Cold injuries (or chilblains) form when body tissues freeze from prolonged exposure to low temperatures. The most commonly affected areas are the fingers and toes, the nose, ears, cheeks and chin; when circumstances are severe it is necessary to amputate the affected area. In most cases, freezing affects only the skin, but in extreme situations even the deepest layers die and must be touched gently. Cold injuries require medical attention to minimize the damage and the chances of further aggravating the situation.
Steps
Part 1 of 3: Determine the Severity
Step 1. Determine if you have gelonic rash
The initial skin irritation due to frostbite is not a real chill, but it represents the initial stage. Ice crystals form on the surface of the skin, rather than in the internal tissues as occurs in chilblains. The blood vessels on the surface contract a lot, making the skin pale or red. You may experience a feeling of numbness, pain, tingling, or tingling in the affected area. However, the skin still reacts to pressure normally without losing sensitivity excessively and still retains its normal texture. Symptoms are resolved by warming the area.
- This form of "initial" frostbite affects children more easily than adults and usually occurs on the extremities such as the ears, nose, toes and hands and cheeks.
- It is an indicator that atmospheric conditions are sufficient to cause a cold injury in case of further exposure.
Step 2. Determine if you have superficial chilblains
Even if the sensation they give you is certainly not "superficial", these injuries are so defined because the damage is reversible with the right treatments. In this case the situation is more serious than the initial frostbite and you can recognize it because you feel a feeling of numbness, the skin becomes white or yellowish-gray with red spots, is sore or throbbing and slightly hard or swollen.
In this circumstance there is less chance of losing tissues. In some people with superficial chilblains, blisters with clear secretions can form within 24 hours. These usually form on the extremities or tips of the affected areas and do not lead to tissue loss
Step 3. Determine if you have a severe cold injury
This is the most dangerous form of chilblains. In severe cases, the skin appears pale and waxy, unusually firm, loses sensitivity and becomes numb. In some situations, damaged tissues form blood-filled blisters or signs of gangrene (dead gray / black skin).
The most severe form of chilblains extends to the muscles, bones and leads to tissue and skin necrosis. In this case the risk of losing the tissues is very high
Step 4. Get away from the cold environment and seek treatment as soon as possible
If you can get to a hospital or an emergency room, I'll be there two hours, you don't have to try to heal yourself. If, on the other hand, you can't avoid being exposed to the cold, don't try to warm the affected area, if there is a risk that it may freeze again. Alternating freezing and thawing phases can cause even more damage than continuous freezing.
If you can't get medical attention within two hours, you can start treating the problem yourself. All three situations - gelonic erythema, superficial or severe frostbite - require the same basic procedures when it comes to "field treatment" (away from a hospital)
Part 2 of 3: Warm Up the Affected Area
Step 1. Start heating the frozen area
As soon as you notice signs of chilblains on the body (typically on the fingers and toes, ears and nose), you need to take steps to warm these areas. Put your fingers / hands under your armpits, place your hands with dry gloves on your face, toes or other areas of the body that require more heat. If you have wet clothes, take them off as they prevent you from raising your body temperature.
Step 2. Take pain relievers if needed
If you suffer from superficial or severe frostbite, the warming process can be painful. To avoid further suffering, you can take non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain, such as ibuprofen. However, avoid taking aspirin, as it can prevent the body from healing properly. Follow the instructions on the leaflet for the right dosage.
Step 3. Heat the frozen area by placing it in hot water
Fill a basin or bowl with water at a temperature of 40-42 ° C. The ideal is 40.5 ° C. Avoid higher temperatures, as they can burn your skin and cause blisters. If you have one available, add antibacterial soap to the water to avoid infections. Submerge the affected area for 15-30 minutes.
- If you don't have a thermometer handy, try to gauge the water temperature by immersing a healthy part of your body, such as your hand or elbow. The water must be very hot, but still at a tolerable level. If it is too hot, cool it down a little.
- If possible, use running water rather than still water. The ideal would be a whirlpool tub, but the current one from the tap is fine too.
- Avoid frozen body parts touching the edges of the bowl or bowl, as this could damage the skin.
- Do not heat the area for less than 15-30 minutes. When it starts to thaw, you may experience severe pain. However, it is important to continue treatment until the tissues have thawed completely. If you stop the procedure too early, you could cause further damage.
- If the cold injuries are severe, you need to warm the area for more than an hour.
Step 4. Do not use dry heat, such as that emitted from a hair dryer, fireplace, or electric heater
These heat sources are too difficult to control and do not guarantee the gradual heating that is necessary in the treatment of chilblains, in addition to the fact that they can cause burns.
Remember that the frozen area is numb and cannot sense the temperature. It can be difficult to accurately monitor dry heat sources
Step 5. Watch out for frozen areas
As your skin starts to heat up, you should start to feel tingling, tingling, and a burning sensation. The areas affected by chilblains should turn pink or red, often patchy, and regain their normal consistency and sensitivity. The skin should not become swollen or blister; these are signs of further damage and you should seek immediate medical attention for proper treatment.
If possible, take a picture of the affected area. It can be helpful for the doctor to track progress and understand if chilblains improve with treatment
Step 6. Prevent future damage
Keep seeking medical help, but avoid making the situation worse. Do not scratch or irritate the frozen skin, avoid subjecting it to excessive movements and do not expose it to too low temperatures yet.
- Allow the heated area to air dry or gently pat it dry with a clean towel, but do not rub it.
- Don't swaddle her. There is no evidence to support the need to protect frozen areas with a bandage before getting proper medical care, and the bandage can also interfere with normal mobility.
- Do not massage the affected area, as this could cause further tissue damage.
- Elevate the area to reduce swelling.
Part 3 of 3: Getting Professional Care
Step 1. Look for further medical treatments
Depending on the severity of the chilblains, there can be different treatments. Hydrotherapy is the most common, but surgery is required in severe cases. If you suffer from severe frostbite injuries, amputation may be the only viable solution, but this decision is only made 1-3 months after the initial cold exposure, when you have a clear view of the extent of the damage.
- The doctor will want to make sure the area has warmed up adequately and will evaluate any "tissue that can't survive," meaning that it can't heal properly. Once you have undergone all treatments and can be discharged from the hospital or emergency room, your doctor will bandage the damaged area and properly instruct you on the precautions you will need to take to heal. These can be different, based on the severity of the chilblains.
- If you have suffered severe frostbite injuries, your doctor will recommend that you move to a burn center for further treatment.
- If you have moderate or severe chilblains you will need to go back to the doctor for a checkup within 1-2 days after leaving the hospital. If you have suffered severe injuries, you will need to undergo further check-ups after 10 days and again after 2-3 weeks.
Step 2. Talk to your doctor about post-treatment recovery
Since the skin has been damaged by the chilblains, there is a risk of further damage once it starts to heal. While recovering, you will likely experience pain and inflammation. Get plenty of rest and talk to your doctor about the following:
- Apply aloe vera. Some studies have found that pure aloe vera applied to painful areas can help prevent further skin damage and promote tissue healing.
- Manage blisters. Blisters are likely to form during the healing phase, but you shouldn't squeeze or break them. Ask your doctor how to treat them until they break on their own.
- Control the pain. Your doctor will likely advise you to take ibuprofen to reduce pain and inflammation. Take the drug according to the directions.
- Prevent infections. The doctor will prescribe antibiotics, especially in severe cases. Make sure you complete the entire course of treatment exactly as directed.
- Walk. If the chilblains have hit their feet or their toes, you need to avoid walking during the healing process, otherwise you can aggravate the situation. Talk to your doctor about using a wheelchair or finding other workarounds.
Step 3. Protect the area from further exposure to the cold
To make sure you heal completely and avoid further damage, you need to protect the affected area and prevent it from being exposed to the cold again for at least 6-12 months.
If you want to avoid future chilblains, reduce the time you spend outdoors when the weather is very cold, especially if the day is windy or humid
Advice
- Treat hypothermia first if it has occurred. Hypothermia means a general reduction in body temperature to dangerously low levels; it can be a deadly situation, so you always have to prioritize it, even before chilblains.
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Prevent Freezing:
- Use mittens instead of regular gloves.
- Dress in several thin layers of clothing instead of a thick one or two.
- Keep clothes dry, especially socks and gloves or mittens.
- Cover babies with multiple layers of clothing and take them indoors every hour to keep them warm. Children are more susceptible to cold injuries and lose heat much faster than adults.
- Make sure your shoes / boots are not too tight.
- Put on a ski cap or mask to protect your ears and nose.
- Seek refuge if you come across a severe blizzard.
Warnings
- Once the deeply frozen limbs have warmed up, it is vital that they do not freeze again, otherwise you could cause irreversible tissue damage.
- Do not smoke or drink alcohol while recovering, as they can impair normal blood circulation.
- If your hands are numb, you can't tell the temperature of the water, so have someone else check it to avoid getting burned.
- Do not heat the area with dry or direct heat, such as fire (of any kind), hot water bottle, or electric heater, as you are unable to feel the sting. The affected area can burn easily.
- Once heated, you should not use the frozen area until it has healed properly, otherwise you could cause further serious injury.
- The organism of children is affected by the cold much faster than that of adults. Pay special attention to them when they are outdoors and the weather is harsh.
- In very cold climates, chilblains can develop in as little as 5 minutes.
