home Consultations What to do if your fingers are frozen. First mandatory steps. What to do if your fingers are frozen Fingers are frostbitten, what to do if they hurt

What to do if your fingers are frozen. First mandatory steps. What to do if your fingers are frozen Fingers are frostbitten, what to do if they hurt

Contents of the article: classList.toggle()">toggle

Frostbite on the hands and fingers of the upper extremities is a common problem in our domestic, sometimes harsh climate.

You can get frostbite on your arms and hands not only in winter at very low temperatures, but even in early spring and late autumn if other weather factors coincide unluckily.

How to detect cold damage in time? What primary aid can be provided to the victim? Are complications possible after frostbite? You will read about this and much more in our article.

The first signs of frostbite on the arms and hands

As you know, the main cause of frostbite on the hands is cold. However, in some cases, cold damage to the upper extremities can occur even at temperatures above zero!

This is facilitated by strong winds and high air humidity (these weather factors increase heat transfer from the body), clothing that is not appropriate for the weather, lack of gloves or mittens, and prolonged exposure to the street without active movement of the upper limbs.

The state of alcoholic intoxication also makes its contribution - alcoholic drinks, entering first the stomach and then the blood, create an imaginary feeling of warmth, but at the same time dilate the blood vessels and the heat leaves the person much faster.

Doctors consider the primary signs of frostbite on the hands to be a burning sensation on the skin of the upper extremities and fingers. After a short period of time (up to 10-15 minutes), the unpleasant sensation is complemented by tingling, mild pain, partial or complete numbness of the affected tissues. The epithelium becomes pale, whitish, sometimes marbled and even bluish in color.

Degrees and symptoms of frostbite on the arms and hands

In modern domestic clinical practice, it is customary to subdivide frostbite into frostbite, expressed in the depth and extent of cold damage.

You can learn more about frostbite on your fingers.

First aid for frostbite on arms and hands

Now let's look at what to do after frostbite on your hands and how to provide first aid. Timely, correct and competent first aid provided to a victim of frostbite on the hands significantly reduces the risk of complications and serious consequences of cold injury.

Key actions include:

If the victim has symptoms of grade 4 frostbite with partial icing of individual locations, then all of the above first aid techniques cannot be used.

The patient should be immediately transported to the hospital directly from the scene of the incident, and during transportation, doctors recommend applying a reinforced heat-insulating bandage (with layers of gauze, cotton fabric, cotton wool and polyethylene as an upper edging) to the affected upper limbs to prevent freezing of the hands outside the hospital walls .

Treatment of frostbite on hands

Drug and hardware conservative treatment of frostbite on the hands can only be carried out under the supervision of a doctor in an outpatient or hospital setting - self-prescription of drugs is fraught with the development of complications.

Specific therapeutic regimens are developed and prescribed by a specialized specialist based on a confirmed diagnosis with an established degree of cold injury and taking into account the individual characteristics of the victim’s body.

Complications and consequences of frostbite on hands

Frostbite on the arms, hands and fingers of the upper extremities, depending on the degree and depth of tissue damage from cold, can cause a variety of negative consequences, especially if the victim was not provided with first aid and qualified hospital treatment in a timely manner.

Possible complications include:

Persistent circulatory disorders in the upper extremities;
A destructive change in the structure of the epithelium, which can become covered with scars and granulations. In addition, the horny plates on the fingers are also susceptible to negative effects - nails with frostbite degree 2 and above become deformed and grow poorly over a long period of time, constantly stratifying;
Bacterial infections of a secondary type, introduced mainly through a violation of the integrity of the skin during frostbite;
Exacerbation of chronic diseases caused by a decrease in both local and general immunity;
Blood sepsis, formed due to extensive tissue necrosis after cell breakdown products enter the bloodstream;
Gangrenous pathological processes that require surgical intervention and often lead to partial or complete amputation of a finger, hand or entire upper limb.

How to prevent frostbite on your hands

Regardless of the circumstances, it is better not to treat the consequences of frostbite on the hands, but to prevent the occurrence of possible cold damage in advance. This is quite easy to do if you follow a number of basic recommendations.

Dress only for the weather. Whether it’s harsh winter, early spring or late autumn, it is advisable to always dress exclusively for the weather so that the body is warm and comfortable;
In cold weather - gloves or mittens. Many people neglect this accessory or do not use it regularly, although a fairly thick coat along with comfortable warm gloves will protect your hands from frostbite even in extreme cold;
Big move. Movement gives a person energy, makes blood flow faster through the arteries, veins and vessels, as a result of which the body’s natural thermoregulation allows it to endure strong temperature changes more comfortably and safely;
Protective cream or ointment for hands against frostbite. Often in early spring or late autumn, when the temperature is above zero, people do not wear gloves or mittens because their hands and palms begin to get very wet from sweat. In this case, an alternative would be a rich cream that envelops the skin and protects from external factors, or a similar ointment;
Balanced diet. For the normal functioning of thermoregulatory mechanisms, the body needs good nutrition, rich not only in proteins, but also in complex carbohydrates and polyunsaturated fats. Eat enough, 4-5 times a day, but in small portions, diversify your diet and do not go for a long walk with an empty stomach;

Don't drink alcohol in cold weather. Alcohol dilates blood vessels, as a result of which the heat transfer of the body in general and the upper extremities in particular increases significantly, which leads to an acceleration of the process of frostbite.

Every winter, after the air temperature drops below zero, people with frostbite begin to be admitted to hospitals. The parts of the body that are located on the periphery are always the first to suffer: the nose, ears, feet, hands and fingers. The degree of damage and the speed of first aid determine whether it will be possible to restore the functionality of the organ. In this article, we’ll look at how to deal with frostbite on your hands and fingers, one of the most common injuries.

Shulepin Ivan Vladimirovich, traumatologist-orthopedist, highest qualification category

Total work experience over 25 years. In 1994 he graduated from the Moscow Institute of Medical and Social Rehabilitation, in 1997 he completed a residency in the specialty “Traumatology and Orthopedics” at the Central Research Institute of Traumatology and Orthopedics named after. N.N. Prifova.

Frostbite is a type of cold injury, its local form. Most often, the lesion develops when exposed to cold air, although there are other options: contact with snow and ice, water, metal.

The effects of cold are sometimes worse accompanying circumstances:

Peripheral circulation disorders due to cardiovascular diseases, diabetes mellitus, etc.;
Vibration disease, osteochondrosis, polyneuropathy, Raynaud's syndrome. These pathologies lead to disruption of the conduction of nerve signals, so a person does not feel that his fingers have already become frostbitten;
Alcohol consumption. Under its influence, blood vessels dilate and the body quickly loses heat. In addition, the person does not adequately assess the environment;
Wearing wet clothes (gloves, mittens), excessive sweating. Water, evaporating, additionally cools the skin;
The imperfection of the thermoregulation system in young children - they are the most easily injured;
Combination of cooling with blood loss (for example, road accidents in winter).

Fingers are predisposed to frostbite by their anatomical features - a thin layer of muscle and fatty tissue that almost does not prevent heat loss through the skin.

The first signs of frostbite

You should be attentive to your own feelings in the cold so as not to miss the onset of hypothermia, and when walking with a baby or a very elderly person, monitor the condition of your hands more often.

The following signs indicate the onset of frostbite on the fingers:

Pale, marbling of the skin;
Cold skin;
Difficulty bending joints;
Feeling of tingling, burning, aching in the fingertips;
Feeling of partial loss of sensitivity.

When you notice the first signs of freezing, you must immediately begin warming your fingers.

It is better to immediately move to a warm room, after placing your hands under your clothes closer to the body - partially unbutton your outer clothing and press it to your stomach and armpits. It is recommended to squeeze/unclench with your fingers and move actively.

Degrees of frostbite

The degree (stage) of damage depends on the depth of freezing of the fingers. The process proceeds quickly, so there is no time to waste.

The first stage is damage to the stratum corneum and granular layer of the epidermis. After warming up, skin restoration occurs quickly and without consequences.

The second stage is damage to the papillary layer of the epidermis. In this case, blisters filled with fluid form on the skin. Healing takes longer; dressings and special treatment will be needed.

The third stage is damage to the subcutaneous fat tissue (poorly developed on the hands) to its full depth. This is a serious injury and cannot be completely cured. The consequences remain for life - scars that impair movement, deformation of the fingers, contractures, impaired tactile sensitivity.

Fourth stage– damage to all soft tissues up to the bone, complete cessation of blood circulation, necrosis. The injury ends with the amputation of dead tissue; it cannot be restored by any conservative methods.

Clinical symptoms of frostbite

Manifestations of frostbite are determined by the degree of tissue damage:

1st degree. Numbness and pallor of the skin, loss of sensitivity in the fingers. After warming up, severe swelling appears. The tint of the fingers is blue-purple, violet-red, the skin is hot. You feel tingling, itching, burning. Later, the top layer of skin peels off. After a person has frostbitten hands, sensitivity to cold remains for life.

2nd degree. The person does not feel the fingers even with strong pressure and cannot move them. The skin is blue and icy to the touch. Later it peels off with the formation of bubbles. Their contents are liquid, sometimes gel-like, yellowish or reddish in color. When warming up, unbearable pain occurs, requiring painkillers. Sometimes they go away, but then the nails grow back.

3rd degree. Darkened areas of necrosis appear on the fingertips - yellowish-blue, grayish. Bloody contents are visible in the blisters due to ruptured capillaries. The legs come off and don't grow anymore. The remaining nails grow incorrectly. Burst blisters become inflamed, often accompanied by a purulent infection.

4th degree. Dry gangrene develops - frostbitten hands mummify, shrink, and turn black. In other cases, wet gangrene is possible (due to infection) - the hand swells greatly, becomes blue-greenish-black, and emits a putrid odor.

There are two periods in the frostbite process: pre-reactive and reactive. The first is characterized by severe vasospasm, leading to disruption of the oxygen supply to tissues (freezing itself).

The second is the period after the fingers warm up. It is characterized by inflammation, severe pain, intoxication of the body due to toxic products of tissue breakdown entering the bloodstream, and the risk of infection.

First aid rules

If a person’s fingers are slightly frostbitten, he can help himself. To do this, you need to go into a warm room, change cold clothes for warm and dry ones, and drink a hot drink.

Then warm the brushes in a bowl of water at 20 °C, raising the temperature to 40 °C for 40 minutes. If this is not possible, gently, with light movements, rub your fingers with a woolen cloth from tips to base, then wrap them warmly. If your fingers hurt badly, take an aspirin/analgin tablet and two no-shpa/papaverine tablets.

Criterion for the success of assistance: the limb became warm, skin sensitivity and finger mobility returned.

At stages 2-4, you need to immediately call an ambulance or take the victim to the hospital as quickly as possible.

You can't deal with trauma on your own!

Before the doctors arrive, warm the person by wrapping him up and giving him a hot drink. Apply an insulating bandage to your hands: a layer of bandage, a thick layer of cotton wool, another layer of bandage, on top - foil, oilcloth, bag. Immobilize the injured limb by taping it to plywood, board, or cardboard. Give painkillers.

What not to do

When dealing with frostbite, it is important not to aggravate the situation by providing assistance incorrectly.

Rub the skin with snow;
Warm up by the fire (stove, fireplace), lean against hot objects;
Place your hands immediately in hot water;
Rub with fat (alcohol, essential oils). In general, massaging a limb is allowed only in the first degree of frostbite.
Drink alcohol “to warm up.”

How to act correctly in case of frostbite on your hands and fingers

Treatment methods for frostbite

At the first and second stages, treatment is conservative. The following groups of drugs are used:

Painkillers (ketorolac, nimesulide, naproxen, etc.). Taken orally or administered intramuscularly.
Antispasmodics (papaverine, drotaverine, etc.). They are also given in tablets or injections. Expand capillaries, improving microcirculation in tissues.
Antihistamines(chloropyramine, cetirizine, etc.) – relieve inflammation and burning of the skin, reduce swelling.
Local remedies: ointments and creams for skin healing (frostbite balm Spasatel, Bepanten, D-Panthenol, etc.).
Antiseptic drugs for the treatment of inflamed blisters (tetracycline ointment, Levomekol, Shostakovsky balm, etc.).

For first-degree frostbite, recovery time is about a week; treatment occurs at home.

In the second degree, children, pregnant women, the elderly and people with serious chronic diseases must be hospitalized; the rest - depending on the circumstances.

At grades 3-4, surgical intervention is necessary - excision of nectrotic tissue, treatment of associated infection.

Traditional methods of treatment

To cure frostbite of 1-2 degrees, you can additionally use folk remedies:

Baths with herbal decoctions (chamomile, calendula, oak bark). Reduce inflammation and itching;
Baths with a solution of potato starch (1 tsp per 200 ml of water). Soften the skin, relieve irritation and peeling.
Sea buckthorn oil - smear it on the skin to speed up regeneration 3-5 times a day, under a bandage;
Compresses with aloe juice provide a regenerating, anti-inflammatory effect.

Conclusion

Frostbite is no less dangerous than a burn, and is fraught with serious consequences. It is important to follow safety rules when being outside in frosty weather, and if your hands are numb, immediately warm them up. Left without fingers - the main organs of manipulation, a person turns into a helpless disabled person, falling out of active life.

What folk remedies are effective for frostbite?

If you are outside in the cold and suddenly feel that some part of your body is very cold and cannot move well, or you are walking with a child whose cheeks are very red, do not wait until you come home. This could be frostbite - a dangerous condition when, under the influence of cold, vasospasm occurs, and the tissues fed by them suffer from lack of nutrition. If urgent measures are not taken, the vessels of deeper tissues will suffer. And the more time passes in conditions of severe frost or moderate cold and high humidity, the greater the likelihood that changes in insufficiently insulated fabrics cannot be cured.

Obviously, the first steps you should start doing while still on the street will be different if your nose or toes are affected. The actions taken in case of frostbite in the first hour or later also vary. Doctors say: sometimes it’s not so much a cold burn that’s scary as illiterate first aid. This is what we will talk about.

When to suspect frostbite

If you go outside and feel that some part of your body that is exposed or poorly protected from the cold is freezing or already hurting, this does not always indicate frostbite. To do this, it is necessary that the air temperature be below minus 10°C with little humidity, or 0°C or lower - in combination with a wind of more than 5 m/s and high humidity. If a person’s clothing does not allow for normal heat exchange and prevents the removal of sweat, or is too light, or is wet, frostbite can develop even at +8°C.

Frostbite can affect the entire face or parts of it: cheeks, nose, ears. Doctors make the same diagnosis when hands in insufficiently warm gloves or feet in light or tight shoes, which in themselves impair blood circulation, are exposed to cold. If pain, numbness and a feeling of cold are felt throughout the body, this is called general hypothermia and is treated separately.

You are more likely to get frostbite if:

the person went out hungry (he ate more than 8 hours ago);
he is in the cold in a state of alcoholic intoxication (the blood vessels are dilated - more heat is lost);
a person has to stand motionless for a long time or hold (carry) some object in the cold;
a person suffers from diabetes mellitus or diseases in which there is a violation of 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 a serious illness);
he lost some blood;
this is a child, a pregnant woman (especially in the 3rd trimester) or an elderly person.

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

The degree of frostbite (that is, the depth to which the cold influence has penetrated) can only be assessed in a warm room, but not immediately, but over several hours.

Actions to be performed while still on the street

The algorithm consists of several simple steps.

1. If you suspect frostbite on your face, immediately begin to warm yourself while walking to your destination, which is located indoors:

put on a hood or hat if your ears are cold;
if your nose is frostbitten, either pull up the collar of your sweater/jacket to hide your nose under it, or tie a scarf so that it covers your nose. You can cover your nose with gloved hands;
the previous paragraph is also suitable for reducing the degree of tissue damage due to frostbite on the cheeks.

If your hands are very cold, put them in your own armpits (as if you were hugging yourself). If your feet are cold, start actively wiggling your toes.

2. If you are far from home or your destination, go to the nearest entrance, store, shopping center, pharmacy, clinic, educational institution or other premises. The best option: stay in the room for at least 10 minutes, drink hot tea or coffee there. If your feet are frozen and along the way you see a store where you can buy an extra pair of socks, be sure to do so: treatment for frostbite on your feet costs more than even a pair of woolen socks.

3. On the way to the room, move actively: you can wave your arms (as during exercise), clap your hands, run, or walk, stamping your feet (you can raise your legs high). This will help increase overall blood circulation and reduce the extent of local damage.

Do not rub snow on a frozen and reddened part of the body under any circumstances: this can cause additional damage to the tissues in which blood circulation is currently affected.

What to do immediately upon arriving home

Frostbite is not a one-time process. Initially, low temperature leads to vasospasm, then the blood supply is reversibly disrupted. If the cold continues to act, blood clots form in these vessels, and blood circulation can be completely stopped. Products of dying tissue enter the bloodstream and cause poisoning of the body.

The entire process of frostbite is divided into 2 periods:

hidden: begins on the street and continues for some time after warming up;
reactive (explicit): appears only after warming for 6-12 hours.

By the appearance of the frostbitten area in the reactive period, it will become clear what degree of cold burn you have. And in order for fabrics:

warmed up faster;
pathological changes did not spread deeper than what had already happened in the cold (this can happen to underlying tissues when they are cooled by a large array of highly chilled tissues from above),
it became clear how serious everything was,

You need to do the following in a warm room:

What not to do if you have frostbite

warm the frostbitten area near the fire, touch it to the battery, put it under hot water;
apply greasy ointments (this should be done before going outside, and not after an accident has occurred);
If blisters appear on the skin soon after warming up, they should not be opened. You can only apply a sterile bandage (if you have a sterile bandage or sterile wipes at home), and then consult a doctor;
rub with snow, ice and even mittens: this will further injure the vessels of the affected area;
drink alcohol;
rub the frostbitten area with alcohol. If you apply it and rub it gently, the heat will evaporate from the surface of the skin. If you rub the frostbitten area with alcohol, you can damage the fragile vessels in this area.

Actions that are important to complete within the next 6-12 hours

If within an hour the frostbitten area has warmed up, but the skin on it has acquired a bluish or red-purple tint and has swollen a little, and the area itself has begun to hurt, do not be alarmed. This is the first degree of frostbite. It can be treated at home. For pain, take any painkiller to which you are not allergic: Ibuprofen, Analgin, Diclofenac. This medicine can be taken several times on the first day, but so that the maximum dosage (as indicated in the instructions) is not exceeded.

If you experience the symptoms described, it does not mean that the danger has completely passed. You must continue to monitor the frostbitten area. If on the 2nd day 1 or more blisters appear at the site of swelling, this is degree 2 frostbite. Bubbles cannot be opened. You need to consult a combustiologist (these are specialists working in burn departments of multidisciplinary hospitals) or a general surgeon at a clinic.

What to do after frostbite, if 2 hours have already passed and you do not feel the affected area (it seems to be numb), or the skin on it remains white, you need to contact a surgeon at the clinic or a doctor at the burn center. This could be 3rd or even 4th degree frostbite. They must be treated in a hospital: only there is it possible to administer medications using IVs that:

can improve blood supply to the affected area, thereby reducing the affected area;
will help dissolve blood clots in the affected area;
will prevent suppuration of frostbitten tissues or reduce its severity.

Unfortunately, medications that can do this efficiently only exist in the form of injections or droppers. In addition, the hospital will monitor your condition and your wound around the clock. If it turns out that you have stage 4 frostbite, when the damage has affected all layers of soft tissue, measures will be immediately taken to remove dead tissue and stop the spread of necrosis even deeper or further (for example, from fingers to hands).

In the hospital, a person’s blood will also be taken to determine the degree of his immune protection against tetanus (the test 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 there is no information about when it was carried out similar vaccination), he will be given the necessary antitetanus drug. This will help avoid the development of tetanus, an infectious disease with a high mortality rate, since frostbite creates optimal conditions for the development of tetanus bacteria in the wound.

Actions to be completed the next day

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

If no bubbles appear - 1st degree. Only the skin is affected.
When blisters (or one bubble) filled with transparent contents appear on purple or bluish-colored skin, and the area itself is very painful – grade 2. The skin and partially subcutaneous tissue are affected.
If the affected area remains pale and cold, the sensitivity on it is reduced or absent, and against this background, blisters filled with bloody contents appear - grade 3. If your fingers or toes are frostbitten, their nails peel off and then do not grow back. Grade 3 indicates damage to the skin, subcutaneous tissue and muscles.
When the skin becomes bluish-marbled or even black, swollen, does not feel touch or even needle pricks, and the joints under such tissues do not move (“do not obey”), this is the 4th degree of frostbite. All layers of muscle are affected, as well as tendons and possibly bones.

Help for frostbite can be provided to yourself (or a relative) at home only in the first two stages. Stages 3 and 4, which you can accurately determine on the second day after frostbite, are treated only in a hospital. Staying at home in these cases is dangerous: you can develop gangrene, get tetanus or blood poisoning; from a large number of decaying tissues that are absorbed into the blood, acute renal failure can develop - a condition no less fatal than the others.

So, what to do if your fingers or other areas are frostbitten during stage 1-2 of frostbite:

if pain is felt, take painkillers (Diclofenac, Ibuprofen, Dexalgin and others) without exceeding the maximum permitted dosage. You need to take these tablets after meals. If you suffer from gastritis or peptic ulcer, you must take Omeprazole (Omeza), Nolpaza, Pantoprazole or Ranitidine while taking painkillers;
if nothing hurts, but you measured your temperature and it turned out to be above 38°C, take Paracetamol. If you are already taking a painkiller, it will reduce the temperature, and taking two similar drugs at once increases their toxic effect on the kidneys and gastrointestinal mucosa;
To speed up the restoration of normal blood flow in the damaged area, take No-shpu (Drotaverine) or Papaverine. They will dilate blood vessels, which will provide better nutrition to diseased areas;
In parallel with taking No-shpa or Papaverine, you will need to use drugs for several days that will destroy blood clots that have formed in the frostbitten area. These are ointments “Lioton”, “Gepatrombin”, heparin gel. If you do not take painkillers or antipyretics (this is one group of drugs), you can use Aspirin at a dose of 75 or 100 mg once a day after meals to prevent the formation of blood clots;
for itching, antihistamines are needed: “Fenistil”, “Erius”, “Diazolin”;
to speed up the process of impulse transmission from nerve to muscle in damaged areas, B vitamins are needed: Neurorubin, Milgamma, Neurovitan. Nicotinic acid is also used in tablet form.

All medications have contraindications, so consult your doctor before taking them.

Local treatment is also necessary. So, to speed up healing with the 1st degree of frostbite, treat the areas with Bepanten (Dexpanthenol) cream, and when going outside or if you need to wash frostbitten hands, apply an emollient to them an hour before: “Physiogel”, “Mustella stelatopia” or any other drug. If you are treating frostbite of the 2nd degree, treat the blisters with an antiseptic without alcohol (Chlorhexidine, Miramistin, a weak solution of potassium permanganate) or with alcohol (a solution of brilliant green or fucorcin). Apply Levomekol ointment around them. When the bubble opens on its own, you can treat the entire affected surface with Levomekol.

Be sure to lightly massage the affected area. You can do this while you apply the cream or ointment. Massage movements bypass the area of opened blisters; they can be performed with sticks wrapped in sterile cotton wool.

Actions to be completed in a week

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

take B vitamins and xanthinol nicotinate preparations (if approved by your doctor);
if there are no contraindications, take Aspirin for 5-7 days;
lubricate the affected skin with Bepanten (if your hands are very dry and flaky, you can no longer use the cream, but the thicker Bepanten ointment;
treat itching with antihistamines;
massage the affected areas.

If frostbite has reached degree 2, when recovery lasts about 2 weeks, treatment is as follows:

taking painkillers with a gradual reduction in dosage;
local treatment with Levomekol;
taking B vitamins;
if the itching is severe, you can not only take an antihistamine, but also apply Fenistil-gel or Psilo-balm to the itchy areas (if it is not the area under the opened blister). If this does not help, contact your surgeon, who may recommend a topical hormonal medication;
you need to massage the affected area, bypassing the wounds formed after opening the blisters.

At grade 3, the wound will take more than a month to heal, most of which you must spend either in a hospital or as a day hospital with daily examinations by a combustiologist or surgeon. Treatment will be carried out using injections and droppers, as well as professional treatment of the wound with special solutions. After healing, scars form, which can subsequently be treated with Contractubex or other recommended drugs.

Frostbite of the 4th degree must be treated in a hospital, where, if necessary, either amputation is performed, or only the removal of dead tissue without removing the underlying bone. Treatment takes more than a month only in a hospital. The doctor will tell you how to be treated later, depending on the current situation and concomitant diseases.

Please note that frostbitten areas will need to be protected much more carefully from both high and low temperatures over the coming year to achieve complete tissue healing.

When to see a doctor

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

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

Traditional treatment of frostbite

You can use these recipes:

from 2 days – with 1st degree of frostbite, from 7 days – with 2nd degree. Recipes are not suitable for grades 3 and 4;
after consultation with a doctor;
if you are not allergic to the components of the recipe;
if the victim is not a child or a pregnant woman.

Recipes for external use:

Rub rose oil into the affected areas.
Make calendula tincture: 1 tsp. pour 500 ml of boiling water over the herbs, leave for 45 minutes, strain. Dip sterile gauze into this infusion and apply to the frostbitten surface for half an hour, 1-2 times a day.
Rub in lemon juice twice a day.
Rub onion juice into the affected area for 15 minutes.
Apply either aloe vera cream or paste made from aloe leaves, peeled and needles, to the frostbite area.
Potato juice lotions. Soak a cotton pad or gauze pad with the juice squeezed out of the potato. They are covered with a dry cloth and fixed on the affected area with a plaster for at least 2 hours.
Pumpkin mask. To do this, grate the raw pumpkin on a fine grater and apply the resulting pulp to the frostbitten area.

Can be taken orally (after consulting with your doctor):

Infusion of chamomile flowers. 1 tablespoon is poured with 500 ml of boiling water, left for 45 minutes, then you can strain and take 1 tablespoon at a time. three times a day.
Viburnum decoction. Take 15 g of berries, pour 500 ml of boiling water, cook for 15 minutes in a water bath, leave for another 45 minutes, and you can strain and take. You need to drink 500 ml of the decoction per day.
A sedative effect is provided by tincture of motherwort or valerian. It is better to buy them at a pharmacy and take them according to the instructions.

Frostbite– tissue damage caused by exposure to low temperatures (mainly cold atmospheric air). Tissue necrosis is caused not by direct exposure to cold, but by circulatory disorders: spasm, and in the reactive period - paresis of blood vessels (capillaries, small arteries), slowing down of blood flow, stopping the movement of blood elements, and thrombus formation.

Low temperature contributes to frostbite only under certain conditions, which include both physical factors (wind, humid air) and
physiological state of tissues exposed to low temperatures (old age, exhaustion, anemia, tissue compression, decreased body resistance).

The degree of frostbite depends on a combination of these factors .

There are 4 degrees of frostbite.

I degree characterized by a disorder of blood circulation in the skin without irreversible damage.
II– necrosis of the superficial layers of the skin.
III– total necrosis of the skin and underlying soft tissues.
IV– necrosis of soft tissues and bones.

The clinical picture of frostbite consists of 2 periods: latent and reactive.

In the latent period, subjective sensations are reduced to a specific sensation of cold, tingling and burning in the area of tissue damage. Then comes a complete loss of sensitivity. Frostbite victims often learn about this from people around them, who point out to them the presence of white skin in the frostbitten area. In some cases, there is a blue discoloration of the frostbitten area of the skin, as well as numbness of the frostbite area. Neither the depth of necrosis nor its spread in this period can be determined.

The reactive period develops after the frostbitten area is warmed up. At this time, signs of necrosis and symptoms of reactive inflammation appear. It takes at least 5–7 days to determine the boundaries of the pathological process both in length and depth. By this time it becomes possible to determine the degree of frostbite.

For frostbite of the first degree the latent period has the shortest duration. In the reactive period, the skin in the area of frostbite is bluish, sometimes
its characteristic marble color. There are no signs of tissue necrosis.

For frostbite II degree characterized by a relatively long latent period. During the reactive period, blisters appear on the skin in the frostbite zone,
filled with transparent content. Their bottom is covered with a film and is very sensitive to mechanical irritation and the action of alcohol (positive alcohol test).

Frostbite of degrees I–II ends with complete restoration of the skin.

For frostbite of the third degree the blisters contain bloody fluid, their bottom is blue-purple in color, and are insensitive to either application of alcohol (negative alcohol test) or mechanical irritation. The death of all skin elements leads to the formation of rough scars; fallen nails do not grow back. IV degree frostbite is characterized by the development of mummification or wet gangrene. The final line of tissue necrosis appears in the first 2 weeks after frostbite.

Frostbite of the first three degrees manifests itself with a relatively mild clinical course. In most cases, fingers are affected by frostbite.
arms and legs, ears and nose, less often - the forefoot, heel area, the entire foot.

As a result of long-term repeated (with alternating cooling and warming) cooling of the legs at temperatures from 0 to +10 ° C with high humidity
A special type of local cold injury develops - “trench foot”. The duration of cooling is usually several days, after which, after a few more days, aching pain in the legs, burning, and a feeling of stiffness occur.

On examination, the feet are pale, swollen, and cold to the touch. There is a loss of all types of sensitivity. Then bubbles with bloody contents appear.
There are pronounced signs of intoxication: high body temperature, increased heart rate, weakness. Sepsis is often associated.

First aid

Rapid warming of the affected part of the body is the main element of treatment, as this leads to a speedy restoration of blood flow. Any means can be used for warming, but the best results are achieved with rapid warming. The victim should be brought indoors as soon as possible. Most often (45% of cases) frostbite affects the lower or upper extremities; they are placed in a foot or hand bath with water at a temperature of 16–20 °C and raised to 39–40 °C for 20–30 minutes, while carefully massaging the limbs from the periphery to the center with your hands or a soapy sponge or washcloth. If there are blisters or signs of tissue necrosis, massage is contraindicated.

After 30–40 minutes of warming and massage, the skin becomes warm and pink. The limb is removed from the bath, dried, the skin is treated with 70% alcohol and
apply an aseptic bandage, insulate with a thick layer of cotton wool, which is fixed with a bandage. The victim is placed in bed, placing the limb in an elevated position, and given a hot drink (tea, coffee), and a little alcohol.

If the ears, nose, or cheeks are frostbitten, rub them with a warm hand or soft cloth until they turn red. Then wipe with 70% alcohol and lubricate with sterile petroleum jelly. In no case should you use rubbing with snow, as this leads to even greater cooling, and ice crystals damage the skin, which can result in infection and the development of erysipelas.

In cases where it is impossible to actively warm the affected part of the body, a heat-insulating bandage is used, which prevents
heat loss and further cooling of the affected area. Sterile napkins are applied to the affected part of the body, on top of which there is only a layer of cotton wool,
which is fixed with a bandage. Wool blankets and fur items can be used for thermal insulation. To restore blood circulation with
a heat-insulating bandage requires 5–6 hours, with active warming – 40–60 minutes.

To warm the limb in the field, heat sources such as fires and heating pads are used. The affected hand can be placed in the armpit
area, on the stomach, between the thighs of the victim or person providing assistance. In all cases of first aid, heat generation should be increased and heat transfer reduced by warming the victim, drinking hot drinks, and administering antispasmodics.

Timely and correct assistance in the latent period helps to avoid primary tissue necrosis.

Treatment

For all types of frostbite, prevention of the development of tetanus is necessary.

Therapeutic measures in the reactive period are carried out according to the stage of frostbite. Thus, in case of frostbite of the first degree, the skin of the affected area is treated with 5% boric alcohol, and physical methods of treatment are used (electric light baths, erythemal doses of ultraviolet radiation, local darsonvalization).

If frostbite is first degree is accompanied by the development of an ulcerative process, ointment dressings are used (Vishnevsky ointment, synthomycin emulsion, etc.).

For frostbite of the second degree the skin of the affected area is treated with alcohol, blisters are removed and an aseptic insulating bandage is applied. If there are no signs of acute inflammation in the frostbite area, the bandage is removed on the 5-10th day and physiotherapeutic treatment is carried out. If there are subungual hemorrhages, during this period the nail plates are removed, which are easily removed. During treatment, it is necessary to recommend that the patient make active (if he cannot, passive) movements in the joints of the limbs to prevent the development of their stiffness.

Frostbite of the third degree, accompanied by the development of areas of tissue necrosis, require their removal: on the 5-6th day after frostbite, when a clear border of tissue necrosis appears, the dead areas are dissected along the axis of the limb.

Subsequently, treatment is carried out using the open method or bandages with a hypertonic solution of table salt are used to reject the scab. As dead tissue is rejected and profuse purulent discharge appears, warm baths with a solution of potassium permanganate added to the water are indicated. During this period, physiotherapeutic treatment is widely used. The scab on the frostbitten surface should be preserved until it separates on its own.

After the scab is rejected and the wound is cleansed of pus, they switch to infrequent dressings in order to preserve the developing scar tissue from damage. In case of fourth degree frostbite, after determining the boundaries of tissue necrosis, the area of frostbite is treated with alcohol and, stepping 1 cm above the border of necrosis, excision and dissection of the dead tissue is performed.

Areas of dead tissue are removed as much as possible. This is a rational preparation for early amputation and prevents the development of general intoxication of the patient’s body. Further treatment is carried out in the same way as for frostbite of the third degree.

Amputation of limbs is performed in the absence of contraindications, after the formation of a dry scab. Throughout the entire period of treatment the patient
it is necessary to give food containing large quantities of carbohydrates, proteins, vitamins, to strive to normalize the function of the nervous system, improve
functions of the circulatory organs.

Frostbite is tissue damage that occurs under prolonged exposure to low temperatures. Frostbite usually occurs in winter, especially if there is high humidity and windiness. Most often it occurs at temperatures of -10 degrees Celsius and below, but under certain conditions it can occur even when the air temperature is significantly above zero. The most susceptible areas of the body to frostbite are the fingers and toes, so this article is entirely devoted to the topic “Frostbite of the fingers, symptoms and treatment.”

Frostbite of the fingers is divided into four degrees of severity, each with its own symptoms:

In most cases it occurs with short exposure to cold. The first degree of frostbite - the skin becomes swollen and pale, and its sensitivity is absent or significantly reduced. When the fingers are already warm, the swelling increases, and the skin becomes blue-purple, burning, itching and dull pain begin. All these symptoms go away on their own in about a week. But increased sensitivity of the fingers to low temperatures may persist for many years.
The second degree of frostbite occurs with longer exposure to cold. First, frostbitten fingers become cold, pale and lose sensitivity. During warming up, the fingers gradually become blue-purple and swelling begins. The main sign that this is stage 2 is the appearance of blisters with transparent contents on frostbitten fingers (appear in the first days after frostbite). The skin of the fingers is completely restored in 1-2 weeks, usually no scars remain.
Dark brown and dark red blisters appear, and skin necrosis occurs. Fingers are cold and pale. At 2-3 weeks, the rejection of dead tissue ends, then scarring occurs and this process can already last about a month. Rough scars remain.
The most severe degree of frostbite involves the death of all tissues, and sometimes even bones. Frostbitten fingers have a marbled or bluish color. After warming up, swelling begins and increases rapidly. The temperature of frostbitten fingers remains much lower than in non-frostbitten areas. One of the signs of fourth degree frostbite is the absolute loss of sensation in the fingers.

Know the symptoms and treating the problem will become easier. If you get frostbite, you can lose a limb, since severe frostbite often provokes the development of gangrene. How can you save your fingers if you get frostbite? So, frostbite of fingers, treatment and first aid:

As trivial as it may seem, at the first signs of frostbite, you need to make every effort to stop it. Get rid of wet clothes as soon as possible, and carefully wash your fingers in lukewarm water, then wrap them in several layers of warm clothing and warm them up. This method is applicable only for first degree frostbite.
Massage your fingers from time to time.
Lubricate frostbitten fingers with hygienic lipstick before starting to warm them up, this will reduce the chance that the skin will crack, and, as you know, frostbitten, cracked skin is not at all easy to treat in winter.
For massage, you can use the following remedy: grind a few peppercorns, then fry them in 1 tbsp. l. sesame seed oil or hot mustard. Strain the resulting mixture and rub in while it is warm.
In case of frostbite of the second degree and above, you should first carefully and gently rub your fingers with a napkin, after moistening it with alcohol or vodka, after which you can dip your fingers in lukewarm water, then begin very slowly (20-30 minutes) to bring the water temperature to 36-37 degrees Celsius. After this, you can begin to rub your fingers little by little (lightly) until sensitivity begins to appear.
You should try not to move frostbitten fingers. Hemorrhage may occur in a frostbitten finger, since the blood vessels become much more fragile during frostbite. You can even apply a splint.
Give the victim a hot liquid to drink, it could be milk, tea or something else.

In what cases should you seek medical help?

Increasing pain when warming up, and the fingers remain cold and pale (most likely this indicates very serious frostbite).
Frostbite in an elderly person or child.
The appearance of blisters on the fingers. It is important to remember not to pop the blisters yourself.
If you experience the following symptoms: cold and pale skin, slow breathing, severe shaking, lethargy, drowsiness, extreme fatigue, impaired consciousness or confusion (all these are symptoms of general hypothermia, which can be very dangerous).

What to avoid if you have frostbite.

Under no circumstances should you open blisters (if any) on frostbitten fingers.
Drink coffee or alcohol or any other drinks that dilate blood vessels, as this can lead to rupture of fragile frozen blood vessels.
Lubricate your fingers with ointments or grease, as this only worsens the cooling and injures the skin.
Rub intensively, immerse in hot water, take a hot shower and other methods of sudden warming. The fact is that because of this, too sharp a temperature difference occurs in the tissues, which prevents blood flow from being restored, and this in turn can lead to skin necrosis.
Rub your fingers with snow. In this case, the cooling only intensifies, while warming is necessary.

Prevention.

If it’s frosty outside, then you should only go out after wearing multi-layered clothes and make sure that your shoes are loose and dry.
Smoking in the cold is not recommended, as smoking reduces blood circulation in the extremities, making them more vulnerable to cold.
You should not lubricate your face with moisturizing creams before going out into the cold. If the temperature is very low, then you should avoid cosmetics altogether; in mild frost, you can use oily cosmetics.
Refrain from wearing metal jewelry; metal cools quickly and turns into another source of cold.