Field treatment is not a good idea and is to be discouraged. Focus entirely on getting to medical attention. The frozen area can not tolerate re-freezing without much more serious injury. Please remember de-frosting is going to hurt a lot and the formerly frozen tissues are going to require very specific medical attention. Just for completeness sake, frozen body parts are often accompanied by overall low body temperature (hypothermia), and dehydration, hence the absolute need for formal medical attention.

Re-warming (de-frosting) is best done in a warm water bath with temperatures held constant at around 104 F (40 C). Substantial pain is to be expected during a prolonged healing process. Once de-frosted, the affected area becomes red and swollen as well as discolored. Large blisters develop at the depth of injury and are to be left alone to re-absorb (photo #1) over the next week or so.

Fingers or toes must be kept separate with sterile bandages (photo #2). A thick, hard, black covering (eschar) develops and healing is from the inside out. This eschar may take a month or so to separate from the healed new tissue beneath. Increased sensitivity to heat and cold can persist for a very long time. Amputation is uncommon and with appropriate treatment that avoids infection and re-freezing, recovery is nearly complete.

Deep frostbite is another story altogether. Think bone-in roast that has been in your freezer for a week. With this situation not only is the skin and subcutaneous tissue frozen, but nerves, large blood vessels, tendons and bones are frozen. This results in a hard, solid and wood like texture. Tissue will be lost either to spontaneous amputation (falling off) during healing or via surgical intervention.

Treatment involves attending the likely co-morbid medical issues and the painful de-frosting procedure. Tissues with deep frostbite do not revive and remain cold, and with a bluish or gray coloration. Blisters eventually develop at the juncture of living and dead tissue. Healing is slow, painful and incomplete with residual and permanent tissue loss.

Needless to say, cold injury is entirely preventable. If you are planning a wilderness trip into the cold, or even a trip in the truck during severe cold weather conditions, prepare for the unexpected. Carry a satellite phone or a homing beacon in case of emergency, more locally a well-charged cell phone. Pack to spend the night even if that is not in the original plan and always have fire-starting tools with you. Extra blankets in the auto are essential this time of year.

As always, be safe, enjoy the outdoors and feel free to contact us anytime via our website www.thehuntdoctors.com