Frostbite
Basics
Description
Description
- Tissue damage caused by cold temperature exposure
- Mechanism:
- Tissue damage results from:
- Direct cell damage: Intracellular ice crystal formation
- Indirect cell damage: Extracellular ice crystal formation leads to intracellular dehydration and enzymatic disruption
- Reperfusion injury: Occurs upon rewarming. Fluid rich in inflammatory mediators (prostaglandin and thromboxane) extravasates through damaged endothelium promoting vasoconstriction and platelet aggregation
- Clear blisters from extracellular exudation of fluid
- Hemorrhagic blisters occur when deeper subdermal vessels are disrupted, indicating more severe tissue injury
- The end result is arterial thrombosis, ischemia, and ultimately, necrosis
- Devitalized tissue demarcates as the injury evolves over weeks to months, hence the phrase “frostbite in January, amputate in July”
- Tissue damage results from:
Etiology
Etiology
- Cold exposure: Duration of exposure, wind chill, humidity, and wet skin and clothing all increase the likelihood of frostbite
- Predisposing factors:
- Extremes of age
- Altered mental status (intoxication or psychiatric illness)
- Poor circulatory status
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Citation
Schaider, Jeffrey J., et al., editors. "Frostbite." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307579/1.1/Frostbite.
Frostbite. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307579/1.1/Frostbite. Accessed November 5, 2024.
Frostbite. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307579/1.1/Frostbite
Frostbite [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 November 05]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307579/1.1/Frostbite.
* Article titles in AMA citation format should be in sentence-case
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T1 - Frostbite
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ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307579/1.1/Frostbite
PB - Lippincott Williams & Wilkins
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DB - Emergency Central
DP - Unbound Medicine
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