Frostbite is damage to any part of the body (up to necrosis) due to low temperatures. Most often, frostbite occurs in the cold winter season at ambient temperatures below -10°C to -20°C. With prolonged exposure outdoors, especially in high humidity and strong winds, frostbite can be sustained in autumn and spring at air temperatures above zero. Factors leading to frostbite in the cold include tight and damp clothing and footwear, physical overexertion, hunger, forced prolonged immobility and uncomfortable posture, previous cold injury, weakened body condition due to illnesses, sweaty feet, chronic diseases of the lower limb blood vessels and cardiovascular system, severe mechanical injuries with blood loss, smoking, etc. Statistics show that almost all severe frostbites leading to limb amputation occurred while in a state of severe alcohol intoxication.
First Aid for Frostbite
The actions taken when providing first aid differ depending on the degree of frostbite, the presence of general hypothermia, age, and concomitant diseases. First aid consists of stopping the cooling, warming the affected limb, restoring blood circulation in the cold-affected tissues, and preventing infection. The first thing to do when signs of frostbite appear is to take the victim to the nearest warm room, remove frozen footwear, socks, and gloves. Simultaneously with carrying out first aid measures, it is necessary to urgently call a doctor or an ambulance to provide medical assistance. In case of frostbite of degree I, the cooled areas should be warmed to redness with warm hands, light massage, rubbing with a woolen cloth, and breathing, and then a cotton-gauze bandage should be applied. In case of frostbite of degrees II-IV, rapid warming, massage, or rubbing should not be performed. Apply a thermal insulating bandage to the affected area (a layer of gauze, a thick layer of cotton wool, another layer of gauze, and a layer of oilcloth or rubberized fabric on top). Immobilize the affected limbs using improvised means (a small board, a piece of plywood, thick cardboard), applying and bandaging them over the bandage. Wadded jackets, padded jackets, woolen cloth, etc., can be used as thermal insulating material. Victims are given hot drinks, hot food, and a small amount of alcohol. It is not recommended to rub patients with snow, as the blood vessels of the hands and feet are very fragile, and therefore their damage is possible, and the resulting microcracks on the skin contribute to the introduction of infection. It is forbidden to use rapid warming of frostbitten limbs by a fire, to uncontrollably use heating pads and similar heat sources, as this worsens the course of frostbite. An unacceptable and ineffective method of first aid for deep frostbite is rubbing oils, fats, or tissues with alcohol. In case of mild general hypothermia, warming the victim in a warm bath with an initial water temperature of 24°C, which is gradually increased to normal body temperature, is an effective method. In case of moderate and severe general hypothermia with impaired respiration and circulation, the victim must be taken to the hospital as soon as possible.
Prevention of hypothermia and frostbite
There are several simple rules that will help you avoid hypothermia and frostbite in severe frost: Do not drink alcohol – alcohol intoxication actually causes significant heat loss, while creating an illusion of warmth. An additional factor is the inability to concentrate on the signs of frostbite. Do not smoke in the frost – smoking reduces peripheral blood circulation, thus making extremities more vulnerable. Wear loose clothing – this promotes normal blood circulation. Dress like an "onion", as there are always air pockets between layers of clothing that retain heat excellently. Outerwear must be waterproof. Tight shoes, lack of insoles, and damp dirty socks often serve as the main prerequisite for chafing and frostbite. Special attention should be paid to footwear by those who sweat a lot. Warm insoles should be placed in boots, and wool socks should be worn instead of cotton ones – they absorb moisture, leaving feet dry. Do not go out into the frost without mittens, a hat, and a scarf. The best option is mittens made of water-repellent and windproof fabric with fur inside. Gloves made of natural materials, although comfortable, do not protect from frost. Cheeks and chin can be protected with a scarf. In windy cold weather, before going outside, lubricate exposed areas of the body with a special cream. Do not wear metal (including gold, silver) jewelry such as rings, earrings, etc. in the frost. Firstly, metal cools down much faster than the body to low temperatures, which can lead to "sticking" to the skin with pain and cold injuries. Secondly, rings on fingers impede normal blood circulation. In general, avoid contact of bare skin with metal in the frost. Use a friend's help – monitor your friend's face, especially ears, nose, and cheeks, for any noticeable changes in colour, and they will monitor yours. Do not allow a frostbitten area to freeze again – this will cause much more significant skin damage. Do not remove shoes from frostbitten extremities in the frost – they will swell, and you will not be able to put the shoes back on. It is necessary to reach a warm room as soon as possible. If your hands are cold, try to warm them under your armpits. After returning home after a long walk in the frost, be sure to check for frostbite of extremities, back, ears, nose, etc. Untreated frostbite can lead to gangrene and subsequent loss of extremities.i. As soon as you feel hypothermia or frostbite of the extremities during a walk, you should go into any warm place as soon as possible – a shop, a cafe, an entrance hall – to warm up and inspect areas potentially vulnerable to frostbite. If your car breaks down far from a populated area or in an unfamiliar place, it is better to stay in the car, call for help by phone, or wait for another car to pass by. Hide from the wind – the likelihood of frostbite in the wind is significantly higher. Do not wet your skin – water conducts heat much better than air. Do not go out into the frost with wet hair after a shower. Wet clothes and shoes (for example, if a person falls into water) must be removed, water wiped off, if possible, dry clothes put on, and the person taken to warmth as quickly as possible. In the forest, you need to light a fire, undress and dry your clothes, while actively doing physical exercises and warming yourself by the fire. It can be useful to take a pair of spare socks, mittens, and a thermos with hot tea on a long walk in the frost. You should eat before going out into the frost – you may need energy. It should be taken into account that children's thermoregulation is not yet fully developed, and in the elderly and with certain diseases, this function may be impaired. These categories are more susceptible to hypothermia and frostbite, and this should be taken into account when planning a walk. When letting a child walk outside in the frost, remember that it is advisable for them to return to warmth and warm up every 15-20 minutes. Finally, remember that the best way to get out of an unpleasant situation is to avoid getting into it. If you do not like extreme sensations, try not to leave the house in severe frost without a special need.