What is the first aid in case of frostbite?

In the course of the theme let us consider methods of the first aid in cases of frostbites

What is the first aid in case of frostbite?  

I.Pavlovsky, Vitebsk



At initial stage, first aid consists in stopping of cooling, warming of extremity, restoration of blood circulation in tissues affected by cold and prevention of infection. 

At first signs of frostbite the victim should be taken to the nearest warm premise, while chilled footwear, socks and gloves should be taken off. Cooled areas should be warmed by warm hands up to reddening, with the help of light massage, rubbing with woollen fabric, with the help of breath, and then it is necessary to apply cotton wool-gauze bandage. 

At signs of deep frostbite people should do not make fast warming, massage or rubbing. It is only necessary to apply heat-insulating bandage (gauze layer, thick layer of cotton wool, again gauze layer, and then on the top of it — oilcloth or rubberized fabric) on the affected area. The affected extremities are put in rest state by means of application of improvised means (small board, piece of veneer, dense cardboard), by putting and applying them over bandage. Quilted jackets, jerseys, woollen fabric and other means can be used as heat-insulating material. 

Victims should be given hot drink, hot food, some alcohol, aspirin tablet, analgin tablet, vasorelaxants (for example papaverine).

Simultaneously with carrying out of activities of first aid, it is necessary to call for a doctor, first aid for rendering of medical help and solving a question on hospitalisation to specialised medical institution. 

It is not recommended to rub an injured person with snow, as blood vessels of hands and feet are very fragile and consequently it is possible to damage them, while arising micro-scratches on the skin promote bringing in of the infection. It is impossible to use fast warming of freezed extremities near the fire, uncontrolledly to apply hot-water bottles and similar sources of warmth as they worsen course of frostbites. An unacceptable and inefficient variant of first aid — is embrocation of oils, fat, rubbing of tissues with spirit at deep frostbite. 

At general cooling of mild degree, one of effective methods is warming of the victim in warm bath at initial water temperature 24°С which is raised up to normal body temperature. 

At average and severe degree of general cooling with disturbance of respiration and blood circulation, treatment is carried out in conditions of resuscitation department.

It is possible to receive frostbite of face skin not only in extremely unpleasant situations, but also during such favourite winter entertainments as skating or skiing. During long stay in the cold the skin becomes dumb, then sensitivity decreases while pain eases. At the same time organism loses more warmth, than is capable to produce. People with cardiovascular diseases, fans of extreme winter sports and people of fashion in non- seasonal clothes are in risk group of frostbite of cheeks. Cheeks, chin and nose turn pale at frostbite, while after warming get crimson-dark blue colour. After painful sensations, edema appears on the skin. While some days later, bubbles with liquid are formed on frostbitten areas. Then the skin peels, after that regenerative process begins. Under influence of cold, capillaries and skin arteries get narrow and this breaks blood circulation. Thus, there is not enough blood flow for normal functioning of derma. These symptoms correspond to the first degree of frostbite. But in five days, or a week, the skin is completely restored.

Frostbite of face can be prevented, if in an hour before going outside to dub the skin with cream with natural oils, goose-grease or special ointment. It is also not recommended to take alcoholic drinks. Under influence of alcohol vessels extend, and the organism loses warmth faster, and alcohol also dulls sensitivity. Smoking narrows vessels, and it, in turn, accelerates skin cooling. Therefore people should not smoke in the cold in order not to break blood circulation. Certainly, it is very important to put on warm clothes. It is possible to cover the face with a collar or warm scarf. At long stay in the street check your cheeks, nose and chin on sensitivity.

By Tatiana Zhukova,
Doctor of higher category,
D.M. Ph.D.

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