![]() The mean intensive care unit (ICU) days and requirement for mechanical ventilation were not significantly different between the two groups, however frostbite patients were significantly more likely to require ICU care (26.5% vs 13.7%, P =. Mean total BSA (TBSA) did not differ between the two groups (frostbite: 2.1 and burn: 1.7, P =. Frostbite patients were less frequently covered by commercial insurance (25.3% vs 41.7%). Patients with frostbite injury were significantly older and more likely to be male. Patients were excluded if they had an inhalation injury recorded or unknown. ![]() The database was cleaned based on published protocols. Patients with frostbite injury and those with isolated hand and/or foot burns were identified in the National Burn Repository. Our aim was to examine differences in the hospital course of frostbite patients compared to those with burns limited to the hands and feet. Compared to the typical burn patient, frostbite injury frequently impacts those with high rates of mental illness, substance abuse, and those suffering homelessness. Place in water with temperature of 37 to 39☌ (98.6 to 102.Numerous demographic, socioeconomic, and injury factors influence a burn patient’s hospital course.Rapid rewarming is the core of therapy and should be initiated as soon as possible.Refreezing will cause even more severe damage.Do NOT attempt until the risk of refreezing is eliminated.Remove all wet or constrictive clothing.If hypothermia present, must rewarm to a core temperature of at least 35☌ before treating frostbite.Skin is mottled with nonblanching cyanosis and formation of deep, dry, black eschar Hemorrhagic blisters form and are associated with skin necrosis and blue-gray discoloration Substantial edema over 4-6 hours skin blisters form within 6-24 hours Desquamate and form hard black eschars over several days Numbness, erythema, swelling, dysesthesia, desquamation (days later) Numbness followed by aching and throbbingĮxtremity feels like a "block of wood" followed by burning, throbbing, shooting pains Stinging and burning, followed by throbbing Tissue loss involving entire thickness of skinĮxtension into subcutaneous tissues, muscle, bone, and tendon little edema Visual determination of tissue viability is difficult in first few weeks classify early injuries as superficial or deep Degree Generally recovers without treatment in It is this zone for which treatment may have benefit.Middle zone characterized by severe, but possibly reversible, cell damage.Resulting damage results in swelling, platelet aggregation, vessel thrombosis.Endothelial damage, beginning at the point of thaw, is the critical event in frostbite.Thawing contributes markedly to the degree of injury.Freezing alone is usually not sufficient to cause tissue death."Hunter's response" - prolonged repeated exposure to cold is protective.High-risk groups: outdoor workers, elderly, homeless, drug or alcohol abusers, psychiatric disease, high-altitude or cold-weather athletes, military personnel.Most commonly affects distal part of extremities, face, nose, and ears.Can develop within 2-3sec when metal surfaces that are at or below –15☌ (5☏) are touched.Wetness and humidity increase the risk (water has 25x thermal conductivity of air).Most often occurs at ambient temperature Risk correlated with temperature and wind speed.It is a disease of morbidity, not mortality.
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