Managing Frostbite: Assessment, Diagnosis, and Rapid Rewarming Protocols for Extremity Injuries

University:
Northwest College
Course:
VN 220 | Medical/ Surgical
Academic year:

2023
Views:

468

Pages:

2
Author:

Yesenia M.

FROSTBITE Trauma from exposure to freezing temps and freezing of the intracellular fluid and fluids in the intercellular spaces. Results in cellular and vascular damage. Can result in venous stasis and thrombosis. Body parts MOST affected → feets, hands, nose, and ears. ASSESSMENT AND DX FINDINGS: Extremity can be hard, cold and insensitive to touch and may appears white or mottled blue-white. Extent of injury is not initially known. MANAGEMENT: GOAL→ to restore NORMAL BODY TEMPERATURE Remove constrictive clothing and jewelry bc it can impair circulation. Remove wet clothing as fast as possible If BLE involved- pt should NOT be allowed to ambulate bc it could cause tissue damage. Controlled yet RAPID rewarming is started. Frozen extremities are usually placed in 37 degree to 40 degree bath for 30-40min spans. During rewarming, an analgesic is given bc this process is very painful. DO NOT HANDLE BODY PARTS- can cause further mechanical injury. DO NOT MASSAGE BODY PARTS. After rewarming- elevate and protect from injury. Apply sterile gauze or cotton in between affected fingers or toes to prevent maceration and a bulky dressing on the extremity. Can use foot cradles HYPERKALEMIA can result and HYPOVOLEMIA- must be corrected RISK OF INFECTION is also great- use aseptic technique during dressing changes and tetanus ppx is given as ordered. NSAIDS given to tx inflammation and pain OTHER MEASURES: Whirlpool baths to help w circulation an debridement of necrotic tissue to help prevent infection Escharotomy- (incision trough eschar) to prevent further tissue damage, allow for normal circulation and permit joint motion. Fasciotomy- to tx potential complication of compartment syndrome DC instructions include: avoid tobacco, alcohol and caffeine bc of their vasoconstrictive effects which can further reduce the already poor blood supply to injured tissues.