What to do when frostbite fingers, feet, hands,cheek, ear, nose

Обновление: Октябрь 2018 If a вы в мороз находитесь на улице, и
suddenly you feel that some part of the body is very cold and bad
moving, or you are walking with a child who has turned red
cheeks, do not wait until you come home. It may be frostbite –
dangerous condition when a spasm occurs under the influence of cold
the vessels, and the tissues fed by them, suffer from nutritional deficiencies.
If a не предпринять срочных мер, пострадают сосуды более глубоких
tissues. And the more time passes in conditions of severe frost.
or mild cold and high humidity, the greater the likelihood
that changes in insufficiently warmed tissues cannot be
cure.

Obviously, the first steps you should start
perform still on the street, will be different with the defeat of the nose or
toes. There are also different actions taken when
frostbite in the first hour or later. Doctors say: sometimes scary
not so much cold burn as illiterately rendered first
help. We will talk about this.

When you need to suspect frostbite

If a вы вышли на улицу и чувствуете, что какая-то открытая или
poorly protected from the cold part of the body freezes or already hurts, it is not
always talking about frostbite. For this you need to temperature
air was below minus 10 ° C at low humidity or 0 ° C or
below – in combination with the wind more than 5 m / s and high humidity.
If a одежда человека не допускает нормального теплообмена и
prevents sweat, or too light, or soaked,
frostbite can develop even at + 8 ° C.

The entire face or parts of it may be exposed to frostbite: cheeks,
nose, ears. Doctors make the same diagnosis when exposed to cold
hands in insufficiently warm gloves or legs in light
or close, in itself, blood circulation disrupting shoes. If a
pain, numbness and feeling of coldness are felt throughout the body, this
It is called general hypothermia and is treated separately.

More chances of frostbite if:что делать при обморожении пальцев рук

  • человек пошел на улицу голодный (ел более 8 o’clock назад);
  • he is in the cold intoxicated
    (vessels are expanded – more heat is lost);
  • man has to stand still or hold for long
    (carry) some object in the cold;
  • a person suffers from diabetes or diseases
    which there is a violation of the general (heart failure,
    systemic vasculitis) or local (Raynaud’s syndrome, obliterating
    atherosclerosis or endarteritis, varicose veins)
    blood circulation;
  • he is physically exhausted (overworked or just suffered heavy
    disease);
  • he lost some blood;
  • is it a child, a pregnant woman (especially in 3 trimester) or
    old man.

These people need at the slightest unpleasant feelings in the area
face and limbs proceed to the algorithm described below.

The degree of frostbite (i.e. the depth to which the
cold exposure) can be assessed only in the warm
помещении, но не сразу, а в течение несколько o’clock.

Actions that must be performed on the street

The algorithm consists of several simple steps.

1. If a вы подозреваете у себя обморожение лица, срочно
start warming up while you go to the destination
located indoors:

  • wear a hood or hat if your ears are cold;
  • when frostbite nose or lift the collar of a sweater / jacket,
    to hide under his nose, or tie a scarf so that he
    covered his nose. Can закрыть руками в перчатках нос;
  • The previous item is suitable and in order to reduce the degree
    tissue damage during frostbite cheeks.

If a сильно мерзнут руки, засуньте их в собственные подмышечные
areas (as if hugging yourself). If a мерзнут ноги, начинайте
actively move your toes.

2. If a вы находитесь далеко от дома или места назначения,
go to the nearest entrance, shop, mall, pharmacy,
clinic, educational institution or other premises. Optimal
option: stay indoors for at least 10 minutes, have a drink there
hot tea or coffee. If a замерзли ноги, и по пути вы увидели
a store where you can buy an extra pair of socks,
be sure to do it: treatment for frostbite of the legs is more expensive
pairs even wool socks.

3. On the way to the room actively move: you can wave
with your hands (as when charging), clap your hands, run, or
walk, tapping (you can raise your legs high). It will help
strengthen the general circulation and reduce the degree of local
damage.

Never rub the frozen and reddened part.
body snow: so you can cause additional damage to tissues,
which at the moment suffered circulation.

What to do immediately upon arrival home

Frostbite – the process is not simultaneous. Low at first
temperature causes vasospasm, then reversibly disrupted
blood supply. If a холод продолжает действовать, в этих сосудах
blood clots occur and blood circulation can be completely stopped.
Dying tissue products enter the bloodstream and cause poisoning
organism.

Весь процесс обморожения условно делится  на 2 периода:

  1. скрытый: начинается еще на улице и
    some time after warming;
  2. реактивный (явный): проявляется только после
    warming for 6-12 hours.

By appearance of the frostbitten area in the reactive period
it will be clear what degree of cold burn you have. And for
In order to fabric:

  • warm up faster;
  • pathological changes did not spread deeper than that
    has already happened in the cold (it can happen to the underlying
    tissues when they are cooled by a large array of heavily chilled
    fabrics from above)
  • it became clear how serious it is,

need in a warm room to do the following:

  1. when frostbite hands or feet – start moving them for
    restoration of blood circulation;
  2. The second thing you need to do is remove the cold or drenched
    clothes;
  3. find an alcohol thermometer and start typing in a bowl or bowl
    warm water, ensuring that it is 26-28 ° C;
  4. at the same time put on a kettle with water or turn on
    electric kettle;
  5. with frostbite of the nose, ears, cheeks or cheekbones – while water is being collected
    – apply a warm palm to the affected area;
  6. when the water has gathered, lower the affected area into it:
    frostbite fingers, immerse in her hand for 10 minutes, the same
    do with your feet. If your ears, nose, or cheeks are cold, soak in
    clean cloth with water and apply to affected areas;
  7. the temperature of the water with which you warm the affected area,
    you need to gradually and very carefully increase: it should become 37
    degrees in 40 minutes;
  8. If there is no warm water, you can:
    • or wrap areas with foil, more shiny side
      inside;
    • or shake the frostbite in a thermal blanket;
    • or cover the affected department with a heating pad, previously
      checking that the temperature that she creates at the minimum
      division, does not exceed 30 ° C. Then, as in the case of water, you need
      will gradually increase the temperature;
    • d) as an option, you can immediately resort to paragraph 10, and after
      perform clause 9;
  9. at the same time as you warm the affected area, start drinking
    warm and sweet tea. If you froze your fingers, it is better to pour
    tea in a bowl to hold it with the palm of your hand, rather than bend your fingers;
  10. after warming, put on frostbite
    thermal bandage. It consists of 5 layers:

    • closer to the skin – gauze;
    • then – a large piece of cotton (especially when ear frostbite, cartilage
      whose blood supply is rather poor);
    • gauze again;
    • oilcloth or polyethylene;
    • wool fabric.

    If one or both ears are frostbite, fix with a bandage or
    шерстяной тканью проводится вокруг головы
    ;

  11. you can freeze, then throw in the heat, so wrap yourself in
    warm dry blanket and drink another cup of warm sweet tea.

What not to do when frostbite

  • warm the frostbitten area near the fire, touch them
    battery, thrust under hot water;
  • smear with fatty ointments (this should be done before going out, and
    not after the disaster happened);
  • if already soon after warming blisters appeared on the skin,
    they can not be opened. You can only apply a sterile dressing (if
    at home there is a sterile bandage or sterile wipes), after which
    consult a doctor;
  • rub with snow, ice and even mittens: so even more
    injured vessels of the affected area;
  • drink alcohol;
  • rub the frostbitten area with alcohol. If it is applied and
    rub gently, the heat will evaporate from the skin surface. If a
    rubbing frostbite with alcohol can damage the
    fragile vessels in this zone.

Actions that are important to perform in the next 6-12
o’clock

If a в течение часа обмороженный участок отогрелся, но кожа на
It acquired a bluish or red-purple shade and a little
swelled, and he began to hurt, do not be alarmed. This is the first degree.
frostbite. It can be treated at home. Accept pain
any anesthetic drug that is not allergic:
�Ibuprofen, Analgin, Diclofenac. This medicine can
take several times in the first day, but so that the maximum
dosage (it is specified in the instructions) has not been exceeded.

If a у вас наблюдаются описанные симптомы, еще не значит, что
the danger is completely over. We must continue to watch
subjected to frostbite plot. If a на 2 сутки на месте отека
появился 1 или несколько пузырей, это – 2 степень frostbite.
Bubbles can not be opened. Need advice from a combustiologist
(these are specialists working in burn wards of diversified
hospitals) or general surgeon polyclinic.

What to do after frostbite, if 2 hours have passed, and you do not
feel the affected area (it is as if numb), or the skin on
it remains white, you need to contact the surgeon clinic or
a burn center doctor. It can be 3 or even 4 degree
frostbite. They should be treated in the hospital: only there is
the ability to use drugs with the help of droppers, which:

  • can improve the blood supply to the affected area, thereby
    reducing the area of ​​damage;
  • will contribute to the dissolution of blood clots in the affected
    areas;
  • will warn suppuration frostbite tissue or reduce
    its severity.

Unfortunately, drugs that can do this qualitatively,
exist so far only in the form of injections or droppers. Besides, in
The hospital will be monitored 24 hours a day.
condition and your wound. If a окажется, что у вас 4 степень
frostbite, when the damage touched all layers of soft tissue,
Immediately measures will be taken to remove dead tissue and stop
spread of necrosis even deeper or further (for example, from fingers
on hand).

In the hospital, a person will also have blood drawn to determine
the degree of his immune defense against tetanus (the analysis is called “Blood
for antibodies to tetanus ”) and, without waiting for the test result
(especially if the ADS vaccination was performed more than 5 years ago or not
data on when such vaccination was carried out), he will be given
the desired tetanus drug. This will help avoid development.
tetanus – an infectious disease with high mortality, since
frostbite creates optimal conditions for the development of tetanus
bacteria in the wound.

Actions to be performed the next day

The next day it will be more clear what degree of frostbite
in person:

  • If a никаких пузырей так и не возникло – 1 степень. Amazed
    only skin.
  • When blistering or bluish-colored skin appears (or
    one bubble) filled with transparent contents, and the area itself
    very painful – 2 degree. Amazed кожа и частично – подкожная
    cellulose.
  • If a пораженный участок остается бледным и холодным,
    sensitivity on it is reduced or absent, and against this background
    bubbles appear filled with bloody contents – 3 degree.
    If a обморожены были пальцы рук или ног, на них отслаиваются ногти,
    which then do not grow back. Grade 3 speaks of skin lesions,
    subcutaneous tissue and muscle.
  • When the skin becomes bluish-marble or even black,
    edematous, does not feel touch or even needle pricking, but
    joints under such tissues do not perform movements (“do not obey”),
    это – 4 степень frostbite. All layers of muscles are already affected, and
    tendons and possibly bones.

Himself (or relative) help with frostbite can
render at home only during the first two stages. 3 and 4
stages that on the second day after frostbite you are exactly
determine are treated only in the hospital. Stay at home in these
dangerous cases: you can run gangrene, get tetanus or
blood poisoning; from a large number of decaying tissues,
which are absorbed into the bloodstream may develop acute renal
failure is not less fatal than
rest.

So what to do when frostbite fingers or other areas with
1-2 stages of frostbite:

  1. if pain is felt, take painkillers
    (“Diclofenac”, “Ibuprofen”, “Dexalgin” and others) without exceeding
    maximum permitted dosage. You need to drink these pills after
    food. If a вы страдаете гастритом или язвенной болезнью, обязателен
    taking Omeprazole (Omez), Nolpaz, Pantoprazole, or
    �”Ranitidine” on the background of taking painkillers;
  2. if nothing hurts, but you measure the temperature, and it turned out
    that it is above 38 ° C, drink Paracetamol. If a вы уже пьете
    painkiller, it will reduce the temperature, and the reception at once of two similar
    drugs increases their toxic effects on the kidneys, mucous membranes
    the gastrointestinal tract;
  3. to accelerate the recovery of normal blood flow in
    Take a no-shpu (Drotaverin) area or
    �”Papaverine”. They will expand the vessels that will provide better nutrition.
    in diseased areas;
  4. in parallel with the reception “No-shpy” or “Papaverina” will need
    a few days to use drugs that will destroy
    thrombus formed in the frostbite. This is Lioton ointment,
    �Hepatrombin Heparin Gel If a вы не принимаете ни
    painkillers, or antipyretic (this is one group of drugs), for
    prevention of blood clots can be applied “Aspirin” in a dose of
    75 or 100 mg once a day after meals;
  5. with itching, antihistamines are needed: “Fenistil”, “Erius”,
    �”Diazolin”;
  6. to speed up the process of passing a pulse from nerve to muscle in
    damaged areas, you need B vitamins: “Neurorubin”,
    �Milgamma, Neurovitan. Nicotinic acid is also used.
    in the form of tablets.

All drugs have contraindications, so before their
consult with your doctor.

Local treatment is also necessary. So, to speed healing
with 1 degree of frostbite, treat the areas with Bepanten cream
(“Dexpanthenol”), and when going outside or if necessary
wash frostbitten hands, in an hour, apply emoment on them:
�”Physiogel”, “Mustella stelatopia” or any other drug. If a
you treat frostbite 2 degrees, treat the bubbles with an antiseptic
without alcohol (“Chlorhexidine”, “Miramistin”, a weak solution
potassium permanganate) or with alcohol (solution of brilliant green or
fukortsina). Apply Levomekol ointment around them. When the bubble itself
open up, you can handle the entire affected surface
�”Levomekolem.”

Be sure to perform a light massage. affected area. Can
это делать в то время, как вы наносите крем или мазь.
Massage movements bypass the zone of opened bubbles; they can
perform with chopsticks wrapped in sterile cotton.

Actions to be completed in a week

Recovery at 1 degree of frostbite occurs within
5-7 days, without scar formation, but passing through the stage
peeling. All this time you:

  • taking B vitamins and xanthinol nicotinate preparations
    (if approved by the doctor);
  • if there are no contraindications, take 5-7 days “Aspirin”;
  • Lubricate the affected skin with “Bepanten” (if the hands are strongly
    dry and flaky, you can already apply not a cream, but a more fat
    ointment “Bepanten”;
  • treat itching with antihistamines;
  • massage the affected areas.

If a обморожение достигло 2 степени, когда восстановление длится
about 2 weeks, the treatment is:

  • taking painkillers with a gradual decrease
    dosage;
  • local processing “Levomekol”;
  • taking vitamins of group B;
  • if itching is strong, you can not only take an antihistamine
    means, but also applied to itchy areas (if it is not an area under
    opened bubble) “Fenistil-gel” or “Psilo-balm”. If a это
    does not help, consult a surgeon who can recommend
    local hormonal drug;
  • need a massage of the affected area, bypassing the wounds formed
    after opening the bubbles.

At grade 3, the wound will heal for more than a month, most
from which you have to spend either in the hospital or in the daytime
a hospital with daily examinations by a combustiologist or surgeon.
The treatment will be carried out with the help of injections and droppers, as well as
professional treatment of wounds with special solutions. After
healing scars are formed which can be subsequently treated
�”Kontraktubeksom” or other recommended drugs.

Frostbite 4 degrees necessarily treated in the hospital, where
necessary, either amputation or only removal
dead tissue without removing the underlying bone. Treatment takes
more than a month only in the hospital. How to be treated later, the doctor will say
depending on the situation and related
diseases.

Note: the frostbitten areas will need much more.
more carefully protect from exposure to both high and low
temperatures over the coming year to achieve full
tissue healing.

When to see a doctor

This should be done as soon as possible in such situations:

  1. warm lips have a bluish tint;
  2. an elderly person or child was injured;
  3. victim fainted;
  4. breathing becomes heavy or extremely weak;
  5. human body temperature – or below 34 ° C or above 38 ° C;
  6. heartbeat more than 100 per minute or less than 60 per minute;
  7. the consciousness of the victim is confused, he expresses delusional
    ideas;
  8. 2 hours after full warming the frostbitten area
    remains cold and insensitive, or has already appeared on it
    blisters filled with blood;
  9. nausea or vomiting developed;
  10. convulsions appeared;
  11. decreased amount of urine despite the fact that you drink 30
    ml / kg / day;
  12. frostbitten area is larger than area of ​​one’s own palm (1
    palm = 1% of the body surface).

Folk treatment of frostbite

Can применять эти рецепты:

  • from 2 days – with 1 degree of frostbite, from 7 days – with 2
    degree. Для 3 and 4 степени рецепты не подходят;
  • after consulting a doctor;
  • if there is no allergy to prescription ingredients;
  • if the victim is not a child or a pregnant woman.

Recipes for external use:

  1. Rub rose oil into affected areas.
  2. Make a tincture of calendula: 1 tsp. herbs pour 500 ml of boiling water,
    insist 45 minutes, strain. Dip in this infusion sterile
    gauze, put on frostbitten surface for half an hour, 1-2 times
    in a day.
  3. Втирать сок лимона дважды in a day.
  4. Rub the onion juice into the affected area for 15 minutes.
  5. Apply to frostbite or aloe vera cream, or
    gruel made from aloe leaf, peeled and
    needles.
  6. Lotions of potato juice. Squeezed from the potato
    the juice is soaked with a cotton pad or gauze cloth. They are covered
    dry cloth and fix on the affected area with a minimum patch
    for 2 hours.
  7. Pumpkin mask. To do this, grate a raw pumpkin on a fine grater
    and apply the resulting gruel on the frostbitten area.

Can принимать внутрь (посоветовавшись с врачом):

  • Infusion of chamomile flowers. 1 st. Spoon pour 500 ml of boiling water,
    Insist 45 minutes, then you can strain and take 1 tbsp.
    трижды in a day.
  • A decoction of viburnum. Take 15 grams of berries, pour 500 ml of boiling water,
    cook for 15 minutes in a water bath, insist for another 45 minutes, and you can
    strain and take. 500 ml of broth to drink per day.
  • Sedation is provided by motherwort tincture or
    valerian. It is better to buy them at the pharmacy and take according to
    instructions.

Автор: Кривега Мария Салаватовна врач-реаниматолог

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