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Frostbite

Última revisão: 1 May 2025
Última atualização: 02 Dec 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • 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)
Detalhes completos

Outros fatores diagnósticos

  • erythema
  • joint dislocation
  • fractures
Detalhes completos

Fatores de risco

  • cold exposure
  • previous frostbite
  • vascular insufficiency
  • high altitude
  • hypoxia
  • alcohol
  • tobacco
  • dehydration
  • extremity trauma
  • constrictive clothing or equipment
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • clinical diagnosis
Detalhes completos

Investigações a serem consideradas

  • technetium-99m pertechnetate scintigraphy
  • magnetic resonance angiography of affected extremity
  • plain radiography
Detalhes completos

Novos exames

  • thermography and duplex imaging

Algoritmo de tratamento

AGUDA

all patients

Colaboradores

Autores

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

Declarações

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

Declarações

CI has been asked to provide expert testimony on frostbite. He has delivered lectures, and produced educational material on frostbite.

Agradecimentos

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.

Revisores

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.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

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.
  • Frostbite images
  • Diagnósticos diferenciais

    • Cutaneous burns
    • Frostnip
    • Raynaud phenomenon
    Mais Diagnósticos diferenciais
  • Diretrizes

    • 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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