Method of conservative treatment of frostbite of the extremities. Applying a thermal insulating bandage Soft bandage bandages
First aid for general hypothermia and frostbite of the extremities
Hello! With the onset of winter cold, a situation may arise when someone will have to provide assistance for frostbite, so I would like to present you with material on first aid for frostbite for publication. The purpose of this material is to teach the correct actions in case of frostbite and help avoid serious mistakes. I hope that this material can be useful and relevant for many. The need to compile this material is dictated by the fact that in various medical reference books, first aid manuals and other publications there are both correct and, to put it mildly, completely inadequate recommendations on how to provide assistance for frostbite! In order not to be unfounded, I will give a few examples: CORRECT: - “Numerous studies have shown that the most pathogenetically substantiated method is slow warming by applying thermal insulating bandages. ... The use of heat-insulating bandages promotes parallel restoration of blood circulation and metabolic processes in tissues, which reduces tissue hypoxia and the likelihood of irreversible changes in the affected area. (“Russian Medical Server” http://medgazeta.rusmedserv.com/2000/3/article_792.html)”; “... with timely and correct use of a thermal insulating bandage, after its removal, no blisters or scars are found underneath it. And most importantly, even in the most severe cases, amputation can be avoided (http://gazeta.aif.ru/_/online/health/440/05_01)."
WRONG! - “The frostbitten limb is first rubbed with a dry cloth, then placed in a basin with warm 32-34C water. Within 10 minutes the temperature is brought to 40-45C.(http://www.medical-center.ru/index/smonol.html)"; “Frostbite should be warmed up quickly, since this gives a higher chance of restoring tissue function and a shorter period of intense pain. (Information center “CITOMED” http://citomedicine.ru/pervaya-pomoshh-pri-otmorozhenii.html)”). FIRST AID FOR GENERAL HYDROCOOLING OF THE BODY AND FROSTBOST OF THE EXTREMITIES The main sign of frostbite (deep cold damage to body tissues) is a local loss of sensitivity that occurs in the cold, along with the absence of signs of blood supply in this area. The main principle in providing first aid for frostbite:
1. Warming a frozen (frostbitten) limb should occur only by restoring its own blood supply;
2. The frostbitten area of the body during self-warming and restoration of internal blood flow in it should be well protected with a heat-insulating bandage (thermal insulating bandage) from any influence of external heat (surrounding warm air, external heat of one’s own body, etc.). CREATION OF A HEAT-INSULATED BANDAGE A heat-insulating bandage includes several layers. The first layer is a “loose” bandage with a gauze bandage to create a clean environment above the skin of the frostbitten limb. Then there are 2-4 layers of cotton wool, secured with a bandage. A layer of oilcloth or polyethylene is applied over the cotton-bandage layers, which is again fixed with a bandage. On top of the heat-insulating bandage described above, additional heat-insulating layers, for example, a layer of woolen fabric, can be applied to improve its heat-insulating properties. To create a heat-insulating bandage from available materials, the following can be used: clothing that retains heat well (for example, a jacket or coat with synthetic padding), a blanket, and the like. The heat-insulating bandage should not be tight (!), so as not to put pressure on the frostbitten limb, and should be applied taking into account the possible development of edema in cold-injured tissues. The heat-insulating bandage should be well secured to the frostbitten limb and isolate the frostbitten limb from external heat for 6 to 24 hours. The more severe the expected degree of frostbite, the longer the heat-insulating bandage should be applied and the better its heat-insulating properties should be. During the entire period of use, the heat-insulating bandage must not be disturbed or removed! The heat-insulating bandage can be removed before the specified time only if full sensitivity has returned to the entire previously frostbitten limb.
IN FROSTBONE:
IT IS FORBIDDEN forcibly change the position of a frostbitten limb, as this leads to injury!
IT IS FORBIDDEN encourage the victim to make active or passive movements in the frostbitten limb.
IT IS FORBIDDEN When providing assistance, warm frostbitten areas of the body (fingers, arms, legs, etc.) with any external heat sources (warm air, warm water, heating pads, warming near a stove or fireplace, near a central heating radiator, etc.).
This is due to the fact that during the process of freezing in the tissues (cells) of the body, all vital processes are gradually suspended and blood flow stops, and with the arrival of heat, the frozen cells and tissues begin to revive (restore their vital functions), but in the absence of the previously restored blood supply in them, they are doomed to death and die as a result of hypoxia (oxygen starvation)!
RESTORATION OF COLD INJURED BUT VITAL TISSUE IS POSSIBLE ONLY WITH SIMULTANEOUS RESTORATION OF THE BLOOD SUPPLY IN THEM!
Any premature (before restoration of blood circulation has occurred) external warming of frozen tissues is extremely destructive for them and therefore completely unacceptable! The desire to quickly warm up a frostbitten limb from the outside is a false stereotype of behavior and, if implemented, will only bring additional suffering to the victim and can seriously aggravate the consequences of the resulting cold injury! DO NOT rub frostbitten areas of the body with snow or any objects - this only causes harm, further injuring the skin. When providing first aid during the first 24 hours, frostbitten areas of the body must NOT be lubricated with any oils, fats, including ointments and creams, especially fat-based - this disrupts the external gas exchange of cold-injured tissues and generally impairs their viability.
GENERAL PROCEDURE FOR PROVIDING HELP IN CASE OF FROSTBOST
1. It is necessary to immediately assess whether there is a threat to the life of the victim from hypothermia, and if so, be prepared to resuscitate the victim (in order to correctly perform cardiopulmonary resuscitation in a critical situation, this skill must be practiced in advance!). If there is no threat to life from hypothermia for the victim, it is necessary, without wasting time, to provide heat-insulating bandages on frostbitten limbs. If there is a suspicion of frostbite in the victim's nose and ears, it is necessary to immediately provide heat-insulating bandages to these areas of the body. 2. If there is a direct danger to the life of the victim from general hypothermia (freezing), the first step is to stop further cooling of the body by starting a GRADUAL WARMING OF THE VICTIM'S TORS, and then immediately proceed to providing heat-insulating bandages for frostbitten limbs. If several people are assisting the victim, gradual warming of the torso and the creation of heat-insulating bandages should begin simultaneously.
CAREFULLY! SHARP WARMING CAN CAUSE A SHOCK REACTION IN THE VICTIM'S BODY!
Rubber heating pads or bottles of warm water (not hot!) can be used as a heat source to warm the torso. Even local warming in the torso area has a general warming effect on the victim, since the incoming heat is transferred through the bloodstream to the entire body. If the victim’s clothes are dry and are not a serious independent source of cold, you can leave them on and immediately begin warming the victim’s torso with warm (in no case hot!) heating pads, placing them directly under these clothes. In extreme cases, heat-insulating bandages on frostbitten limbs can be applied over the victim’s clothing, provided that the very nature of the clothing and its properties do not prevent this. If the victim’s clothing is wet and frozen and is a serious independent source of cold, it is urgently necessary to remove it and immediately wrap the victim’s torso in dry warm clothes or a blanket and cover them with warm (not hot!) heating pads, and quickly provide heat-insulating bandages to frostbitten limbs. If the victim’s frozen clothing cannot be easily removed, it should be cut first. ATTENTION! - if the lower extremities are frostbitten, the victim’s shoes should be removed and then immediately applied with heat-insulating bandages. If necessary, shoes can be pre-cut for easy and non-traumatic removal from frostbitten lower extremities. In the process of providing first aid to a frostbitten person, you cannot forcibly change the position of frostbitten limbs. When undressing/dressing the victim, you should also not allow direct contact of the victim’s frozen limbs with the victim’s torso, so that the cold is not transferred to the torso!
3. Give the victim: An anesthetic (analgin or other analgesic), since the process of reviving frozen tissue can be very painful; Vasodilator (for example, no-spa). As a vasodilator, an adult victim can be given 50-100 g of alcohol (for example, vodka or cognac) Warm drink (for example, warm tea, coffee).
4. Ensure that the victim is transported to the hospital. The victim should be transferred to a very heated room only after providing him with the above-described first aid, which is best done in cool, but not cold, conditions.
Useful links on the topic of frostbite: http://gazeta.aif.ru/_/online/health/440/05_01 http://medgazeta.rusmedserv.com/2000/3/article_792.html Useful links on the topic of resuscitation: http: //www.spruce.ru/urgent/resuscitation/review_2.html
Russian, Orthodox religion,
former traumatologist
Nikolaev Maxim Evgenievich
Contents of the article: classList.toggle()">toggle
Thermal insulating bandage is a special product used for frostbite of degree 2 and above. It is designed to slow down the rate of thawing of affected areas of the body.
How to apply a bandage correctly? Does it help get rid of complications of frostbite? What other first aid can be given to the victim? You will read about this and much more in our article.
Degrees and symptoms of frostbite
Manifestations of frostbite can be divided into two groups - the first occur immediately during the cold injury itself (pre-reactive period), while the second appear after the process of warming the skin and tissues of the body begins (reactive period).
In the pre-reactive period, the initial symptoms, regardless of the degree of cold damage, are quite similar - this is a decrease in the mobility of body parts caused by partial cold paralysis of muscle fibers, as well as a decrease or complete disappearance of local tactile sensitivity due to blocking of nerve endings and receptors. The higher the degree of cold injury, the faster these two negative conditions develop.
You can find out more about periods of frostbite.
The degree of cold injury in the pre-reactive period can be distinguished by skin tone and general deterioration in vital signs:
During the reactive period, with the beginning of thawing of the skin and soft tissues, the symptoms of frostbite are more vivid and make it possible to accurately determine the depth of the damage from the cold.
- 1st degree. In the affected areas, a burning sensation, tingling and mild pain are felt. The skin has a reddish tint and is susceptible to hyperemia, sensitivity returns immediately. After a few days, the epithelium begins to peel off, the overall recovery time ranges from 5-7 days;
- 2nd degree. Burning and tingling is accompanied by moderate pain. The skin turns blue, bubbles with transparent or yellowish contents form on the epithelium, the nail plates are susceptible to destruction, and the sensitivity of the affected areas returns only partially. The general recovery time and complete reversible regeneration of tissues and nails is about 2 weeks;
- 3rd degree. There is no tingling or burning sensation - instead, severe pain immediately appears. The skin has a dark or burgundy tint, is covered with blisters with bloody fluid, and there are isolated foci of epithelial necrosis with damage to surface tissues and peripheral vessels. The sensitivity of the affected areas is very weak or absent for several days. The healing process is accompanied by the formation of granulations, spots, and scars that do not disappear even after the rehabilitation procedure (they can only be removed surgically). Full recovery time – up to 1 month;
- 4th degree. The skin acquires gray-black shades. There is a very strong pain syndrome, a complete lack of sensitivity, along with the immediate development of extensive swelling in the areas affected by the cold. After a few days, the swelling subsides, the frostbitten parts succumb to systemic necrosis (the process can affect the skin, all soft tissues, including cartilage, joints and bones), dry out, or wet gangrene develops. Almost always, the victim requires surgical intervention and intensive or resuscitation therapy. The average recovery time in the presence of qualified inpatient treatment is 1.5-3 months.
You can find out more about the degree of frostbite.
First aid for frostbite
The victim of frostbite should be provided with all possible assistance.
Applying heat-insulating bandages for frostbite
In the vast majority of cases, a heat-insulating bandage when providing first aid in cases of frostbite of degree 2 or higher is created from available means at hand. The materials for it can be cotton wool, bandages, cotton fabric, cardboard, polyethylene, rubber, etc.
Possible sequence of layers, taking into account potential serious damage to the skin and soft tissues:
The basic principle of forming a heat-insulating bandage is an arithmetic progression in relation to the degree of cold injury. The higher it is, the more layers there should be in the product. It is possible not to use a heat-insulating bandage only in the case of clearly diagnosed 1st mild degree of frostbite, but in most cases it is quite difficult to install it in the pre-reactive period and “field” conditions, so it is advisable to apply the product under any circumstances related to frostbite, including prophylactically -preventive purpose.
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Methods for applying a heat-insulating bandage depend on the specific location of frostbite. Since the main thing is bandaging (the first and last layers consist of this material), when installing the structure, you need to adhere to the general and specific rules of this procedure, taking into account the characteristic features of cold injury.
General rules:
- The first turn is applied obliquely, subsequent turns overlap it in such a way that a “pin” is formed that protects the entire bandage from loosening;
- You need to wrap it not too loosely (the structure will dangle), but not too tightly (so as not to pinch parts of the body). The best option is tight bandaging;
- The affected parts must be in a physiologically correct position;
- The bandage should be evenly distributed over the location, its edge covering the affected area with a margin of 1 centimeter.
Features of applying a heat-insulating bandage depending on the location of frostbite:
- Limbs. The width of the bandage is from 7 to 9 centimeters. The bandage is applied to the main part of the legs and arms using a combination of circular (complete covering of layers) and spiral (the next layer partially covers the previous) winding methods. Since frostbite primarily affects the fingers and hands with the feet, it is also necessary to apply a heat-insulating bandage to them (using the eight-shaped, spica-shaped and cross-shaped winding methods with turns intersecting along, across, diagonally). In case of severe cold injury, it is advisable to make a “mitten” for the hands, and a solid “boot” for the feet;
- Head. The width of the bow is 9-12 centimeters. Using the above methods, as well as paying attention to the upper and lower parts of the head (for them, respectively, you need to make a “cap”, “bonnet” and “bridle”), you must carefully apply a bandage, covering the affected areas (ears, nose, lips, cheeks), but at the same time leaving small slits for breathing and eyes. For the nose, you can organize a sling-shaped bandage, the fastening of which is brought through both sides of the ears and fixed on the crown of the head;
- Other parts of the body. The width of the bandage is 15-20 centimeters. On the chest - a spiral or cross-shaped bandage. The shoulders are a spiral ascending design. Hips – spicate.
How does a heat-insulating bandage help?
Thermal insulating bandage for frostbite performs 2 main functions:
- Thermal insulation of the affected area. For frostbite of 2, 3 and 4 degrees, the most important element of first aid is to prevent rapid warming of the affected area. This process should be as smooth and natural as possible to avoid the so-called “AfterDrop” effect - a sudden drop in venous and blood pressure along with the formation of shock. This phenomenon is formed due to the rapid entry of cooled blood into the base bloodstream and the temperature contrast between the still frostbitten deep layers of soft tissue and the already warmed skin;
- Basic protection against external factors. Thermal insulating bandage also provides basic contact protection for cold-affected areas with high degrees of frostbite. Soft tissues are susceptible to necrosis, peripheral vessels suffer, as a result of which, through a violation of the integrity of the skin, infection with secondary bacterial infections can occur, the risks of sepsis and toxemia increase, and the preconditions for the development of gangrene are created.
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required:
a) in the pre-reactive period
b) in the reactive period
60. Apply to the burned surface:
a) bandage with furacillin
b) bandage with synthomycin emulsion
c) dry sterile dressing
d) bandage with a solution of tea soda
61. Cooling the burned surface with cold water is indicated:
a) In the first minutes after injury
b) only for 1st degree burns
c) not shown
62. A typical attack of angina is characterized by:
a) retrosternal localization of pain
b) duration of pain for 15-20 minutes
c) duration of pain for 30-40 minutes
d) duration of pain for 3-5 minutes
e) effect of nitroglycerin
e) irradiation of pain
The optimal position for the patient during an attack
angina pectoris is the situation:
c) lying on your back with your legs elevated
d) lying on your back with the leg end down
64. Conditions under which nitroglycerin should be stored:
a) t - 4-6 degrees
b) darkness
c) sealed packaging
65. Contraindications for the use of nitroglycerin are:
a) low blood pressure
b) myocardial infarction
c) acute cerebrovascular accident
d) traumatic brain injury
e) hypertensive crisis
66. The main sign of a typical myocardial infarction is;
a) cold sweat and severe weakness
b) bradycardia or tachycardia
c) low blood pressure
d) chest pain lasting more than 20 minutes
First aid for a patient with acute myocardial infarction
includes the following activities:
a) put the patient to bed
b) give nitroglycerin
c) ensure complete physical rest
d) immediately hospitalize by passing transport
e) if possible, administer painkillers
In a patient with myocardial infarction in the acute period,
the following complications develop:
b) acute heart failure
c) false acute abdomen
d) circulatory arrest
e) reactive pericarditis
69. Atypical forms of myocardial infarction include:
a) abdominal
b) asthmatic
c) cerebral
d) asymptomatic
d) fainting
In the abdominal form of myocardial infarction, pain may
feel:
a) in the epigastric region
b) in the right hypochondrium
c) in the left hypochondrium
d) be encircling in nature
d) all over the abdomen
e) below the navel
71. Cardiogenic shock is characterized by:
a) restless behavior of the patient
b) mental excitement
c) lethargy, lethargy
G). decrease in blood pressure
e) pallor, cyanosis
For local treatment burn wounds use two methods: indoor and outdoor. First, the primary toilet of the burn wound is performed. Using swabs moistened with a 0.25% solution of ammonia, 3-4% solution of boric acid, gasoline or warm soapy water, the skin around the burn is washed from contamination, after which it is treated with alcohol. Scraps of clothing, foreign bodies, exfoliated epidermis are removed, large blisters are incised and their contents are released, small ones are often not opened, fibrin deposits are not removed, since the wound is healing underneath them. Very contaminated areas of the burn surface are cleaned with a 3% hydrogen peroxide solution. The burn surface is dried with sterile wipes.
As a rule, primary toileting of a burn wound is performed after preliminary injection of 1-2 ml of a 1% solution of promedol or omnopon under the skin.
Private method treatment is more common and has a number of advantages: it is used to isolate the burned surface, create optimal conditions for local medicinal treatment of burn wounds, ensure more active behavior of patients with significant burns and their transportation. Its disadvantages are labor intensity, high consumption of dressing material and painful dressings.
Deprived of these shortcomings open method of treatment. It accelerates the formation of a dense scab on the burned surface under the influence of the drying effect of air, ultraviolet irradiation or lubrication with substances that cause protein coagulation. However, this method of treatment makes it difficult to care for victims with extensive deep burns, there is a need for special equipment (cameras, special frames with light bulbs), there is an increased risk of nosocomial infection, etc.
Each of the methods has certain indications and they should not be opposed, but their rational combination is necessary.
Superficial burns of II and III degrees with the open method of treatment heal on their own. The open method should be used for burns of the face, genitals, and perineum. With an open method of treatment, a burn wound is lubricated 3-4 times a day with an ointment containing antibiotics (5 and 10% syntomycin emulsion) or antiseptics (0.5% furacilin, 10% sulfamylon ointment). When suppuration develops, it is advisable to apply bandages. If deep burns are detected and granulating wounds form, it is also better to switch from an open method of treatment to a closed one.
Currently, mafenide (sulfamilon hydrochloride) in the form of a 5% aqueous solution or 10% ointment is successfully used, especially in cases where the microflora of burn wounds is insensitive to antibiotics. Preparations containing silver and non-hydrophilic sulfonamides (silver sulfadiazine) are becoming widespread. They have a pronounced antibacterial effect and promote epithelization in optimal terms.
With a favorable course, II degree burns self-epithelialize within 7-12 days, III degree burns by the end of the 3-4th week after injury.
In case of deep burns, the formation of a scab continues for 3-7 days according to the type of wet or coagulative (dry) necrosis. In the first case, the spread of necrosis, a pronounced suppurative process, and intoxication are noted. Rejection of dry burn scab begins at 7-10 days with the formation of a granulation shaft and ends at 4-5 weeks. Step by step, the burn eschar is separated from the underlying tissue and removed. For deep burns in the first 7-10 days, the main task is to create a dry burn scab by drying the burn surface with a Sollux lamp, using ultrasound irradiation, and treating with weak solutions of potassium permanganate. To accelerate the rejection of the scab, chemical necrectomy, proteolytic enzymes, and 40-50% salicylic or benzoic acid are used.
3. Application of thermal insulating dressings
First, the frostbitten limb must be bandaged, and very loosely! Then, wrap it in a thick layer of cotton wool. An oilcloth or 2-3 layers of plastic film are placed on top of the cotton wool. Finally, this entire “layer cake” is wrapped in woolen fabric: a scarf, shawl, handkerchief or blanket.
Such a thermally insulating bandage provides a thermostat effect. Isolated from a direct heat source, the frostbitten limb continues to maintain a subzero temperature for some time. Heat comes to it from the center, as if creeping up unnoticed, gradually, which entails not a sharp, but a gradual increase in the temperature of the frostbitten area. It is fundamentally important that blood circulation is first restored, and then tissue thawing occurs. After a few hours, after blood circulation has been restored, the bandage can be removed.
With the timely and correct use of a thermal insulating bandage, after removing it, no blisters are found underneath it, and therefore the wound heals without scars. But most importantly, even in the most severe cases, amputations can be avoided.
With the onset of winter cold, a situation may arise when someone will have to provide assistance for frostbite, so I would like to present you with material on first aid for frostbite for publication. The purpose of this material is to teach the correct actions in case of frostbite and help avoid serious mistakes. I hope that this material can be useful and relevant for many.
The need to compile this material is dictated by the fact that in various medical reference books, first aid manuals and other publications there are both correct and, to put it mildly, completely inadequate recommendations on how to provide assistance for frostbite!
RIGHT:“Numerous studies have shown that the most pathogenetically substantiated method is slow warming through the application of thermal insulating bandages. ... The use of heat-insulating dressings promotes parallel restoration of blood circulation and metabolic processes in tissues, which reduces tissue hypoxia and the likelihood of irreversible changes in the affected area. (“Russian Medical Server” http://medgazeta.rusmedserv.com/2000/3/article_792.html)”; “... with timely and correct use of a thermal insulating bandage, after its removal, no blisters or scars are found underneath it. And most importantly, even in the most severe cases, amputation can be avoided (http://gazeta.aif.ru/_/online/health/440/05_01).”
WRONG!— “The frostbitten limb is first rubbed with a dry cloth, then placed in a basin with warm 32-34C water. Within 10 minutes the temperature is brought to 40-45C. (http://www.medical-center.ru/index/smonol.html)"; “Frostbite should be warmed up quickly, since this gives a higher chance of restoring tissue function and a shorter period of intense pain. (Information center “CITOMED” http://citomedicine.ru/pervaya-pomoshh-pri-otmorozhenii.html)”).
FIRST AID FOR GENERAL HYPOCOOLING OF THE BODY AND FROSTBOST OF THE LIMB
The main sign of frostbite (deep cold damage to body tissues) is a local loss of sensitivity that occurs in the cold, along with the absence of signs of blood supply in this area.
The main principle in providing first aid for frostbite:
1. Warming a frozen (frostbitten) limb should occur only by restoring its own blood supply;
2. The frostbitten area of the body during self-warming and restoration of internal blood flow in it should be well protected with a heat-insulating bandage (thermal insulating bandage) from any influence of external heat (surrounding warm air, external heat of one’s own body, etc.).
CREATION OF A HEAT-INSULATING BANDAGE
Thermal insulating bandage includes several layers. The first layer is a “loose” bandage with a gauze bandage to create a clean environment above the skin of the frostbitten limb. Then there are 2-4 layers of cotton wool, secured with a bandage. A layer of oilcloth or polyethylene is applied over the cotton-bandage layers, which is again fixed with a bandage. On top of the heat-insulating bandage described above, additional heat-insulating layers, for example, a layer of woolen fabric, can be applied to improve its heat-insulating properties.
To create a heat-insulating bandage from available materials, the following can be used: clothing that retains heat well (for example, a jacket or coat with synthetic padding), a blanket, and the like.
The heat-insulating bandage should not be tight (!), so as not to put pressure on the frostbitten limb, and should be applied taking into account the possible development of edema in cold-injured tissues.
The heat-insulating bandage should be well secured to the frostbitten limb and isolate the frostbitten limb from external heat for 6 to 24 hours.
The more severe the expected degree of frostbite, the longer the heat-insulating bandage should be applied and the better its heat-insulating properties should be. During the entire period of use, the heat-insulating bandage must not be disturbed or removed! The heat-insulating bandage can be removed before the specified time only if full sensitivity has returned to the entire previously frostbitten limb.
IN FROSTBONE:
DO NOT forcibly change the position of a frostbitten limb, as this leads to injury!
DO NOT encourage the victim to make active or passive movements in a frostbitten limb.
When providing assistance, DO NOT warm frostbitten areas of the body (fingers, arms, legs, etc.) with any external heat sources (warm air, warm water, heating pads, warming near a stove or fireplace, near a central heating radiator, etc.).
This is due to the fact that during the process of freezing in the tissues (cells) of the body, all vital processes are gradually suspended and blood flow stops, and with the arrival of heat, frozen cells and tissues begin to revive (restore their vital functions), but in the absence of the previously restored blood supply in them, they are doomed to death and die as a result of hypoxia (oxygen starvation)!
RESTORATION OF COLD INJURED BUT VITAL TISSUE IS POSSIBLE ONLY WITH SIMULTANEOUS RESTORATION OF THE BLOOD SUPPLY IN THEM!
Any premature (before restoration of blood circulation has occurred) external warming of frozen tissues is extremely destructive for them and therefore completely unacceptable! The desire to quickly warm up a frostbitten limb from the outside is a false stereotype of behavior and, if implemented, will only bring additional suffering to the victim and can seriously aggravate the consequences of the resulting cold injury!
DO NOT rub frostbitten areas of the body with snow or any objects - this only causes harm, further injuring the skin.
When providing first aid during the first 24 hours, frostbitten areas of the body must NOT be lubricated with any oils, fats, including ointments and creams, especially fat-based ones - this disrupts the external gas exchange of cold-injured tissues and generally impairs their viability.
GENERAL PROCEDURE FOR PROVIDING HELP IN CASE OF FROSTBOST
1. It is necessary to immediately assess whether there is a threat to the life of the victim from hypothermia, and if so, be prepared to resuscitate the victim (in order to correctly perform cardiopulmonary resuscitation in a critical situation, this skill must be practiced in advance!). If there is no threat to life from hypothermia for the victim, it is necessary, without wasting time, to provide heat-insulating bandages on frostbitten limbs. If there is a suspicion of frostbite in the victim's nose and ears, it is necessary to immediately provide heat-insulating bandages to these areas of the body.
2. If there is a direct danger to the life of the victim from general hypothermia (freezing), the first step is to stop further cooling of the body by starting GRADUAL WARMING OF THE VICTIM'S TORS, and then immediately move on to providing heat-insulating bandages for frostbitten extremities. If several people are assisting the victim, gradual warming of the torso and the creation of heat-insulating bandages should begin simultaneously.
CAREFULLY! SHARP WARMING CAN CAUSE A SHOCK REACTION IN THE VICTIM'S BODY!
Rubber heating pads or bottles of warm water (not hot!) can be used as a heat source to warm the torso. Even local warming in the torso area has a general warming effect on the victim, since the incoming heat is transferred through the bloodstream to the entire body.
If the victim’s clothes are dry and are not a serious independent source of cold, you can leave them on and immediately begin warming the victim’s torso with warm (in no case hot!) heating pads, placing them directly under these clothes. In extreme cases, heat-insulating bandages on frostbitten limbs can be applied over the victim’s clothing, provided that the very nature of the clothing and its properties do not prevent this.
If the victim’s clothing is wet and frozen and is a serious independent source of cold, it is urgently necessary to remove it and immediately wrap the victim’s torso in dry warm clothes or a blanket and cover them with warm (not hot!) heating pads, and quickly provide heat-insulating bandages to frostbitten limbs. If the victim’s frozen clothing cannot be easily removed, it should be cut first.
ATTENTION!— in case of frostbite of the lower extremities, the victim’s shoes should be removed, and then immediately applied with heat-insulating bandages. If necessary, shoes can be pre-cut for easy and non-traumatic removal from frostbitten lower extremities.
In the process of providing first aid to a frostbitten person, you cannot forcibly change the position of frostbitten limbs. When undressing/dressing the victim, you should also not allow direct contact of the victim’s frozen limbs with the victim’s torso, so that the cold is not transferred to the torso!
3. Give the victim:
An anesthetic (analgin or other analgesic), since the process of reviving frozen tissue can be very painful;
Vasodilator (for example, no-spa). As a vasodilator, an adult victim can be given 50-100 g of alcohol (for example, vodka or cognac)
Warm drinks (for example, warm tea, coffee).
4. Ensure that the victim is transported to the hospital.
The victim should be transferred to a very heated room only after providing him with the above-described first aid, which is best done in cool, but not cold, conditions.
