Frostbite

Frostbite - damage to the woven, caused by local exposure to cold.

Total cooling (frostbite) occurs when the body is exposed to cold for an unusually long time. In peacetime, this is a relatively rare phenomenon (shipwreck, accidents with climbers, heavy alcohol intoxication, loss of consciousness or coma). During the war, general cooling is more common, especially injured.

Symptoms. Feeling cold snoring, chills. The skin is pale. The skin loses its elasticity, becomes dry and rough ("goosebumps"). At a body temperature of about 35 ° C there are pallor of the face, cyanosis, pain in the knees, feet, genitals, there is a gastroenteritis syndrome. Urination is painful, polyuria (cold diuresis). Mood worsens, indifference, apathy, impaired coordination of movements, visual impairment, fatigue, drowsiness. There may be hallucinations (the feeling of being in a warm room).

There are 4 phases of general cooling. In the first phase, body temperature is not reduced due to peripheral vasoconstriction. In the second phase, the temperature is reduced by 1-2 g. C. Skin covers pale, cold. Cold feels like pain. Initially, there may be a slight increase in blood pressure and tachycardia, clear consciousness, there may be mild exaltation, reflexes are alive. In the third phase, the body temperature is 34 to 27 g. C. Pain sensitivity decreases until anesthesia, confused consciousness, reflexes are weakened. Minute breathing volume is reduced. At temperatures up to 30 g. With cardiac contractions are regular, bradycardia is noted, with further lowering of temperature there is an arrhythmia and signs of cardiac decompensation. In the fourth phase at a temperature below 27 g. C there is a picture of "imaginary death". Breathing, pulse and blood pressure are barely perceptible. Reflexes are not called. When the temperature drops below 24 degrees. With changes in the body are irreversible.

The cause of death is the suppression of the function of the central nervous system, especially the vasomotor and respiratory centers.

Treatment should begin immediately; The longer the interval between cold trauma and heating, the heavier the consequences. The patient should be placed in a warm room, take off cold clothes and wrap in heated blankets. Hot drink, intravenous warmth isotonic sodium chloride solution or 5% glucose, enema with warm water. Rapid warming is possible in a warm bath (temperature up to 37 ° C), while the head and neck are raised. When the body reaches body temperature 33-35 g. The heating in the bath should be stopped. At the same time, a purposeful fight against acidosis, hypovolemia and hypoxia begins. Follow the BP (possible collapse on the basis of generalized vasodilation).

The prognosis remains serious, complications from the heart and the circulatory system are possible. Patients complain of increased sensitivity to cold for a long time.