Frostbite on the skin, treatment can save lives! Doctors tell you how to prevent and treat it

During the National Day holiday, I rewatched The Captain and The Climbers, which left the deepest impression on me during last year's National Day. At an altitude of more than 10,000 meters with a temperature of -40 degrees Celsius, the cold wind cut Liu Changjian, played by Zhang Hanyu, like a knife. He endured the strong cold wind and overcame various difficulties to successfully land the plane at the airport. The captain's hands were completely frozen, his skin was purple, and his bones were brittle, but he saved hundreds of lives.

On the windy and cold Mount Everest, Yang Guang, played by Hu Ge, gave his sleeping bag to his teammates. He protected his teammates, but eventually suffered frostbite and had to have his leg amputated.

Although we don't fly planes or climb Mount Everest, winter is coming soon, and there are many patients suffering from frostbite every winter. Especially in recent years, many hikers like to cross mountains and forests in winter. Once they encounter heavy snow and extremely low temperatures, climbers are very likely to suffer from frostbite.

What is frostbite? Frostbite is very common. In simple terms, frostbite is local or systemic damage to the human body caused by being in an extremely cold state for a long time.

Mild frostbite can cause redness and swelling of skin tissue, poor local blood circulation, and itching, tingling, numbness and other sensations, which require treatment;

Severe frostbite will be accompanied by hypothermia, blackening of the skin, necrosis of blood vessels, and then loss of consciousness, causing permanent damage to the whole body and may be life-threatening, so early treatment is required.

How to classify frostbite? Generally speaking, frostbite can be divided into two categories. One is chilblains, trench foot and immersion foot caused by low temperature and humidity; the other is freezing frostbite caused by low temperature below freezing point, including local frostbite, freezing and freezing to death.

When the outside temperature is below -30℃, it only takes a few minutes for tissue to freeze. The air temperature for skin to freeze is -15℃. Liu Changjian, played by Zhang Hanyu in "The Captain", suffered from this type of frostbite.

Alpine frostbite is mainly freezing frostbite caused by the low temperature environment in the mountains. This type of frostbite is more likely to occur during mountaineering and exploration. Once it occurs, it can easily cause disability if not treated in time. It must be taken seriously. Yang Guang, played by Hu Ge in "The Climber", suffers from this type of frostbite.

How is frostbite graded? In medicine, frostbite is divided into four degrees according to the degree of frostbite:

First degree frostbite: Also known as "frostbite", damage occurs in the epidermis, the affected area becomes red, swollen and congested, and the affected area feels hot, itchy and burning. The symptoms disappear after a few days and no scars are left.

Second degree frostbite: Injury to the superficial layer of the skin. In addition to redness and swelling, the frostbitten area is also accompanied by blisters. Edema, severe pain, and dull skin sensation may occur in the deeper part. The injury will heal after scabbing.

Third degree frostbite: damage to subcutaneous tissue, redness and swelling of the frostbitten area with large blisters, black or purple-brown skin, loss of pain. Third degree frostbite will cause irreversible damage to tissues, leaving scars and long-term hypersensitivity or pain.

IV degree frostbite: damages muscles and bones. Dry and wet necrosis may occur, leading to amputation.

First and second degree frostbite are mild frostbite, and the difference between them and severe frostbite lies in the presence or absence of obvious tissue necrosis.

How to treat frostbite scientifically and in a standardized manner? 1. The basic treatment goal of frostbite is to quickly rewarm, prevent further cold exposure, and restore blood circulation. If the frostbitten part is likely to be frostbitten again during the subsequent journey after rewarming, it should not be rewarmed. Early treatment of frostbite includes covering the frozen part or other body surfaces with clothing or warm hands to keep them at an appropriate temperature to maintain adequate blood supply. Rewarming only requires soaking the frostbitten part in warm water above 36°C, and the water temperature should not be higher than 40°C. 20-40 minutes each time, 2-3 times a day.

2. Unless contraindicated, analgesics should be taken during rapid thawing to relieve pain. When the skin is ruddy and smooth, it indicates complete thawing. It is contraindicated to wipe frozen limbs with ice cubes, dry heat or slow rewarming, which may further damage the tissue; any friction on the injured part is prohibited.

3. After rewarming, if there are wounds on the frostbitten area, you can first wash it with disinfectant (clean it), then use frostbite medicine to cover the entire frostbitten surface (keep it dry), and bandage the frostbitten area with gauze or bandage.

4. Supportive therapy should be given, such as bed rest, high-protein/high-calorie diet, wound protection, and avoidance of trauma. Antimicrobial drugs should be used to prevent infection, and tetanus antitoxin should be given in a timely manner. The recovery process can take several months. Injuries that affect the proximal phalanges, carpal bones, or tarsal bones may require amputation.

How to prevent frostbite? To prevent frostbite, we need to pay attention to two aspects: one is to protect ourselves, and the other is to "prevent frostbite by moving". Self-protection means taking effective preventive measures against various causes of frostbite.

1. Keep warm

In view of the low temperature, you should equip yourself with various cold-proof clothing, especially shoes, socks, gloves, hats, masks, etc. of guaranteed quality and quantity. The clothing should be tight on the outside and loose on the inside, with multiple layers for insulation. The outer coat should be fitted and windproof to prevent cold air from penetrating and forming convection with the air inside the clothes, causing heat loss. The inner layer should be appropriately loose, forming an air isolation layer between the layers of underwear.

2. Frostbite often occurs at the extremities of the limbs such as the hands and feet. In colder environments, you should wear down gloves.

3. Keep your body dry

Humidity is an important factor that triggers frostbite. To deal with humidity, keep the parts that are prone to freezing, underwear, hats and masks dry. Feet are prone to sweating, so be sure to prepare dry spare socks and change shoes and socks in time after wading.

4. Pay attention to wind protection and avoid traveling in strong winds in the afternoon

Wind is an important factor that causes frostbite. Wind can accelerate heat convection and heat loss, and promote the decrease of ambient temperature. The higher the wind speed, the more heat the human body consumes, and the easier it is to cause frostbite. At the same low temperature, if there is no wind, it may not cause frostbite, but if there is strong wind, it may cause frostbite. Different wind speeds will cause different degrees of frostbite.

5. Carry high-calorie food

In view of the fact that outdoor sports consume a lot of calories and reduce the ability to resist cold, you should always carry some high-calorie food for emergency use. Drinking can cause blood vessels to dilate and increase heat dissipation, and smoking has a significant effect of constricting peripheral blood vessels. Therefore, you should try to quit smoking and drinking when climbing.