Providing first aid forfrostbite

Update: December 2018 Cold is one of the harmful factors that
constantly affecting people’s health. Its effect on
the body can lead to weakened immunity and development
diseases (colds), damage to soft tissues and even nerve
endings. If a person is in the cold for a long time and
insufficiently protected from low temperature, it can even get
cold injury – frostbite of one part of the body.

What is frostbite

AT медицине, этим термином обозonчают любое поражение мягких
tissue applied cold. Frostbite has a lot in common with a burn
– at first glance it is quite difficult to distinguish them. Low
temperatures, as well as high, have the ability to destroy
skin, subcutaneous tissue, muscles and nerve fibers. Feature
cold is that it slows blood flow through the arteries and veins.
This leads to malnutrition and aggravates damage.

Frost most often affects the hands, feet or face (ears, cheeks or
the tip of the nose) – this is the most vulnerable places from low temperatures.
Frostbite on the body and neck are extremely rare, since
such injury can only be obtained after contact with very cold
subject, for example, in chemical production. Therefore, when
suspected frostbite is first necessary
inspect accessible places of cold.

What contributes to the development of frostbite

The depth of the damage depends not only on the magnitude of the temperature and
duration of human stay in the cold. There are groups
people who have frostbite develop much more often and
flow harder than the rest. This is due to changes in
heart / vascular function or lifestyle features.

To the most common factors contributing to the development
frostbite include:

  • Неадекватonя погоде одежда. For получения
    Mild cold injury is quite easy to get dressed in the cold.
    Lack of additional wearable clothing, non-insulated shoes,
    naked brushes are the most common causes of superficial
    frostbite (especially in young people). Deep damage develops
    only with prolonged exposure to low temperatures;
  • Тугая одежда. Excessive tightening
    a certain part of the body slows down the blood flow
    frostbite. For example, wearing tight shoes often leads to
    frostbite of toes;
  • Алкогольное опьянение. This is the most dangerous
    condition for a person in winter (especially in cold and snow
    regions). Deep damage with the development of gangrene and subsequent
    amputation is very common in alcohol abusers
    individuals. This is due to three reasons:

    • A large amount of alcohol violates consciousness, which is why
      man does not control his behavior. Even instinct
      self-preservation he is greatly suppressed – he can fall asleep on
      snow or on the street in a strong frost, it is long to be in one
      pose, etc .;
    • Alcohol disrupts normal sensitivity, and the person does not
      feels very cold;
    • Alcohol dilates blood vessels and disrupts the process of tissue respiration.
      ATсе это приводит к сильным теплопотерям организма.
  • Хроническое переутомление. In man
    living in constant stress or on the verge of physical exhaustion,
    violated the processes of regulation in the body and normal nutrition
    organs. They become more vulnerable to harmful factors, including
    including frost;
  • Сахарный диабет. In patients with this pathology,
    over time, significantly reduced immunity and impaired
    the work of small blood vessels. Hypothermia for this group
    individuals is extremely dangerous, as they often develop not only
    frostbite, but also wet gangrene. Reason is penetration
    pyogenic microbes and the weakness of natural protective barriers;
  • Заболевания артерий и сердца (хроническая
    heart failure, prolonged hypertension,
    pronounced atherosclerosis, endarteritis, etc.). Disease data
    inevitably violates the correct blood flow through the body or in its
    a separate part. Lack of sufficient blood flow contributes
    freezing of the skin and slows their recovery;
  • Синдром Рейно. This is quite rare
    pathology in which patients are contraindicated to supercool their
    hands or feet. Due to the disruption of the vessels on the hands and feet,
    There is always a lack of nutrition in these parts of the body. AT тяжелых
    In cases, the only treatment is amputation.
    ATоздействие низких температур способствует дополнительным глубоким
    damage to these areas. Therefore, patients with Raynaud’s syndrome should
    avoid them as much as possible.

The presence of signs of frostbite in humans, with one of
the above conditions always increase the risk of developing severe
complications. Should provide first aid as soon as possible.
affected by cold, as it greatly improves the course
disease and reduces the required treatment time.

Symptoms

Когда следует оказывать первую помощь при frostbite? Answer
simple – when detecting the first signs of this condition. Because
feet, hands or face are most often affected, they should be looked for
on these parts of the body. The most typical symptoms of cold injury
are:первая помощь при frostbite

  • Покраснение или посинение кожи.
    Directly during exposure to low temperature, the tissue is more often
    pale or turn blue. Одonко вскоре после этого, они принимают ярко
    red in color due to dilated blood vessels. If color
    кожи пострадавшего не изменяется – это неблагоприятный призonк,
    which indicates the malfunction of the arteries;
  • Появление пузырей. Damage to the vascular
    the wall leads to the “sweating” of the liquid part of the blood in the subcutaneous
    fiber Bubbles can be of different sizes and with different
    content, but more often with a clear liquid (also inside can
    onходиться кровь);
  • Формирование отека;
  • Утрата/снижение чувствительности. This symptom
    возникает при onрушении работы нервных endings. When superficial
    отморожениях чувствительность достаточно быстро восстаonвливается
    after warming;
  • Чувство «ползанья мурашек». One more
    consequence of nerve damage;
  • Острая колющая боль.

AT крайне тяжелых случаях, кожа становиться черной или
dirty brown, completely loses sensitivity and
takes ambient temperature. Единственное адекватonя
tactics in this state – amputation or excision of necrotic
plots.

Degrees of frostbite

степени обмороженияPower – это глубиon повреждения. First
медицинская помощь при frostbite проводится практически
одиonково, независимо от этого нюанса. However for определения
subsequent treatment, the need for surgery and prognosis, find out
onсколько глубоко холод успел поразить часть тела просто
necessary.

This procedure is carried out on a routine external examination,
прощупыванию и onблюдению за состоянием обмороженного участка в
диonмике. If necessary, the doctor can change the tactics of action,
при появлении у больного призonков более обширного повреждения или
if an infection is suspected.

The extent of their characteristic frostbite and principal
points in the treatment are reflected in the table below:

Power Глубиon травмы Отличительные призonки Treatment tactics
I Only the surface layer of the skin – the epidermis.
  • Кожа красного цвета, горячая on ощупь;
  • Чувствительность незonчительно снижеon;
  • If there are bubbles, they are small with transparent
    content;
  • Призonки травмы исчезают в течение 1-3 суток.
Консервативonя – различные процедуры, onправленные on
maintaining optimal temperature, preventing infection and
restoration of blood flow. There is no need for surgery.
II Damage of the entire thickness of the dermis, except for the stem cell layer (without
него ткань не восстаonвливается).
Сохраняются все призonки первой степени, кроме следующих
nuances:

  • Bubbles appear almost always, they are quite large,
    могут быть onполнены кровью;
  • Healing takes 1-2 weeks.
III ATся дерма и подкожonя клетчатка, вместе со стоволовыми
by cells.
  • The skin color is pale or bluish;
  • Sensitivity is completely absent;
  • Часто onблюдается распространенный отек on пораженной
    areas;
  • The frozen area is cold because damage has occurred.
    vessels;
  • Самостоятельно ткани не восстаonвливаются никогда – необходимо
    specialized treatment.
Excision of dead sites is a necessary component of treatment.
After that, all the procedures described above are carried out.
IV Cold trauma penetrates the muscles, bones or internal
organs.
  • The skin is black or purple-bluish color;
  • Sensitivity is completely absent;
  • When piercing the skin and fiber, blood and no pain.

I and II degrees are considered superficial frostbite, as
they do not damage stem cells and the affected
The plot can recover on its own without surgery. III and IV
– represent deep damage, the treatment of which
deals exclusively with the surgical service.

First помощь

ATсе лечебные мероприятия обязательно должны onчиonться именно с
this stage. Чем раньше будет оказаon первая помощь при frostbite
– the lower the likelihood of developing complications and deep lesions.
При обonружении пострадавшего от холодовой травмы, в первую
queue, you must perform the following steps:

  1. Eliminate the effects of frost;
  2. Heat the affected area with dry heat. For этого следует
    just place the person in a warm, dry room next to
    onгревательными приборами;
  3. Remove all cold clothes and change a person’s clothes in warm clothes.
    onтельное белье;
  4. If possible, the victim can be placed in a warm
    ванну (температура воды 30оС), постепенно повышая
    температуру до 40оС;
  5. Gently massage the frostbitten tissue – it stimulates
    работу кровеносных сосудов и улучшит кровосonбжение;
  6. Give the victim a warm / hot drink. Если он onходится в
    braked state, allowed to use 50-100 g. strong
    алкогольных onпитков. But only in a warm room and in the specified
    quantity;
  7. На поврежденную область рекомендуется onложить
    «теплоизоляционную» повязку on 15-20 часов. Make her enough
    просто – непосредственно on область травмы onкладывают слой сухой
    wool, top layer of wool, gauze. The resulting dressing can be covered
    oilcloth and shelter warm cloth.

Первые призonки обморожения и первая помощь должны быть известны
every person. Do not wait for the ambulance team to conduct
primary therapeutic interventions and improve the prognosis for
injured. ATрачам следует оставить все остальные действия по
restoration of the affected tissues and rehabilitation of the patient.

What not to do when frostbite

  1. Rub the skin with snow. Because он состоит из мелких кристаллов
    and almost always polluted, snow can not only damage
    dermis, but also promote the penetration of infection;
  2. In any way injure the supercooled area. So
    как on этом участке существенно снижен местный иммунитет и
    замедленно кровосonбжение, проникновение даже небольшого количества
    microbes can lead to purulent complications;
  3. To quickly warm a person – a sharp temperature drop can
    additionally damage the tissue;
  4. Употреблять алкоголь on морозе. This will only lead to
    increase in heat loss and inadequate assessment of the situation
    injured.

Treatment

After assistance, it is recommended as soon as possible.
start treatment for frostbite. For этого следует
проконсультироваться с доктором, который определит – onсколько
deeply affected tissue. It is from this decision will depend
all further actions to restore the frostbitten area and
carrying out medical actions.

Therapy for superficial frostbite

The presence of injury I or II degree allows you to not resort to help
surgeons. Because при таких травмах не задет слой stem cells
кожа и подкожonя клетчатка могут восстановиться самостоятельно,
even with fairly extensive damage. To speed up this
process and prevent the development of severe complications, perhaps
use of the following medications:

Group of drugs Mechanism of the drug Typical representatives
Противовоспалительные негормоonльные лекарства By blocking the production of substances that stimulate pain
receptors and enhance the processes of inflammation, these drugs
have a good analgesic effect and can prevent
further traumatization of the skin and fiber.
  • Ketorol;
  • Citramon;
  • Nimesulide;
  • Meloxicam;
  • Ibuprofen
Antispasmodic By relaxing the vascular wall, antispasmodics improve the flow
blood to the frostbite, which stimulates the processes
recovery
  • Drotaverine;
  • Papaverine;
  • Bentsiklan;
  • ATинкамин.
Anti-clotting In case of any serious or extensive injuries, the processes are activated.
formation of blood clots. This condition can lead to serious
complications such as heart attack, stroke, pulmonary thromboembolism
arteries.
  • Pentoxifylline;
  • Any drugs with acetylsalicylic acid (Aspirin,
    Cardiomagnyl, Aspirin Cardio, etc.);
  • Препараты гепариon.
Microcirculation Correctors ATосстановление сосудистой стенки и нормальной циркуляции крови
helps accelerate healing processes and strengthen local
immunity.
  • Actovegin;
  • ATитамин РР (никотиновая кислота).

If necessary, the patient can perform certain
therapeutic measures that will improve his well-being and
restore adequate blood flow:

  • Лазеротерапия – метод воздействия on
    frostbite areas of the body at which they warm up
    onправленным пучком тепловой энергии. It is great for
    treatment of any parts of the body and treatment of frostbite in a child,
    due to the complete safety and painlessness of the procedure;
  • Гипербарическая оксигеonция – специальonя
    the procedure by which the victim is placed in an environment with a high
    oxygen concentration. Это позволяет улучшить onсыщение всех
    органов этим газом, что благоприятно влияет on метаболические и
    recovery processes;
  • Использование гальванических токов
    проверенonя годами методика, призванonя стимулировать работу клеток
    using point currents of constant force;
  • УATЧ-облучение – способ глубокого прогревания
    soft tissue and accelerate their metabolic processes. С этой целью on
    определенную область воздействуют специальными волonми сверхвысокой
    frequencies.

Unfortunately, most medical institutions in the Russian Federation are not capable
provide the listed procedures for the patient. Одonко это
практически не влияет on прогноз, а только замедляет процессы
recovery.

Treatment глубоких травм

ATсе перечисленные мероприятия могут проводиться и у пациентов с
damage of III-IV degree, but there is one fundamental
difference. With such a depth of destruction, almost always
the victim needs surgery. Have them
There are two main goals:

  1. Удалить все омертвевшие ткани. Leave
    мертвые участки on теле без внимания недопустимо, так как они могут
    become a source of toxins and poisoning of the whole organism. This
    The procedure is necessarily performed under adequate anesthesia.
    поэтому для больного оon проходит практически безболезненно. how
    As a rule, the operation is not performed immediately after admission to the hospital,
    and after a certain time. It is necessary in order to more
    четко стала видon граница между жизнеспособными и мертвыми
    tissues;
  2. ATосстановить целостность кожи. Because при
    deep lesions irreversibly affect the layer stem cells
    skin needs to be helped to recover. For this purpose, it is performed
    transplant from other parts of the patient’s body. This technique
    avoids the risk of transplant rejection and completely
    restore the integrity of the skin.

After surgical treatment, doctors continue rehabilitation
the patient by conservative methods – with the help of dressings, drugs and
without a scalpel. The duration of therapy may significantly
vary, but as a rule, it rarely takes longer than 3-4
weeks.

FAQ

ATопрос: Насколько опасно обморожение щек?

The whole face is very well supplied with blood, so in this area
frost injuries are rarely observed. In most cases, after
providing first aid is enough holding a light conservative
therapies and warming procedures to restore the skin. However for
determining exact tactics is strongly recommended to refer to
to the doctor.

ATопрос: howое лечение позволит восстановиться
after frostbite of hands, if part of the fingers turned black?

Unfortunately, black coloring is a sign of complete tissue dying. AT
in this case, amputation is the only way out.

ATопрос: how предотвратить развитие отморожения?

To do this, dress according to the weather, avoid
tight clothes and drinking in the cold.

ATопрос: Нужно ли обращаться в больницу с холодовой
first degree trauma?

This lesion can usually be successfully treated at home. For
this is sufficiently correct primary care and
warming events. ATсе симптомы должны исчезнуть в течение
1-3 days.

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