Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- 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)
Otros factores de diagnóstico
- erythema
- joint dislocation
- fractures
Factores de riesgo
- cold exposure
- previous frostbite
- vascular insufficiency
- high altitude
- hypoxia
- alcohol
- tobacco
- dehydration
- extremity trauma
- constrictive clothing or equipment
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- clinical diagnosis
Pruebas diagnósticas que deben considerarse
- technetium-99m pertechnetate scintigraphy
- magnetic resonance angiography of affected extremity
- plain radiography
Pruebas emergentes
- thermography and duplex imaging
Algoritmo de tratamiento
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.
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
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
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
Conectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal