Frostbite is freezing of the skin that occurs due to exposure to cold temperatures. Frostbite often starts out with mild symptoms and can progress and become quite severe and even limb-threatening.Mild frostbite is considered skin that is either red and painful, or white and numb. Severe frostbite includes blistering skin, hard skin (due to frozen bone and blood vessels), and possibly gangrene (tissue that has died and turned black, after blood vessels became frozen).Frostbite is often associated with hypothermia.First Aid GuideIn the case of mild frostbite, the following measures should be taken: Move the person someplace that is warmer. Remove clothing from the affected area. Rewarm the affected area until sensation in the skin has returned and the skin is soft (for at least 30 minutes). Rewarming of frostbitten skin is typically accompanied by pain, swelling, and color change. To rewarm an extremity, place the limb in a bath of warm water (ie, 100°–105° F). Continue to circulate and refresh the warm water. To rewarm an area that cannot be soaked in a bath of water, apply a warm compress. (Ensure that the compress is warm but not hot.) Apply a clean (sterile, if possible), dry dressing to the affected area. Re-cover the affected area with dry clothing to keep it warm. Obtain medical help.Note: Frostbitten areas, once thawed, should be moved as little as possible. Do not massage the affected area to attempt to rewarm it. Avoid disturbing any blisters or skin that has become gangrenous. Do not use direct heat (hair dryers, heating pads, etc) to rewarm the affected area. If there is potential for refreezing of an area, do not attempt to thaw, as thawing followed by refreezing can cause even more extensive damage to the area.When a person has both frostbite and hypothermia, contact emergency medical services, and give first aid for the hypothermia followed by first aid for the frostbite.First aid measures for hypothermia are as follows: Check the person's ABCs: open the airway, and check breathing and circulation. Move the person to a warmer area, and replace any wet or constricting clothes with loose, dry clothing. To rewarm the person: Cover the person completely with foil or a space blanket, or use your own body heat to help warm him/her. Use warm compresses on the neck, chest, and groin. Give warm, sweet fluids. (Any fluids given should be nonalcoholic, as alcohol interferes with the blood's circulation.)
Hypothermia results when a person's internal body temperature drops below normal due to cold exposure. While hypothermia typically occurs outdoors, it can also occur indoors because there are many things that can make a person lose body heat.Hypothermia starts with mild symptoms but can progress and potentially become life-threatening. A person experiencing a late stage of severe hypothermia may go into a coma or suffer cardiac arrest.First Aid GuideIn the case of mild hypothermia, complete the below self-care measures and get medical care as soon as possible. In the case of severe hypothermia, call emergency medical services immediately.First aid for hypothermia:Check the person's airway, breathing, and circulation. Move the person to a warmer area, and replace any wet or constricting clothes with loose, dry clothing. To rewarm the person, based on the means available, try any combination of the following:Cover the person completely with foil or a space blanket, or use your own body heat to help warm him/her. Use warm compresses on the neck, chest, and groin. Give warm, sweet fluids. (Any fluids given should be nonalcoholic, as alcohol interferes with the blood's circulation.)Note: When a person has both frostbite and hypothermia, contact emergency medical services, and give first aid for the hypothermia (above) followed by first aid for the frostbite, which can be found in the topic on Frostbite.
A blister (bulla) is caused when the outer layer of the skin separates from a layer of skin below, creating a collection of fluid between the layers. Blisters can be caused by chemical means, such as an allergic reaction; physical injury, such as from heat, frostbite, or friction; or from a disease. If the blister has been caused by a burn, see the Burns, First Aid write-up via the Disease List. If the blister has been caused by frostbite, see the Frostbite, First Aid write-up, which can also be found via the Disease List.First Aid GuideBlisters often go away on their own without needing any care, and the skin over the blister is its best defense against infection. If the blister is large or painful, however, you can drain the blister in such a way as to relieve the discomfort and hopefully avoid infection. Note: Blisters that look like they will pop on their own should be drained, unless the blister looks infected or you have a fever; multiple, grouped blisters; diabetes; or poor circulation. Clean your hands and the affected area with soap and warm water. Apply rubbing alcohol to the affected area. Wipe a needle with rubbing alcohol to sterilize it. Puncture the blister with the sterilized needle at its edge, making the hole big enough to drain fluid. Let the fluid drain, making sure to leave the overlying skin in place. Note: This skin will help prevent infection. Apply an antibiotic ointment (eg, bacitracin) to the blister, and bandage the affected area. Once the overlying skin has dried, allow it to fall off naturally or use sterilized scissors to cut the dead skin off. Apply antibiotic ointment and a bandage, if necessary.Prevention of blisters is key. The following measures will help prevent blisters from occurring: Wear acrylic socks, particularly ones that fit you well. While cotton socks were once the recommendation to avoid blisters, they tend to become misshapen when wet and are never as form-fitting as acrylic socks. When picking out shoes, be sure to go shopping during the middle of the day, when your feet are slightly swollen. (Feet normally swell as the day goes on.) Make sure you can wiggle your toes, and be sure that both the left and right shoes fit properly. (Many people have two different size feet.) Apply powder to your feet before activity that may cause friction. Wear work gloves when using tools that cause friction on hands.
During the winter months, I hear a lot of concern from patients about frostbite. Frostbite is a very real danger in extremely cold weather. However, patients often confuse other dermatological conditions – such as frostnip, Raynaud’s phenomenon, and pernio – with frostbite. I hope to clear up some of the confusion by explaining these conditions here.
Disease summary is provided courtesy of VisualDx, the visual diagnostic decision support system for health care professionals. To view more images of Cocaine Levamisole Toxicity and other visually presenting diseases and adverse drug reactions, log in to VisualDx or try it now. Diagnosis Synopsis Cocaine Levamisole Toxicity : Cocaine contaminated with levamisole has been detected in the United States since 2003, and the incidence of toxicity caused by this contamination has been increasing rapidly since 2008. Use of cocaine that has been adulterated with levamisole can lead to a constellation of symptoms including agranulocytosis, neutropenia, and a vasculitis-like purpuric tender skin eruption. The most common sites of purpura are the external ears and cheeks. The purpura is generally followed by skin necrosis, but resolves several weeks after cessation of cocaine use. Recurrent use of contaminated cocaine generally results in recurrent skin eruptions.