Frostbite

• Published in: Emergency medicine clinics of North America Vol. 35; no. 2; pp. 281 - 299
• Main Authors: Handford, Charles, MBChB (Hons), MRCS, DMCC, Thomas, Owen, MBChB (Hons), BMedSc (phys), DTM&H, Imray, Christopher H.E., MB BS, DiMM, MSc, PhD, FRCS, FRCP, FRGS
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2017
• Subjects: Amputation; Emergency; Emergency Medical Services - methods; Fibrinolytic Agents - therapeutic use; Frostbite; Frostbite - diagnosis; Frostbite - prevention & control; Frostbite - therapy; Gangrene; Humans; Prostacyclin; Remote Consultation - methods; Rewarming; Rewarming - methods; rTPA; Telemedicine; Thrombolysis; Thrombolytic Therapy - methods; Vasodilator Agents - therapeutic use; Frostbite; Telemedicine; rTPA; Amputation; Gangrene; Prostacyclin; Rewarming; Thrombolysis
• ISSN: 0733-8627; 1558-0539
• DOI: 10.1016/j.emc.2016.12.006

Deep frostbite is a thermal injury associated with significant morbidity. Historically, this has been associated with military personnel; however, increasingly it is becoming an injury that afflicts the civilian population. The use of intravenous iloprost or intra-arterial thrombolytics has led to promising tissue salvage. This article provides an up-to-date understanding of frostbite pathophysiology, classification, prevention, and management. It also highlights the role of telemedicine in optimizing patient outcomes. To further the understanding of optimal frostbite management, larger, likely multicenter, high-quality trials are required. An international frostbite register would facilitate data gathering.