I mentioned previously in this blog that Olympic gold medalist Rulon Gardner was able to save the majority of his foot despite severe frostbite by not rewarming it while there was still a chance of the tissue refreezing. (It would have been dead meat—literally—if it had frozen again.) He was also able to reach a medical facility, as you can see.

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What if you can’t get professional treatment? What if you’re trapped in a shack or a tent and no help is coming? Here are some first-aid dos and don’ts if assistance isn’t on the way.

Keep in mind: Don’t reheat the tissue until you’re confident it won’t refreeze again.

1. The optimal first-aid approach for rewarming frostbite is to immerse the afflicted region in warm water (100 to 108 F) for 15-30 minutes. The tissue should thaw within 15-30 minutes. Of course, you can’t check the temperature of the water without a thermometer, but you should be able to put your unbroken hand into it without removing it.

  • To prevent scalding, remember that the water must always be moving. It helps to keep the warmest water closest to the injury.
  • Don’t let the water get too hot or too cold. If the temperature varies, more skin damage may occur.

2. Expect significant swelling, big blisters, and excruciating agony. That indicates the tissue is rewarming.

  • Take aspirin or ibuprofen (Advil, Motrin) for pain if one is accessible, since they provide further frostbite advantages that aid in the healing process.
  • Don’t pop a blister until it has already begun to leak, even if the blister is large. A sterile environment and reduced infection risk are two advantages of sealed blisters.

3. Keep the following in mind throughout and after rewarming:

  • When treating a cut, be very cautious.
  • When moving, don’t walk or put weight on the hurt area.

4. Let the injured area air dry.

  • Do handle with care.
  • Don’t towel dry or rub.

5. For swelling, remember:

  • Keep the wounded area at or near your heart level.
  • Don’t wrap your wound in a bandage that is too tight.

6. To keep the blood circulating and aid healing,

  • Ulcers are a big problem, especially among people who have had varicose veins. Taking a blood-pressure medicine (vasodilator) is an option. If you’re already on one, your blood pressure medication can assist. Aspirin may help. If you don’t have ulcers, niacin might be worth a try. (Niacin may cause your entire skin to flush and tingle.)
  • Don’t smoke. Smoking narrows blood vessels.

7. To dress wounds,

  • Keep absorbent padding, like gauze or cotton, between hurt fingers or toes to avoid your injuries from getting worse.
  • Use antibiotic cream if needed. Silvadene (silver sulfadizine) is an excellent choice. bactracin and gentamicin are other options for triple antibiotic therapy.
  • When you have finished cleaning the wound, apply a light covering or leave it open to the air.
  • do start antibiotics, if available.

Photo credit: Sylvia Szczepanska

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