American Medical Association Family Medical Guide - American Medical Association [123]
7. Don’t rub or massage the skin, which can cause skin damage. Check and treat for frostbite (below) if necessary.
Frostbite
Frostbite is damage to skin and other tissues resulting from exposure to extremely low temperatures. Most cases of frostbite occur at temperatures below 44°F after 7 to 10 hours of exposure. Frostbite occurs when the fluid that is normally inside skin and tissue cells freezes and crystallizes, blocking blood flow to an area and causing tissue damage. Frostbite usually affects the ears, hands and fingers, feet and toes, and nose.
In the early stages, symptoms of frostbite include red skin that stings or burns or feels cold. Later, the skin may look white, grayish yellow, or waxy, and may throb and swell or become numb. If only the skin and underlying tissues are affected, recovery is usually complete. If blood vessels are affected, damage is usually permanent and the frostbitten part may have to be amputated.
To treat frostbite:
1. If the frostbite seems severe or extensive, call or have someone call 911 or your local emergency number, or send someone for help.
2. Until you get the person to a warm place, cover the frozen part with extra clothing or blankets. Tuck frostbitten hands and fingers under the person’s armpits, or cup a frostbitten ear or nose with a hand. Do not massage or rub the frostbitten part.
3. Once inside a warm place, remove any wet, cold, or constricting clothing.
4. Rewarm the frostbitten body part rapidly, which can cause some pain. Put the frostbitten part in warm (not hot) water (104°F to 107°F) for 15 to 30 minutes. Do not place the frozen body part too close to a direct heat source (such as a heat lamp, heating pad, radiator, or hot stove); burns can occur because the frostbitten area is numb.
5. Keep the frostbitten parts elevated if possible to prevent swelling, which can cause more tissue damage.
6. Give the person warm, nonalcoholic beverages (alcohol restricts blood flow). Do not let the person smoke, because smoking constricts the arteries and directs warm blood away from the surface of the skin.
7. Give the person an over-the-counter pain reliever (such as ibuprofen) if necessary. Ibuprofen is most helpful at an adult dose of 400 milligrams every 12 hours.
8. As frostbitten parts warm up, have the person move them gently, but don’t let a person who has frostbite of the feet walk. The weight of the body can damage frostbitten toes.
9. Stop the warming process when the skin returns to its normal color and feeling returns to the frostbitten area. Do not break any blisters. To aid healing, apply aloe vera to frostbitten skin every 6 hours.
Heat Exhaustion
Heat exhaustion occurs when someone is exposed for prolonged periods to high (especially humid) temperatures or exercises excessively in hot weather without taking in enough salt and water to replace salt and fluids lost through excessive sweating.
The person may feel generally ill and dizzy and may faint; may look pale; and may have cool, clammy skin. He or she will sweat profusely, and his or her pulse rate and breathing may become rapid. Usually the person’s temperature is normal or only slightly elevated (100°F). The person may also have a headache and muscle cramps and may vomit. He or she may faint. Heat exhaustion may lead to heatstroke (see below), which is more serious.
To treat heat exhaustion:
1. If the symptoms are severe or become worse, call or have someone call 911 or your local emergency number or send someone for help.
2. Lay the person down in a cool, shady place, and elevate the person’s feet. Move the person to an air-conditioned room if possible.
3. Loosen any tight clothing.
4. Cool the person in any way you can. Fan the person by hand, with a blow dryer set on cool, or with an electric fan. Sponge him or her with cool water; spray him or her with water from a hose or spray bottle; place cool, wet cloths on his or her forehead; or place