Prolonged exposure to cold may cause frostbite. Frostbite is the result of skin and flesh tissue is cooled below its freezing level. Most common in the lower extremities including the toes. Also, susceptible are the ears, nose, face and knees. Consider that exposed or covered areas that are in direct contact or exposed to cold are likely to exhibit frostbite. Because circulation to extremities is often shunted when exposed to cold, these areas are most susceptible.
There are four degrees of frostbite: 1st. degree: swelling, redness, numbness.
2nd. degree: vesiculation (puffing, swelling, formation of a small vesicle, bladder)of the skin
3rd. degree: entire thickness of the skin and may extend into subcutaneous tissue.
4th. degree: Skin and subcutaneous tissue involved all the way to and including bone.
Loss of sensation in the effected area is typically exhibited during and after the injury, perhaps for years.
Therapy:
GOAL: Reduce, prevent and decrease tissue loss, discomfort and long term effects.
If possible place effected body part in a water bath. Water temperature should be between 104-110 degrees F. Submerge part and stimulate circulation gently and manually with your hand. Make certain body part is completely submerged in a large enough container to provide a constant or at least a gradual loss of temperature. Add hot water to maintain temperature. If you don't have a thermometer 110 degrees is about as warm as your hand can stand without discomfort. If the water is too uncomfortable, burning you, lower the temperature slightly.
When maintaining the water temperature do not pour hot water over the wound, add it to the side of the container.
Administer warm water to the victim to help move core temperature to extremities.
Should there be skin tissue damage protect the wounded area with sterile gauze, gloves or the like. For example, you could make a sheet cradle from a clean sheet to isolate a foot or knee. Surgical gloves can be worn on the hands to prevent infection and provide protection.
Deep 2nd to 4th degree frost bite requires expeditious evacuation. Remove victim to professional medical care as soon as possible.