- After initial life threats are excluded, rewarming is the highest priority.
- This is accomplished rapidly in a water bath heated to 40-42°C (104-107.6°F) and continued until the thaw is complete (usually 15-30 minutes).
- Narcotic pain medications may be given because this process is very painful.
- Because dehydration is very common, IV fluids may also be given.
- After rewarming, post-thaw care is undertaken in order to prevent infection and a continuing lack of oxygen to the area.
- Small clear blisters are left intact. Large clear blisters are removed while bloody ones are often drained but left intact so as not to disturb the underlying blood vessels and to decrease the risk of infection.
- A tetanus booster is given if needed.
- People with frostbite are hospitalized for at least 1-2 days to determine the extent of injury and to receive further treatment.
- Aloe vera cream is applied every 6 hours, and the area is elevated and splinted.
- Ibuprofen is given twice per day to combat inflammation and penicillin or another appropriate antibiotic given to prevent infection.
- For deep frostbite, daily water therapy in a 37° to 39°C (98.6° to 102.2°F) whirlpool bath will be performed in order to remove any dead tissue.
- A number of experimental therapies exist, many of which aim to further treat the inflammation or decreased blood flow seen in frostbite. As of yet, none of them has proven beneficial.
Next Steps - Follow-up
Symptoms follow a predictable pathway. Numbness initially is followed by a throbbing sensation that begins with rewarming and may last weeks to months. This is then typically replaced by a lingering feeling of tingling with occasional electric-shock sensations. Cold sensitivity, sensory loss, chronic pain, and a variety of other symptoms may last for years.
The treatment of frostbite is done over a period of weeks to months. Definitive therapy, possibly in the form of surgery, may not be performed for up to 6 months after the initial injury. Therefore, establish a working relationship between you and your doctor that will continue throughout the healing process.