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Backpacker Magazine – January 2009

Survive This: Frostbitten Feet

Frostbite is bad news. Learn how to safely treat frozen feet.

by: Kelly Bastone

(Illustration by Andy Potts)
(Illustration by Andy Potts)
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PREDICAMENT
You're on a winter dayhike when an unexpected blizzard develops. Visibility drops to nil, and you're forced to spend a night out in frigid temps. By morning, the storm has passed, but the stabbing pain in your feet has given way to stony numbness.

LIFELINE
Hike out to medical help immediately. If you suffer from frostbite–the formation of ice crystals between your skin cells–only one treatment will do: rapid thawing in a warm-water bath, administered by professionals. Don't attempt to thaw tissues yourself: Rubbing skin causes more cell damage, and exposing numb feet to a campfire can lead to serious burns. Until you reach help, it's actually crucial that your feet stay frozen. Once rewarmed, frostbitten areas become so painful and swollen that walking is impossible–and if thawed areas re-freeze, tissue death and amputation are all but certain. To keep feet from thawing as you walk out, adjust your layers so your body feels slightly cool. (Don't dress down so much that you risk hypothermia, of course.) Quickly improvise crutches if hiking is difficult. If you cannot keep feet completely frozen, remove socks or boot insoles to accomodate the swelling and continue walking out.


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READERS COMMENTS

It's always dangerous to administer meds to anyone who's medical history is not known to you. It's good planning to have a log of medical histories on all who will be in attendance on your outting. In emergency type contingencies less is always best. Apply the 7 P's to your outdoor activities and all should be well.
Posted: Jul 05, 2009 Robert

There seems to be a general desire for more information:
There are four main stages of frostbite. The first stage is "frostnip" or superficial frostbite, which ultimately does not result in tissue loss. The affected area will turn from red to pale. Do not expose this area to windburn, as this might aggravate the condition. When the area becomes numb, this is first degree frostbite. Second degree, or partial thickness frostbite, can only be diagnosed during thawing, and is recognized by the formation if blisters. In third degree, or full-thickness frostbite, skin tissue will be purple or black, indicating tissue necrosis. As is stated in the article, thawing and refreezing of any frostbite can cause mummification and pretty much assures tissue death and possibly amputation. First, remove cold or wet items. Use loose dressings and splints (improvise) to transport the patient if necessary. If you are ABSOLUTELY sure that you can prevent refreezing, thawing should be performed in a warm water bath of 104 to 108 degrees Fahrenheit. Never use dry heat, like a fire, because frostbitten areas are extremely susceptible to burns. All thawing is extremely painful, so if the water is too cold, thawing will be unnecessarily drawn out in terms of time. Aspirin is useful for preventing clotting during this process, but it is also a risk to administer any medication the victim has never taken before. Also, the affected area should not touch the walls of the thawing bath.
That's the best I can do really. All of this information is from the protocol of an Emergency Medical Technician, and should help. The main idea is not to let it refreeze, as was stated in the article.
Posted: Mar 19, 2009 Anonymous

Don't let your feet get cold. or wet
Posted: Mar 10, 2009 Mountain man

That's It?
wow you deffinately need more details!
Posted: Feb 26, 2009 Anonymous

Or you could just man up and finish the trip.
Posted: Feb 20, 2009 Sean

That's It?
Posted: Feb 15, 2009 Anonymous

wow you deffinately need more details!
Posted: Feb 13, 2009 gg

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