptible to frostbite include:   

  • Ears

  • Nose

  • Cheeks

  • Fingers

  • Toes

 

In the earliest stages of frostbite, your skin may feel cold and prickly and appear red. As the frostbite worsens, your skin may feel numb to the touch and initially appear white or blueish-white, followed by grayish-yellow. In extreme cases, the skin may feel hard and waxy and turn purple, brown, or even ashen. 

If you see or feel any of these signs, take these steps to warm your skin:

  • Move to a warmer place

  • Take off any wet or tight clothes

  • Take steps to warm the body including:

  • using your own body heat by placing cold and numb fingers under your arms in your armpits

  • placing affected body parts in warm water for no more than 30 minutes. Do NOT use hot water on frostbite, which can cause burns. When drying wet skin, pat it dry. Do NOT rub the skin dry.

 

When warming up affected areas, DO NOT USE DRY HEAT, like heating pads, fireplaces, or blow dryers, which can cause burns.

In addition, DO NOT RUB OR MASSAGE frost-bitten areas as this can increase skin damage/irritation.

 

WHEN TO SEEK EMERGENCY CARE

  • If the person exposed to cold is passing out, having trouble speaking, appears confused or clumsy, is not shivering, or displays difficulty or abnormal breathing. These could be signs of hypothermia, a life-threatening condition in addition to frostbite.

  • If the skin is hard, waxy, or has turned black.

  •  If you do not feel sensation returning to your body after trying warming efforts, or if the skin begins to turn gray.

 

To reduce your risk of frostbite, follow these steps whenever venturing out in the cold for extended periods of time:

  • Dress in layers: Begin with layers of light, loose moisture-wicking synthetic clothing.  Top that with an insulating layer of wool or fleece. And because wet skin is more at risk of frostbite than dry skin, wear a wind- and waterproof outer layer.

Protect your head and face with a wool or fleece hat that covers your ears and a wool or fleece scarf wrapped to mask your face. Choose insulated gloves, wool—not cotton—socks, and waterproof boots that reach above your ankles

  • Stay dry: Because wet skin is more susceptible to frostbite than dry skin, take precautions to keep snow out of your boots, mittens, and clothing. If you get wet, go inside immediately and remove wet clothing.

  • Stay hydrated: Be sure to drink plenty of water before, during, and after spending time out in the cold.

  • Stay alert: If you’re outside for stretches longer than 30 minutes, be sure to check yourself for signs of frostbite every 30 minutes. If you see or feel signs of frostbite, head indoors at once.

  • Stay sober: Drinking alcohol can cause the body to lose heat faster than normal. Save the alcoholic beverages for when you’ve safely returned indoors.

  • Minimize time outdoors: If you have a condition that causes poor circulation, such as diabetes, peripheral artery disease, and peripheral neuropathy, avoid extended exposure to cold temps and always dress appropriately to minimize your risk.

 

Lisa Moulton, FNP is a member of the care team at SVMC’s Deerfield Valley campus.

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Emergency Department: Open, Ready, Safe. 

The last 3 months have been a uniquely challenging experience in the SVMC Emergency Department (ED) and emergency departments and hospitals all over the country and the world. I am very proud of all our staff has done and continues to do to ensure safe care for patients during this era of COVID-19. We are grateful that cases of COVID-19 in our area have been the lowest in the U.S. and have decreased even further over the past several weeks. We are also heartened to see that patients who had been avoiding the ED are now confident to return to get the care they need.

It may be surprising to hear that over the past few months, the sickest patients we have seen in the ER have not had COVID-19. Many people have refrained from seeking care for serious medical problems due to the fear of being exposed to the virus, assuming that the hospital was not a safe place to be and not recognizing the seriousness of their symptoms. The most challenging moments of the past several months have involved critically ill patients who tried to stay away for far too long due to fear of being exposed to COVID-19. We have had many sad moments trying to care for those who waited until it was too late for us to help with conditions that could have been easily treated if presented sooner.

One might expect that the greatest challenges related to the pandemic were those needed to adapt our facilities and procedures and the work of caring for sick COVID-19 patients. SVMC is fortunate to have built a strong foundation of safety and infection-prevention methods over many years, which made this transition much easier. Still, when it became apparent that we were going to see COVID-19 cases coming through our doors, we implemented many COVID-specific changes very quickly.

From day one our staff have all been fully trained to use protective equipment effectively, to focus on cleaning and disinfecting, and to move patients safely through the new areas created to keep them safe. We also spaced the waiting room chairs to allow for plenty of distance and initiated drive-by testing to keep potentially contagious people outside and away from other patients.

We immediately increased our standard of protective equipment we use. For example, all staff who relate with patients now wear both a mask and protective shield, which is a proven and effective strategy to prevent transmission. Those staff who work with patients with respiratory or other contagious symptoms also wear a gown and advanced respirators developed in cooperation with Mack Molding in Arlington. They look strange, but they help us deliver care safely.

We also quickly built special spaces and units in the hospital to treat and segregate patients with respiratory symptoms who might be contagious from those with other routine medical problems. Outpatients with symptoms that could be related to COVID-19 are directed to a spacious area called the Respiratory Evaluation Center. There they can be taken to a safe treatment space called a negative-pressure room without encountering any patients who are using the ED for other reasons or any staff who are not fully equipped with protective gear. There are similar, safe, negative-pressure units for those who require treatment in the ED or hospital.

Our hard work paid off. We have treated a number of COVID-19 patients in our ED and, as far as we know, not a single staff member was sickened in relation to their work here, and no patients have contracted COVID-19 while under our care. With our current procedures and drastically declining COVID numbers, we are confident that we can continue that trend. Furthermore, SVMC recently received a perfect score on a rigorous survey specifically designed to judge our ability to prevent transmission of COVID-19. At this time our ED is safer than just about any other public place you could go.

My goal in writing today is to communicate that SVMC’s Emergency Department is open, ready, and safe. If you need emergency care, we are here and we can care for you safely. Please do not defer emergency care until it is too late for us to help. While many symptoms can represent a serious medical problem, the most concerning are chest pain, difficulty breathing, fast heart rate, confusion, high fever, intense headache, drooping face, dehydration, or weakness. Of course, with any other symptom you feel indicates a serious problem, come in right away or call 9-1-1.

For us, spending time with patients and connecting on a personal level is the best part of our jobs. We take pride in our life-saving role in our communities and the work we have been able to do during the pandemic, but we cannot help if you do not come in. Please don’t hesitate to get the care you need when you need it.

Adam Cohen, MD, is a board-certified emergency medicine physician at Southwestern Vermont Medical Center. He also serves as the chair of the Department of Emergency Medicine and the medical director of SVMC’s Emergency Department.

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