Stages of Frostbite

Frostbite, also known by its medical term of ‘congelatio’, is a condition in which localised damage occurs on the skin and other tissue caused by the cold – usually around the extremities – as a result of extreme cold. This is most likely to occur in areas furthest from the heart where not as much blood will circulate and in extreme cases can require amputation. The earlier stages of frostbite are sometimes known colloquially a ‘frost nip’. There are a number of different forms of frostbite and similar conditions:

Frost nip – This is a superficial cooling of tissues that causes no cellular degeneration.

Chilblains – Chilblains are superficial ulcers that occur on the skin of affected individuals. This will occur in individuals who have a predisposition and who are regularly exposed to the cod.

Frostbite – This is a non-superficial cooling of tissue that is sufficient that it causes tissue damage and kills cells.

Hypothermia – Hypothermia is a point at which the internal body temperature falls below 35C.

Trench foot – This is caused by the individual repeatedly exposing their feet to cold (non-freezing) water.

Stages of Frostbite

The stages of frostbite are in fact progressive and there are several terms referring to different ‘levels’ of frostbite.

First degree – This is frost nip and simply freezes the surface level of skin. The skin will turn white and yellow and will cause itching and some pain. It may alternatively become numb.

Second degree – At this point if freezing continues the skin may completely freeze and harden. The deep tissues will still remain unaffected. This will normally blister around 2 days after thawing. This normally results in full recovery, but might on occasion result in permanent lack of sensitivity to hot and cold in those areas.

Third and Fourth degree – At this degree the frostbite will freeze more deeply and start to affect muscles, tendons, blood vessels and nerves. At this point the skin will feel hard and waxy and you will lose use of the area temporarily and depending on the severity and duration – permanently. Deep frostbite will cause the area to develop purple or black blisters and this will often result in nerve and cell damage. Often the extremities will require amputation if it leads to an infection of gangrene, or might even fall off on their own.

The best treatment in any case is to warm and potentially thaw the affected area. Thawing will be advisable in severe cases, but only once the individual is in a stable and warm environment. Warming can be done by simply exposing the area to a warmer temperature by keeping it in a room or sunning (passive warming), or by shaking and rubbing the area (active warming).

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