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Frostbite

Jeffrey D. Kueter, MD, FAAFP Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A severe localized injury due to cold exposure, causing tissue to freeze, resulting in direct cellular injury and progressive dermal ischemia (most commonly of exposed hands, feet, f...

DIAGNOSIS

HISTORY

  • Significant cold exposure—determine length and severity.

  • Throbbing pain

  • Paresthesias

  • Numbness

  • Loss of coordination and dexterity

PHYSICAL EXAM

  • Hands, feet, face, and ears are most commonly ...

TREATMENT

GENERAL MEASURES

  • Correct hypothermia.

  • Assess for additional injuries.

  • Remove jewelry from affected extremities.

  • Initiate rewarming of affected body part only if there is no risk of refreezing.

  • Wa...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Protect injured body parts.

  • Continue physical therapy.

  • Avoid smoking.

  • Avoid recurrent cold exposure.

  • Ensure properly fitting clothing and footwear.

Patient Monitoring

  • F...

REFERENCES

1
1 Cauchy E, Chetaille E, Marchand V, et al. Retrospective study of 70 cases of severe frostbite lesions: a proposed new classification scheme. Wilderness Environ Med.  2001;12(4):248–...

ADDITIONAL READING

  • Handford C, Thomas O, Imray C. Frostbite. Emerg Med Clin North Am.  2017;35(2):281–299. {L-End} {L-End} [View Abstract on OvidMedline]

  • Imray C, Grieve A, Dhillon S; for Caudw...

SEE ALSO

  • Hypothermia

  • Algorithm: Hypothermia

CODES

ICD10

  • T33.90XA Superficial frostbite of unspecified sites, init encntr

  • T34.90XA Frostbite with tissue necrosis of unsp sites, init encntr

  • T33.829A Superficial frostbite of unspecified foot, initial...

CLINICAL PEARLS

  • Frostbite is a tetanus-prone injury. Provide appropriate tetanus prophylaxis.

  • Avoid rewarming en route to the hospital if there is a chance of refreezing; rewarm only with water.

  • Assess ...

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