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FrostBite Treatment, Opinions, Information

Medical Trauma Flesh Immobile Frostbite

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#1 Panch0Villa

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Posted 15 November 2013 - 12:13 PM

Understanding what causes and happens before during and after frostbite. Frostbite primer.

Since knowledge is power it is important to know what frostbite is. Knowing what is happening to the cells helps you understand treatment options as well as what makes sense. Yes there are multiple treatment options for frostbite. For example if you are frostbitten and still need to hike out of an area it is bester to stay frozen than thaw. However if you are able to get to medical help quickly you may want to rapidly thaw the frostbitten portion.

Frostbite can be mild with the epidermis being reddened to extreme where the affected area is white, grey, hard, immovable, and weeping plasma, fluid, blood. Frostbite is the freezing from mild to extreme of human flesh, skeleton, and organs.


Generally the the most affected areas in order are the:
1. Toes
2. Fingers
3. Feet
4. Hands
5. Nose
6. Forehead
7. Lips
8. Ears

The entire human body can succumb to frost bite. Generally our core does a great job of fighting off frost bite to the vitals. That is why all the other areas begin to freeze (get frostbite). Our body limits circulation to these extremities to keep the vital organs and brain warm. What fluids are left in the extremity begin to freeze. As the water content in our cells begins to freeze expansion occurs and begins weakening cell walls. Once water is in the process of freezing razor sharp crystals of ice begin to form piercing cell walls and damaging nearby cells. Yeah it's that bad.

With frost bite, prevention is the key…
Most important aspects of of preventing frostbite include
1. Hydration
2. Caloric Intake, quality calories
3. Circulation
4. Activity level

Hydration is wicked important
Yeah I know I can still hear my Corpsman yelling “Drink water!” but it’s true. Hydration is as important in cold weather as it is when the temperature rises. I have heard some alpinists, mountaineers, and guides say it is more important at low temps.

Hydration is a combination of water, electrolytic salts, and time. Cold water is metabolised faster than warm water (weird I know). However in cold temps you will want to be cautious about your body’s energy expenditure warming cold water. Lukewarm to warm water is recommended just understand that this will impact the time it takes to metabolise. Electrolytes are crucial in cold weather as they marginally raise the freeze point of water and increase blood pressure. In general the accepted norm is seven hours to metabolise water, for some it will be faster and others it will be slower. This is a good rule of thumb to remember: water you drink now will only be bio-available in seven hours (this helps me hydrate instead of drink water when I am thirsty, big difference between the two).

What you eat.
Our diets are shit gentlemen (and ladies if you’re reading). We stuff ourselves with carbohydrates because they are a low cost convenient calorie source. I am not gonna go on about this you’ve heard a million times. I am sure your PCP at the VA hospital has told you a hundred times. So just do it, eat this:
Veggies and fruits
Protein, protein, protein
Carbs
Fats

Instead we eat like this:
Carbs
Fats
Low quality protein
Veggies if I am forced to.

This caloric intake will make frostbite all the more likely. While you can argue that the layer of Army Body Armor (Marines call that fat, don’t get bent out of shape doggies I’m just kidding) will provide insulation it also means that greater areas of your skin will frost bite as the fat keeps warmth below the fat layer which in most body parts sits on top of musculature just below the skin. Remember that skin is the body’s largest organ.

Circulation
Here is where cardio conditioning comes in. Make sure you have a strong heart and good circulation. Limiting fats, salts, and processed foods helps circulation immediately. As does adding foods like grapes, raisins, wine (yeah I wish it was beer too). But all of this is pointless if your heart has lost some of that conditioning. Now I am not saying go Force Recon on me (but if you want to I encourage it) at least take a walk every day. EVERY DAY!

Activity Level
Simply put, if you move you live. This can apply to more than just frost bite, but that's another post. Movement keeps joints flexible, requires the heart to redirect blood flow to nourish working muscles, increases blood flow, and creates HEAT.

In the SUCK
Alright so you’ve done all you can do. But the Allfather has decided to send the Valkyries to test your will to live, and recover the body if you die valiantly.

More than likely frost bite will happen during a sedentary period, where you are dehydrated, low on calories, and its cold outside (duh). Sleep is death anyone? It will more than likely hit your toes first. Toes will feel numb not cold if you are beginning to frostbite. Depending on what happens next determines what you should do.

If you are looking at a long drawn out survival scenario let 'em freeze as quickly as you can (this makes ice crystals smaller and not as sharp). Yeah this is a shit deal, but if you swallow the whole turd fast you won't taste it as much. I would rather not eat the turd at all but sometimes we don't get that option.

Being numb will help deal with the excruciating pain that will come when they thaw, keep em numb, keep em frozen. This gives you a solid stump to hobble out with. When I did research for this post over and over again I read that frozen limbs can generally regenerate well. The problem with frostbite it that it is cyclical with freezing then thawing that completely destroys cells and causes gangrene and amputation. Don’t get me wrong you're probably gonna lose a couple toes maybe a foot but you will have a functional stump with which to walk out on.

If it is not extended survival get that damn thing thawed ASAP. Never use a campfire directly, your limb is numb and you will not feel the skin burning. Instead warm your hands with the fire, or through friction and then gently hold, DO NOT RUB the extremity. Keep doing this until it is thawed. You will know it is thawed because it will hurt like hell. Women reading, yes it hurts worse than childbirth. I know because a woman I met on Mount Rainier a few years ago got frostbite on her small toe out snowmobiling. She didn’t even realise it until they got back in the cabin and it started thawing. Within about three hours it was black and she lost it. Her words not mine: “I would have rather given birth to a full grown person than go through those three hours.”

Love to hear more thoughts, anger, criticism or hatred. If I save one of your toes I will have done my duty. As the discussion develops I will post more. I am by no means an expert just sharing what I have learned if you have something better share it!

Edited by Panch0Villa, 17 November 2013 - 09:58 AM.

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#2 ARM_Alaska

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Posted 15 November 2013 - 03:05 PM

Great information!

Edited by ARM_Alaska, 15 November 2013 - 03:06 PM.

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#3 Panch0Villa

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Posted 16 November 2013 - 08:24 AM

What the hell is a guy from AZ writing about frostbite for? :evil:
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#4 Davis

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Posted 16 November 2013 - 10:29 PM

What the hell is a guy from AZ writing about frostbite for? :evil:


Maybe you use to live someplace where it actually got cold? I know I did... and now I happily live here where I no longer have to put up with snow and ice.

Good article and some very good points. Thanks for writing.

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#5 Panch0Villa

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Posted 17 November 2013 - 09:07 AM

Maybe you use to live someplace where it actually got cold? I know I did... and now I happily live here where I no longer have to put up with snow and ice.

Good article and some very good points. Thanks for writing.


Yeah Davis, lived up in the pacific northwest. Wet and cold. I guess it can get pretty damn chilly down here too. But at least it is drier. Thanks for commenting.

Hope it helped.

Edited by Panch0Villa, 17 November 2013 - 09:57 AM.

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#6 Panch0Villa

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Posted 09 February 2014 - 11:28 AM

Hey everyone new post on the main page that I thought warranted sharing.  If you haven't taken the time to go through it in detail.  It is damn good.  

 

While mine focuses on frostbite specifically this deals with the stages before and into frostbite.  Really really good stuff.

 

http://www.itstactic...ements-and-win/

 

You will not rise to the occasion.  You will fall back on your training.


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#7 mangeface

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Posted 09 February 2014 - 11:38 AM

Great info in that article. I personally have encountered the beginning stages of frostbite a couple of times (both while working on the Osprey in the Marines- first time was in VA, second while crossing the northern Atlantic and temps were 10 or less). It's not a fun experience to go through.

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#8 DeathwatchDoc

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Posted 09 February 2014 - 12:41 PM

I really did like that article. Frostbite sucks... 


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