Summary
Definition
History and exam
Key diagnostic factors
- cold or numbness of affected extremity
- pain during rewarming
- purplish skin discoloration
- white or yellowish, waxy skin discoloration
- superficial skin vesiculation
- deep purple blisters
- tissue necrosis and mummification (dry gangrene)
Other diagnostic factors
- erythema
- joint dislocation
- fractures
Risk factors
- cold exposure
- previous frostbite
- vascular insufficiency
- high altitude
- hypoxia
- alcohol
- tobacco
- dehydration
- extremity trauma
- constrictive clothing or equipment
Diagnostic investigations
1st investigations to order
- clinical diagnosis
Investigations to consider
- technetium-99m pertechnetate scintigraphy
- magnetic resonance angiography of affected extremity
- plain radiography
Emerging tests
- thermography and duplex imaging
Treatment algorithm
all patients
Contributors
Authors
Elizabeth A. Kaufman, MD, CAQ-SM
Attending Physician
Department of Orthopedics, Sports Medicine
Scripps Clinic
Attending Physician
Rady Children’s Hospital San Diego
Department of Orthopedics, Sports Medicine
San Diego
CA
Disclosures
EAK declares that she has no competing interests.
Christopher Imray, PhD, FRCS, FRCP, FRGS
Consultant Vascular and Renal Transplant Surgeon
University Hospital Coventry and Warwickshire NHS Trust
Professor Coventry University, Warwick Medical School, Exeter University
Coventry
UK
Disclosures
CI has been asked to provide expert testimony on frostbite. He has delivered lectures, and produced educational material on frostbite.
Acknowledgements
Professor Christopher Imray and Dr Elizabeth A. Kaufman would like to gratefully acknowledge Professor Paul S. Auerbach and Dr Claire Turchi, previous contributors to this topic. PSA and CT declare that they have no competing interests.
Peer reviewers
Luanne Freer, MD, FACEP, FAWM
Medical Director
Yellowstone National Park
WY
Founder/Director
Everest Base Camp Medical Clinic
Nepal
Declarações
LF declares that she has no competing interests.
Grant S. Lipman, MD
Clinical Assistant Professor of Surgery and Emergency Medicine
Associate Director Wilderness Medicine Fellowship
Assistant Research Director
Stanford University School of Medicine
Palo Alto
CA
Declarações
GSL declares that he has no competing interests.
Peter Hackett, MD
Director
Institute for Altitude Medicine
Telluride
CO
Declarações
PH declares that he has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
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Referências
Principais artigos
McIntosh SE, Freer L, Grissom CK, et al. Wilderness Medical Society clinical practice guidelines for the prevention and treatment of frostbite: 2024 update. Wilderness Environ Med. 2024 Jun;35(2):183-97.Texto completo Resumo
Sheridan RL, Goverman JM, Walker TG. Diagnosis and treatment of frostbite. N Engl J Med. 2022 Jun 9;386(23):2213-20.
Rabold MB. Frostbite and other localized cold-related injuries. In: Tintinalli JE, Kelen GD, Stapczynski JS, et al. Tintinalli's emergency medicine: a comprehensive study guide. 6th ed. New York, NY: McGraw-Hill; 2004.
Roche-Nagle G, Murphy D, Collins A, et al. Frostbite: management options. Eur J Emerg Med. 2008 Jun;15(3):173-5. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Cutaneous burns
- Frostnip
- Raynaud phenomenon
Mais Diagnósticos diferenciaisDiretrizes
- 2024 American Heart Association and AmericanRed Cross Guidelines for First Aid
- Clinical practice guidelines for the prevention and treatment of frostbite: 2024 update
Mais Diretrizes
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